NORTHSIDE MEDICAL, INC.


Address: 211 Greenhill Blvd Nw, Fort Payne, AL 35967-3755
Phone: 2568459355

NORTHSIDE MEDICAL, INC. (NPI# 1205089372) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1205089372
Entity Type Organization
Organization Name NORTHSIDE MEDICAL, INC.
Practice Address 211 Greenhill Blvd Nw
Fort Payne
AL 35967-3755
Mailing Address Po Box 680047
Fort Payne
AL 35968-1601
Practice Telephone 2568459355
Mailing Telephone 2568459355
Enumeration Date 2008-11-02
Last Update Date 2008-11-02
Authorized Official Name DR. ROBERT W. THEAKSTON (PRESIDENT)
Authorized Official Telephone 2568459355
Authorized Official Credential M.D.
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 261QP2300X Clinic/Center
Specialization: Primary Care
Ambulatory Health Care Facilities

Office Location

Street Address 211 GREENHILL BLVD NW
City FORT PAYNE
State AL
Zip Code 35967-3755

Providers in the same location

NPI Name Taxonomy Address Enumeration
1255374492 Robert W Theakston Emergency Medicine 211 Greenhill Blvd Nw, Fort Payne, AL 35967-3755 2006-06-14
1578940235 Patrick Gregory Tatum Nurse Practitioner 211 Greenhill Blvd Nw, Fort Payne, AL 35967-3755 2015-05-01

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1073086922 Ft Payne Careplus, LLC Clinic/Center 3000 Gault Ave North, Ft Payne, AL 35967 2019-01-03
1851739023 Marlon Chad Williamson Emergency Medicine 617 Gault Ave N, Fort Payne, AL 35967 2013-06-11
1447552401 Karole Kelley Ohme Counselor 216 Gault Avenue N, Relationship Clinic, Fort Payne, AL 35967 2010-11-24
1720112014 Dekalb County Mr Board Case Management 117 First St Nw, Fort Payne, AL 35967 2007-03-16
1447275490 Glynn Whiddon Odom Nurse Anesthetist, Certified Registered 200 Medical Center Drive, Fort Payne, AL 35967 2006-07-12
1477521698 Michael Ray Parker Optometrist 900 Gault Ave S, Fort Payne, AL 35967 2006-03-14
1144204843 Dale Ray Stierwalt Family Medicine 1618 Gault Ave. N., Fort Payne, AL 35967 2005-12-06
1417951112 Barton Drake Ibsen Physical Therapist 121 Drinkard Dr, Fort Payne, AL 35967 2005-06-09
1407363146 Tyson Scott Rainer Nurse Practitioner 1040 Glenn Blvd Sw, Fort Payne, AL 35967 2018-01-03
1801336599 Caitlin Kirby Massage Therapist 216 Gault Ave N, Fort Payne, AL 35967 2017-03-01
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Taxonomy Information

Taxonomy Code 261QP2300X
Grouping Ambulatory Health Care Facilities
Classification Clinic/Center
Specialization Primary Care

Taxonomy Definition

Definition to come...

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1124675459 Mainstreet Family Care LLC Clinic/Center 1500 1st Ave N Unit 3, Birmingham, AL 35203-1866 2019-08-21
1568016004 Fenton Chiropractic LLC Clinic/Center 301 1st St S, Reform, AL 35481-8013 2019-08-01
1568967081 Bernice R Swain Do Pllc Clinic/Center 2424 Danville Rd Sw Ste L, Decatur, AL 35603-4219 2018-03-27
1578088001 Coastal Health & Wellness Clinic/Center 14 Confederate Dr S, Spanish Fort, AL 36527-3062 2017-08-05
1760918494 Killen Urgent Care, Inc. Clinic/Center 152 J C Mauldin Hwy, Killen, AL 35645-9106 2017-05-01
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Competitor

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City FORT PAYNE
Zip Code 35967

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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