Grand Ole Docs of the Southside, LLC
NPI 1639359037 · Family Medicine Physician · Indianapolis, IN
Grand Ole Docs of the Southside, LLC is a Family Medicine Physician organization in Indianapolis, IN (NPI 1639359037).
Provider details
- NPI number
- 1639359037
- Entity type
- Organization
- Primary specialty
- Family Medicine PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Jeffrey Dewester, Owner(317) 807-0247
- License
- 01036126A (IN)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
18 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
Mailing address
Other names (DBA / former)
- Doing business as
- Central Indiana Medical Group
Registry dates
- Enumerated
- 2007-11-14
- Last updated
- 2013-12-05
Frequently asked questions
- What is Grand Ole Docs of the Southside, LLC's NPI number?
- Grand Ole Docs of the Southside, LLC's National Provider Identifier (NPI) is 1639359037, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Grand Ole Docs of the Southside, LLC?
- Grand Ole Docs of the Southside, LLC is classified in the NPPES registry as Family Medicine Physician (Allopathic & Osteopathic Physicians).
- Where is Grand Ole Docs of the Southside, LLC located?
- Grand Ole Docs of the Southside, LLC's practice location on file with NPPES is 6349 S East St, Indianapolis, IN 46227-7107.
- What is Grand Ole Docs of the Southside, LLC's phone number?
- The practice phone number listed in the NPPES registry for Grand Ole Docs of the Southside, LLC is (317) 807-0247.
- Who is the authorized official for Grand Ole Docs of the Southside, LLC?
- The authorized official listed on Grand Ole Docs of the Southside, LLC's NPPES record is Jeffrey Dewester, Owner. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Grand Ole Docs of the Southside, LLC's NPI active?
- Yes — Grand Ole Docs of the Southside, LLC's NPI (1639359037) is active in the NPPES registry as of the last update on 2013-12-05.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.