Tahir Siddiq

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

Legal business name

TAHIR SIDDIQ

Practice address

441 Chaseway Dr
Pike Road, AL 36064-3312

Phone

(334) 396-0201

NPI assigned

May 13, 2021

Last updated

Jul 13, 2022By 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

Tahir Siddiq, MDNPI 1174631758

Title

Owner

Phone

(469) 530-4932

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AL

Enrollment records 1

Locations

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

• Main and Associates Inc

  dba Southern Springs Healthcare Facility

  • Skilled Nursing Facility
  • Union Springs, AL
  • NPI 1609872290

  Adp of the SNF, Operational/Managerial Control

  CMS ownership

Practitioners 1

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.

• Tahir Siddiq, M.D.

  • Specialist
  • Union Springs, AL
  • NPI 1174631758
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1620864000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1657670400000",
    "number": "1114591393",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "441 CHASEWAY DR",
            "city": "PIKE ROAD",
            "state": "AL",
            "postal_code": "360643312",
            "telephone_number": "469-530-4932"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "441 CHASEWAY DR",
            "city": "PIKE ROAD",
            "state": "AL",
            "postal_code": "360643312",
            "telephone_number": "334-396-0201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TAHIR SIDDIQ",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-05-13",
        "last_updated": "2022-07-13",
        "certification_date": "2022-07-13",
        "status": "A",
        "authorized_official_last_name": "SIDDIQ",
        "authorized_official_first_name": "TAHIR",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "469-530-4932",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nicole Christine Shears, MS, CCC-SLP
• Maria Elizabeth Silva, PA
• Ballard Lander Smith
• Southeast Psychiatry Services, LLC
• Rachel Lee Stewart, PT
• Mary Elizabeth Terrell
• Christina R Thompson, CRNP
• Theresa M Thornton
• Morgan Vangilder, OTR/L
• Christopher Joseph Waguespack, D.O.

• Primary Care Clinic/Center in Pike Road, AL
• Providers in Pike Road, AL by specialty
• Primary Care Clinic/Center in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.