Southside Medical Center, PA

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

29495 Issued in NC

Legal business name

SOUTHSIDE MEDICAL CENTER, PA

Practice address

1925A Oleander Dr
Wilmington, NC 28403-2334

Phone

(910) 329-1707

NPI assigned

Mar 28, 2014

Organization subpart

No

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

Authorized official

Name

James Pridgen, MD

Title

Director/Owner

Phone

(910) 431-6000

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1395964800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1395964800000",
    "number": "1447677356",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1925A OLEANDER DR",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284032334"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1925A OLEANDER DR",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284032334",
            "telephone_number": "910-329-1707"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHSIDE MEDICAL CENTER, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-03-28",
        "last_updated": "2014-03-28",
        "status": "A",
        "authorized_official_last_name": "PRIDGEN",
        "authorized_official_first_name": "JAMES",
        "authorized_official_title_or_position": "DIRECTOR/OWNER",
        "authorized_official_telephone_number": "910-431-6000",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "NC",
            "license": "29495",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rose S Southerland, DPM
• Southern Cross Commuinty Services Inc
• Southern Cross Community Services, Inc
• Southern Cross Community Services, Inc
• Southside Medical Center PA
• Sovereign Solutions Logistics
• Max Gilbert Sox Jr.
• Kristina Spackman, M. S.
• Zoe Spadaro, OTR/L
• Kim M Spader, P-LCSW

• Internal Medicine Physician in Wilmington, NC
• Providers in Wilmington, NC by specialty
• Internal Medicine Physician in North Carolina

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