Southside Community Health Center – Federally Qualified Health Center (FQHC), NPI 1861513343

Southside Community Health Center is a healthcare provider. based in Toledo, Ohio. specializing in Federally Qualified Health Center (FQHC). The NPI Number for Southside Community Health Center is 1861513343

Main info

Organization
Name
Southside Community Health Center
NPI
1861513343
Phone
(419) 720-7883
Address
313 JEFFERSON AVE
Authorized Official
KELLY JO STONE KLINE RCM
Enumeration Date
3 April 2007
Last Update Date
1 July 2019
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience43
Completeness80
Years active:19State licenses:0Digital endpointsUpdated within 12 months

Provider Addresses for Southside Community Health Center

  • 313 JEFFERSON AVE

    TOLEDO, OH 436041004

    Phone: (419) 720-7883

    Fax: (419) 720-7895

    Type: Mailing

  • 732 SOUTH AVE

    TOLEDO, OH 436092768

    Phone: (419) 321-6106

    Fax: (419) 321-1525

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2003-09-25

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Past revalidation due date

Earliest CMS due date was 2024-01-31 (865 days ago).

Enrollment records

1

Earliest due date

2024-01-31

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
O20030925000045OFederally Qualified Health Center (Fqhc)OH2024-01-31

What to do next

  • Verify current status on the CMS Revalidation Lookup Tool immediately.
  • Complete revalidation in PECOS or contact your Medicare Administrative Contractor (MAC).
  • Overdue revalidation can lead to deactivation of Medicare billing privileges.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 43604)

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Reviews

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Frequently asked questions

Does Southside Community Health Center have a public NPI I can cite?
Public records show Southside Community Health Center under NPI 1861513343.
Should I treat Southside Community Health Center as an active provider?
Patients and plans typically see Southside Community Health Center as active in the national extract.
What type of care does Southside Community Health Center provide?
Southside Community Health Center's profile centers on Federally Qualified Health Center (FQHC). Clinical services aligned with this taxonomy classification.
Can patients visit Southside Community Health Center in Toledo, Ohio?
For routing, start with Toledo, Ohio for Southside Community Health Center, then verify phone and hours locally.
Why is information missing for Southside Community Health Center?
Providers choose how much contact data to publish. Missing fields do not mean the profile is fake.

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