Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Prime Healthcare Foundation - Southern Regional, LLC

Organization Cardiovascular Disease Physician · NPI 1154795581

Prime Healthcare Foundation - Southern Regional, LLC is a Cardiovascular Disease Physician in Riverdale, Georgia. Licensed in Georgia. Registered with an NPI since 2015.

Licensed in
GA
In the registry since
2015
Specialties on file
2
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

11 Uppr Riverdale RD SW
Riverdale, GA 30274-2615
Phone: (770) 991-8000
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

General Acute Care Hospital (primary) Taxonomy 282N00000X · Licence 031-442 (GA)
Cardiovascular Disease Physician Taxonomy 207RC0000X

Record details

NPI number1154795581
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Christopher Doan — Managing Associate General Counsel · (310) 259-4706
Other names Southern Regional Medical Center
NPI enumeratedNovember 23, 2015
Last updated in NPPESSeptember 14, 2021
Certification dateSeptember 14, 2021
Mailing address11 Upper Riverdale Rd Sw, Riverdale, GA 30274-2615

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