Northside Medical Clinic, P.C.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

NORTHSIDE MEDICAL CLINIC, P.C.

Practice address

31 Hughes Dr
Jackson, TN 38305-1505

Phone

(731) 668-2800

Fax

(731) 668-6161

NPI assigned

Nov 29, 2006

Last updated

Dec 4, 2012By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

John R. Blenis

Title

Administrator

Phone

(731) 668-2800

Specialties & licenses 1

Addresses

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Brittany Delana Hart, FNP

  • Family Nurse Practitioner
  • Parsons, TN
  • NPI 1689915142
  NPD
• David Larsen, M.D.

  • Family Medicine Physician
  • Jackson, TN
  • NPI 1346335981
  NPD
• Fred J Sesti, FNP

  • Nurse Practitioner
  • Jackson, TN
  • NPI 1174618516
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1164758400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1354579200000",
    "number": "1083781595",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31 HUGHES DR",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383051505",
            "telephone_number": "731-668-2800",
            "fax_number": "731-668-6161"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31 HUGHES DR",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383051505",
            "telephone_number": "731-668-2800",
            "fax_number": "731-668-6161"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHSIDE MEDICAL CLINIC, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-29",
        "last_updated": "2012-12-04",
        "status": "A",
        "authorized_official_last_name": "BLENIS",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "R.",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "731-668-2800"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• North Jackson Family Clinic Inc
• Northbrooke Health Care and Rehab Clinic
• Northbrooke Healthcare and Rehab Center
• Northbrooke Healthcare and Rehab Center LLC
• Jordan Timothy Northrop
• Norwood Family Eye Care, LLC
• Nothside Dental Center, PA
• Victor C Nwazue, M.D.
• Sylvester Agorua Nwedo, MD
• Chibuzo E. Nwokolo, MD

• Family Medicine Physician in Jackson, TN
• Providers in Jackson, TN by specialty
• Family Medicine Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.