Individual provider Active NPI

Roxanne Miller Sides, CRNP

  • Family Nurse Practitioner
  • Horsham, PA
National Provider Identifier
1174708218
Registry record updated May 9, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
SP009693 Issued in PA
Practice address
680 Blair Mill Rd
Horsham, PA 19044-2223
Phone
(866) 297-9232
NPI assigned
Jan 8, 2008
Last updated
May 9, 2014By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 9, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X SP009693 PA Primary

Addresses

Primary practice location

680 Blair Mill Rd
Horsham, PA 19044-2223

Mailing address

514 Farnum Rd
Media, PA 19063-1610
Phone (610) 566-2975

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080430000262 PA Practitioner - Nurse Practitioner 7911086186 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Residentialist Housecall Med GRP, PC a Pennsylvania Corp CurrentSince May 8, 2017 Accepting new patients
Ophelia Medical Group, P.C. CurrentSince Apr 11, 2022 Accepting new patients
Kensington Hospital- Cambria Clinic CurrentSince Oct 1, 2023 Accepting new patients
Kensington Hospital CurrentSince Oct 1, 2023 Accepting new patients
Kensington Hospital Current Accepting new patients
Housecall Doctors Medical Group Inc PastSince May 8, 2017 Accepting new patients
Kensington Hospital Past Accepting new patients

Locations

3800 Kilroy Airport Way
Ste 270
Long Beach, CA 90806
Phone (949) 366-1053

136 Diamond St
Philadelphia, PA 19122
Phone (215) 426-8100

4190 City Ave
Ste 528
Philadelphia, PA 19131
Phone (866) 453-8800

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1199750400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1399593600000",
    "number": "1174708218",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "514 FARNUM RD",
            "city": "MEDIA",
            "state": "PA",
            "postal_code": "190631610",
            "telephone_number": "610-566-2975"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "680 BLAIR MILL RD",
            "city": "HORSHAM",
            "state": "PA",
            "postal_code": "190442223",
            "telephone_number": "866-297-9232"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIDES",
        "first_name": "ROXANNE",
        "middle_name": "MILLER",
        "name_prefix": "Ms.",
        "credential": "CRNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-01-08",
        "last_updated": "2014-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "PA",
            "license": "SP009693",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Horsham, PA

Sources for this page

Verify at the official NPI Registry.