NPIMap

Organization Active NPI

Siddall Medical Services, Inc.

  • Emergency Medicine Physician
  • Clear, AK
National Provider Identifier
1467559138
Registry record updated Jan 23, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
Legal business name
SIDDALL MEDICAL SERVICES, INC.
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
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2012

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

Authorized official

Name
James J Siddall, PA-CNPI 1366549032
Title
Owner
Phone
(907) 585-6415

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X NU Primary
Physician Assistant 363A00000X 036 AK

Addresses

Primary practice location

200 A St
Clear Afs
Clear, AK 99704-5360

Mailing address

PO Box 70851
Fairbanks, AK 99707-0851
Phone (907) 585-6415

National Provider Directory

National Provider Directory

Locations

200 A St
Clear, AK 99704
Phone (907) 585-6415

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/21088/brand/1/csg/1/fhir/r4

Practitioners & affiliated clinicians

Practitioners 5

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": "1158451200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1327276800000",
    "number": "1467559138",
    "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": {
        "organization_name": "SIDDALL MEDICAL SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-17",
        "last_updated": "2012-01-23",
        "status": "A",
        "authorized_official_last_name": "SIDDALL",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "907-585-6415",
        "authorized_official_credential": "PA-C"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AK",
            "license": "036",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clear, AK

Sources for this page

  • 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.