NPIMap

Organization Active NPI

Hillside Family Practice PC

  • Family Medicine Physician
  • Enterprise, AL
National Provider Identifier
1255504866
Registry record updated Aug 28, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
DO1000 Issued in AL
Legal business name
HILLSIDE FAMILY PRACTICE PC
Practice address
1008 Boll Weevil Cir
Suite B
Enterprise, AL 36330-1312
Phone
(334) 475-2067
NPI assigned
Apr 4, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2015

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

Authorized official

Name
David Ryan, D.O.
Title
Owner
Phone
(334) 475-2067

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X DO1000 AL Primary

Addresses

Primary practice location

1008 Boll Weevil Cir
Suite B
Enterprise, AL 36330-1312

Mailing address

1008 Boll Weevil Cir
Suite B
Enterprise, AL 36330-1312
Phone (334) 475-2067

National Provider Directory

National Provider Directory

Locations

1008 Boll Weevil Cir
Ste B
Enterprise, AL 36330
Phone (334) 475-2067

103 E Memorial Ave
#A
Opp, AL 36467
Phone (334) 493-0781

NPI Registry JSON

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

{
    "created_epoch": "1207267200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1440720000000",
    "number": "1255504866",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1008 BOLL WEEVIL CIR",
            "address_2": "SUITE B",
            "city": "ENTERPRISE",
            "state": "AL",
            "postal_code": "363301312",
            "telephone_number": "334-475-2067"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1008 BOLL WEEVIL CIR",
            "address_2": "SUITE B",
            "city": "ENTERPRISE",
            "state": "AL",
            "postal_code": "363301312",
            "telephone_number": "334-475-2067"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HILLSIDE FAMILY PRACTICE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-04",
        "last_updated": "2015-08-28",
        "status": "A",
        "authorized_official_last_name": "RYAN",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "334-475-2067",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "AL",
            "license": "DO1000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Enterprise, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2015; 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.