NPIMap

Organization Active NPI

Northside Onsite Medical Services, Inc.

  • Family Medicine Physician
  • Fort Payne, AL
National Provider Identifier
1386056216
Registry record updated May 28, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
NORTHSIDE ONSITE MEDICAL SERVICES, INC.
Practice address
106 45TH St NE
Fort Payne, AL 35967-4010
Phone
(256) 304-2109
NPI assigned
May 27, 2014
Last updated
May 28, 2014By the provider in NPPES
Organization subpart
Yes
Parent organization
NORTHSIDE MEDICAL, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on May 28, 2014

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

Authorized official

Name
Dr. Robert Theakston, M.D.NPI 1255374492
Title
President
Phone
(256) 845-9355

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
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

106 45TH St NE
Fort Payne, AL 35967-4010

Mailing address

211 Greenhill Blvd NW
Fort Payne, AL 35967-3755
Phone (256) 845-9355

National Provider Directory

National Provider Directory
Part of
Northside Medical Inc

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 7

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": "1401148800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1401235200000",
    "number": "1386056216",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "211 GREENHILL BLVD NW",
            "city": "FORT PAYNE",
            "state": "AL",
            "postal_code": "359673755",
            "telephone_number": "256-845-9355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "106 45TH ST NE",
            "city": "FORT PAYNE",
            "state": "AL",
            "postal_code": "359674010",
            "telephone_number": "256-304-2109"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHSIDE ONSITE MEDICAL SERVICES, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "NORTHSIDE MEDICAL, INC.",
        "enumeration_date": "2014-05-27",
        "last_updated": "2014-05-28",
        "status": "A",
        "authorized_official_last_name": "THEAKSTON",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "256-845-9355",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Payne, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2014; 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.