Southside Pediatrics Assoc

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

Legal business name

SOUTHSIDE PEDIATRICS ASSOC

Practice address

2727 W Cleveland Ave
Milwaukee, WI 53215

Phone

(414) 384-9880

Fax

(414) 384-0134

NPI assigned

Apr 15, 2008

Last updated

Apr 15, 2008By 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

Mr. Randall T Westley

Title

Owner

Phone

(414) 322-3030

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1208217600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208217600000",
    "number": "1427222082",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2727 W CLEVELAND AVE",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "53215",
            "telephone_number": "414-384-9880",
            "fax_number": "414-384-0134"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2727 W CLEVELAND AVE",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "53215",
            "telephone_number": "414-384-9880",
            "fax_number": "414-384-0134"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHSIDE PEDIATRICS ASSOC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-15",
        "last_updated": "2008-04-15",
        "status": "A",
        "authorized_official_last_name": "WESTLEY",
        "authorized_official_first_name": "RANDALL",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "414-322-3030",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "32696700",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Southeastern Family Practice SC
• Southeastern Pediatric & Adolescent Medicine, S.C. (Southeastern Pediatric & Adolescent Medicine)
• Southern Home Health
• Southern Lakes Physical Therapy
• James F Southern, MD
• Southside Primary Care
• Southwest Pharmacy Inc (The Pharmacy Shoppe)
• Janet Marie Sova, C.O.T.A.
• Alexis Ann Sover, PA-C
• Sovereigns Circle of Love Prenatal Assessment Program

• Pediatrics Physician in Milwaukee, WI
• Providers in Milwaukee, WI by specialty
• Pediatrics Physician in Wisconsin

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