James J Siddall, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

036 Issued in AK

Practice address

200 A St
Clear Afs
Clear, AK 99704-5360

Phone

(907) 585-6415

Fax

(907) 585-6244

NPI assigned

Sep 17, 2006

Last updated

Jan 23, 2012By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/21088/brand/1/csg/1/fhir/r4
• Direct secure messaging: james.siddall.1@21088.direct.athenahealth.com

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.

• Siddall Medical Services, Inc.

  • Emergency Medicine Physician
  • Clear, AK
  • NPI 1467559138
  NPD (past) Authorized official
• Emergency Medicine Associates PC

  • Emergency Medical Services (Emergency Medicine) Physician
  • Fairbanks, AK
  • NPI 1275529109
  NPD (past)

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

{
    "created_epoch": "1158451200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1327276800000",
    "number": "1366549032",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 70851",
            "city": "FAIRBANKS",
            "state": "AK",
            "postal_code": "997070851",
            "telephone_number": "907-585-6415",
            "fax_number": "907-585-6244"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 A ST",
            "address_2": "CLEAR AFS",
            "city": "CLEAR",
            "state": "AK",
            "postal_code": "997045360",
            "telephone_number": "907-585-6415",
            "fax_number": "907-585-6244"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIDDALL",
        "first_name": "JAMES",
        "middle_name": "J",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-17",
        "last_updated": "2012-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "AK",
            "license": "036",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pearl Margaret Churchill, PA-C
• Andrew Joseph Holland, PAC
• Siddall Medical Services, Inc.

• Medical Physician Assistant in Clear, AK
• Providers in Clear, AK by specialty
• Medical Physician Assistant in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 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.