OrganizationActive
South Boston Pediatrics, PC
NPI 1356690366 · Pediatrics Physician · South Boston, VA
Provider details
- NPI number
- 1356690366
- Entity type
- Organization
- Primary specialty
- Pediatrics PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Nonna Ebalo, President(434) 470-3489
- License
- 0101232220 (VA)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Profile Score
Detailed profile(79/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
13 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
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
2202 Beechmont Rd
South Boston, VA 24592-1614
Phone: (434) 572-3635
Street-level locationGet directions
Mailing address
Po Box 774
South Boston, VA 24592-0774
Registry dates
- Enumerated
- 2012-09-05
- Last updated
- 2012-09-05
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.