Southern Dominion Health System, Inc.
NPI 1104069996 · Federally Qualified Health Center (FQHC) · Victoria, VA
Enrolled with Medicare as Part a Provider - Federally Qualified Health Center (fqhc) · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Southern Dominion Health System, Inc. is a Federally Qualified Health Center (FQHC) organization in Victoria, VA (NPI 1104069996).
Provider details
- NPI number
- 1104069996
- Entity type
- Organization
- Primary specialty
- Federally Qualified Health Center (FQHC)Ambulatory Health Care Facilities
- Parent organization
- Southern Dominion Health System, Inc.
- Organization subpart
- Yes
- Authorized official
- April King, Ceo(434) 696-2165
Specialties & taxonomies
Ambulatory Health Care Facilities
Ambulatory Health Care Facilities
- Federally Qualified Health Center (FQHC)261QF0400X
Ambulatory Health Care Facilities
Ambulatory Health Care Facilities
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
17 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
2 documented practice locations
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Other names (DBA / former)
- Doing business as
- Sdhs Counseling & Behavioral Services
Additional practice locations (1)
- 13855 Courthouse RdDinwiddie, VA 23841-2254Phone: (804) 469-3731
Registry dates
- Enumerated
- 2009-04-09
- Last updated
- 2024-02-07
- Certified
- 2024-02-07
Frequently asked questions
- What is Southern Dominion Health System, Inc.'s NPI number?
- Southern Dominion Health System, Inc.'s National Provider Identifier (NPI) is 1104069996, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Southern Dominion Health System, Inc.?
- Southern Dominion Health System, Inc. is classified in the NPPES registry as Federally Qualified Health Center (FQHC) (Ambulatory Health Care Facilities).
- Where is Southern Dominion Health System, Inc. located?
- Southern Dominion Health System, Inc.'s practice location on file with NPPES is 1508 K V Rd, Victoria, VA 23974-2624.
- What is Southern Dominion Health System, Inc.'s phone number?
- The practice phone number listed in the NPPES registry for Southern Dominion Health System, Inc. is (434) 696-2319.
- Does Southern Dominion Health System, Inc. accept Medicare?
- Southern Dominion Health System, Inc. is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Who is the authorized official for Southern Dominion Health System, Inc.?
- The authorized official listed on Southern Dominion Health System, Inc.'s NPPES record is April King, Ceo. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Southern Dominion Health System, Inc.'s NPI active?
- Yes — Southern Dominion Health System, Inc.'s NPI (1104069996) is active in the NPPES registry as of the last update on 2024-02-07.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.