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

Southside Family Practice PC

Organization Family Medicine Physician · NPI 1780700765

Southside Family Practice PC is a Family Medicine Physician in Petersburg, Virginia. Licensed in Virginia. Registered with an NPI since 2007.

Licensed in
VA
In the registry since
2007
What do these letters mean?
PC — Professional corporation
A form of business registration, not a clinical qualification.

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Practice location Address checks out

24 S Adams St
Petersburg, VA 23803-4525
Phone: (804) 733-3739
Fax: (804) 722-0634
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence 0101054986 (VA)

Record details

NPI number1780700765
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Shirlene Moten — Medical Director · (804) 733-3739
Other names Southside Family Practice
NPI enumeratedMarch 22, 2007
Last updated in NPPESNovember 16, 2008
Mailing address24 S Adams St, Petersburg, VA 23803-4525

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