Southside Internal Medicine PC
NPI 1740583194 · Primary Care Clinic/Center · Riverdale, GA
Enrolled with Medicare as Part B Supplier - Clinic/Group Practice · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Southside Internal Medicine PC is a Primary Care Clinic/Center organization in Riverdale, GA (NPI 1740583194).
Provider details
- NPI number
- 1740583194
- Entity type
- Organization
- Primary specialty
- Primary Care Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Casimir Okoro, Medical Doctor(770) 997-6644
Specialties & taxonomies
Ambulatory Health Care Facilities
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
15 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
Registry dates
- Enumerated
- 2010-12-07
- Last updated
- 2015-01-14
Frequently asked questions
- What is Southside Internal Medicine PC's NPI number?
- Southside Internal Medicine PC's National Provider Identifier (NPI) is 1740583194, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Southside Internal Medicine PC?
- Southside Internal Medicine PC is classified in the NPPES registry as Primary Care Clinic/Center (Ambulatory Health Care Facilities).
- Where is Southside Internal Medicine PC located?
- Southside Internal Medicine PC's practice location on file with NPPES is 804 Commerce Blvd, Riverdale, GA 30296-7198.
- What is Southside Internal Medicine PC's phone number?
- The practice phone number listed in the NPPES registry for Southside Internal Medicine PC is (770) 997-6644.
- Does Southside Internal Medicine PC accept Medicare?
- Southside Internal Medicine PC 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 Southside Internal Medicine PC?
- The authorized official listed on Southside Internal Medicine PC's NPPES record is Casimir Okoro, Medical Doctor. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Southside Internal Medicine PC's NPI active?
- Yes — Southside Internal Medicine PC's NPI (1740583194) is active in the NPPES registry as of the last update on 2015-01-14.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.