Northside Medical LLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

1631 Issued in VI

Legal business name

NORTHSIDE MEDICAL LLC

Practice address

252 Estate Glynn
Agape Medical Center
Kingshill, VI 00850-9826

Phone

(340) 772-2000

NPI assigned

Feb 15, 2012

Last updated

Feb 15, 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

Dr. Albert A Titus, M.D.

Title

Owner

Phone

(340) 772-2000

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1329264000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1329264000000",
    "number": "1184997678",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "252 ESTATE GLYNN",
            "address_2": "AGAPE MEDICAL CENTER",
            "city": "KINGSHILL",
            "state": "VI",
            "postal_code": "008509826",
            "telephone_number": "340-772-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "252 ESTATE GLYNN",
            "address_2": "AGAPE MEDICAL CENTER",
            "city": "KINGSHILL",
            "state": "VI",
            "postal_code": "008509826",
            "telephone_number": "340-772-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHSIDE MEDICAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-02-15",
        "last_updated": "2012-02-15",
        "status": "A",
        "authorized_official_last_name": "TITUS",
        "authorized_official_first_name": "ALBERT",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "340-772-2000",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "VI",
            "license": "1631",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Desiree James, RN, CDE
• Lovine H. Johnson, M.S.W., C.S.W.
• Christa Nandra Mathurin, FNP STUDENT
• Erica McNealey, CNM
• Kimberly Mills, PH.D, B.C.B.A.
• Jewel Victoria Owen, PSY.D.
• Jenissa Pemberton
• St Croix Health & Wellnes Center PC (West End Chiropractic)
• St Croix Health & Wellness Center P.C. (West End Chiropractic)
• St Croix Oral and Facial Healthcare Center, LLC

• Internal Medicine Physician in Kingshill, VI
• Providers in Kingshill, VI by specialty
• Internal Medicine Physician in U.S. Virgin Islands

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 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.