NPIMap

Organization Active NPI

Northside Medical Clinic Walk in LLC

  • Urgent Care Clinic/Center
  • Yuma, AZ
National Provider Identifier
1245226398
Registry record updated Apr 20, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urgent Care Clinic/CenterTaxonomy code 261QU0200X
License
OTC3723 Issued in AZ
Legal business name
NORTHSIDE MEDICAL CLINIC WALK IN LLC
Practice address
1394 W 16TH St
Yuma, AZ 85364-4430
Phone
(928) 539-0055
Fax
(928) 539-0053
NPI assigned
Sep 23, 2005
Last updated
Apr 20, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2008

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

Authorized official

Name
Mr. Daniel R. Ortiz, PA-CNPI 1679596134
Title
Medical Director
Phone
(928) 539-0055

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urgent Care Clinic/Center 261QU0200X OTC3723 AZ Primary

Addresses

Primary practice location

1394 W 16TH St
Yuma, AZ 85364-4430

Mailing address

1394 W 16TH St
Yuma, AZ 85364-4430
Phone (928) 539-0055

National Provider Directory

National Provider Directory

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/11296/brand/1/csg/1/fhir/r4

Practitioners & affiliated clinicians

Practitioners 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1127433600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208649600000",
    "number": "1245226398",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1394 W 16TH ST",
            "city": "YUMA",
            "state": "AZ",
            "postal_code": "853644430",
            "telephone_number": "928-539-0055",
            "fax_number": "928-539-0053"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1394 W 16TH ST",
            "city": "YUMA",
            "state": "AZ",
            "postal_code": "853644430",
            "telephone_number": "928-539-0055",
            "fax_number": "928-539-0053"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHSIDE MEDICAL CLINIC WALK IN LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-23",
        "last_updated": "2008-04-20",
        "status": "A",
        "authorized_official_last_name": "ORTIZ",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_middle_name": "R.",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "928-539-0055",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PA-C"
    },
    "taxonomies": [
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": "AZ",
            "license": "OTC3723",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Yuma, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2008; 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.