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Grand Old Docs of the Southside

Family Medicine Physician in Greenwood, IN · enumerated 2006 · authorized official Brenda Russell, Physician.

Data current as of Jul 13, 2026 · sourced from CMS NPPES

National Provider Identifier

1790886844

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Registry record

Entity type Organization (Type 2)
Legal business name Grand Old Docs of the Southside
Other name <Unavail>
Practice address 360 S Madison Ave, #200, Greenwood, IN, 46142
Phone (317) 865-9090
Fax (317) 865-0523
Enumeration date Sep 25, 2006
Last updated in NPPES Jun 30, 2008

Taxonomy & classification

207Q00000X Family Medicine Physician Allopathic & Osteopathic Physicians Primary

Authorized official

Name Brenda Russell
Title Physician
Phone (317) 865-9090

Other identifiers

Identifier Type State Issuer
5457630003 Other IN DME
CI4722 Other IN GROUP RR MEDICARE NUMBER

What is an NPI number?

A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes, even if the provider moves or changes specialty.

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Frequently asked questions

What is a Type 2 NPI?
A Type 2 NPI identifies an organization (group practice, hospital, pharmacy, lab), while Type 1 NPIs identify individual providers. Organizations bill under their Type 2 NPI.
What type of organization is Grand Old Docs of the Southside?
Grand Old Docs of the Southside is registered in NPPES as a Family Medicine Physician (its primary provider taxonomy).

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Source: CMS NPPES (public data). Snapshot 2026-07-13. Provider record last updated 2008-06-30.