EXCLUDEDPROVIDER
Entity Program Suspension

Southside Clinic, INC

Ballwin, MO 63021

Public HHS-OIG LEIE exclusion record

Southside Clinic, INC of Ballwin, MO is registered in the CMS NPI Registry under National Provider Identifier (NPI) 1497823314 with a primary specialty of Clinic/Center, Rural Health. According to the HHS-OIG List of Excluded Individuals/Entities (LEIE), Southside Clinic, INC is currently excluded from participation in federally funded health care programs due to exclusion or suspension under a federal or state health care program, as of April 19, 2012.

Status
Currently listed by HHS-OIG
Record type
Entity
Location
Ballwin, MO 63021
Exclusion date
April 19, 2012
Exclusion type
Program Suspension (1128b5)
NPI
1497823314

Record summary

Southside Clinic, INC appears in the HHS-OIG List of Excluded Individuals/Entities (LEIE) public dataset as an entity record associated with Ballwin, Missouri. The latest imported LEIE dataset lists this record as currently excluded from participation in federally funded health care programs. The exclusion date shown in the source record is April 19, 2012, and the exclusion type is 1128b5, identified by HHS-OIG as exclusion or suspension under a federal or state health care program.

Source record

SourceHHS-OIG LEIE (public dataset)
Record typeEntity
Current statusCurrently listed by HHS-OIG
Exclusion dateApril 19, 2012
Exclusion typeExclusion or suspension under a federal or state health care program (1128b5)
NPI1497823314
Source dataset dateMay 2026

What this exclusion type means

HHS-OIG identifies exclusion type 1128b5 as “Exclusion or suspension under a federal or state health care program.” Exclusion or suspension under a federal or state health care program (permissive exclusion).

This exclusion type is a statutory category used by HHS-OIG in the LEIE dataset. The category describes the legal authority associated with the exclusion record, not a separate investigation or additional reporting by Excluded Provider.

Location and provider classification

This LEIE record is associated with Ballwin, MO 63021. The listed provider category is Physician Practice. The listed specialty is General Practice.

NPI Registry context

The LEIE record lists NPI 1497823314. CMS NPPES public registry data lists this NPI as an organization record with primary taxonomy Clinic/Center, Rural Health (261QR1300X). Registered practice location: Mount Vernon, IL. NPI enumeration date: Nov 30, 2006. NPPES status: Active.

NPI Registry data is administrative provider-identification data from CMS. It does not independently verify or explain the HHS-OIG exclusion record above. Verify exclusion status directly with HHS-OIG.

Other excluded providers in Ballwin, MO

Other individuals and entities currently listed in the HHS-OIG LEIE public dataset with a Ballwin, MO address.

Makin Uddin Ahmed Individual Revocation
Ballwin, MO · License revocation, suspension, or surrender · Excluded Jan 2026
Kathleen Marie Holliday Individual Revocation
Ballwin, MO · License revocation, suspension, or surrender · Excluded Mar 2025
Yvette Jacinta Thomas Individual Program Crime
Ballwin, MO · Conviction of program-related crimes · Excluded Jan 2025
Michael J Mccormac Individual Program Crime
Ballwin, MO · Conviction of program-related crimes · Excluded Nov 2024
Hend Msallati Individual Program Crime
Ballwin, MO · Conviction of program-related crimes · Excluded Jul 2020
Rehan Anwar Rana Individual Program Crime
Ballwin, MO · Conviction of program-related crimes · Excluded Feb 2020
Michael David Russo Individual Revocation
Ballwin, MO · License revocation, suspension, or surrender · Excluded Nov 2017
Walter Javier Martinez Individual Patient Abuse
Ballwin, MO · Conviction relating to patient abuse or neglect · Excluded Jul 2017

See all 23 excluded providers in Ballwin →

How to verify this record

This page is a public-record summary and should be treated as a possible LEIE match, not final identity verification. To verify the record, use the official HHS-OIG LEIE search and compare available identifying information through the official process. Name, location, provider category, specialty, exclusion date, and NPI should be treated as matching clues rather than final proof of identity.

What this page does not include

This page summarizes the HHS-OIG LEIE public dataset only. It does not search state Medicaid exclusion lists, state licensing-board actions, court records, malpractice records, employment history, civil lawsuits, or non-public investigations.

Verify this record with the official HHS-OIG source Save or print this record Monitor this provider/entity Need to screen a list? Join the bulk screening beta

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Related

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