Organization Active NPI

Nest Pediatric Therapy

  • Multi-Specialty Clinic/Center
  • Madison, AL
National Provider Identifier
1558017343
Registry record updated Mar 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
Legal business name
NEST PEDIATRIC THERAPY
Practice address
385 Gooch LN
Madison, AL 35758-8366
Phone
(318) 450-7268
NPI assigned
Mar 1, 2022
Last updated
Mar 1, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 1, 2022

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

Authorized official

Name
Yvonne Sides
Title
Office Manager
Phone
(256) 601-1990

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Multi-Specialty Clinic/Center 261QM1300X NU Primary

Addresses

Primary practice location

385 Gooch LN
Madison, AL 35758-8366

Mailing address

385 Gooch LN
Madison, AL 35758-8366

Other identifiers 1

IdentifierTypeStateIssuer
6979358OtherALDRIVER'S LICENSE

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1646092800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1646092800000",
    "number": "1558017343",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "385 GOOCH LN",
            "city": "MADISON",
            "state": "AL",
            "postal_code": "357588366"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "385 GOOCH LN",
            "city": "MADISON",
            "state": "AL",
            "postal_code": "357588366",
            "telephone_number": "318-450-7268"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEST PEDIATRIC THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-03-01",
        "last_updated": "2022-03-01",
        "certification_date": "2022-03-01",
        "status": "A",
        "authorized_official_last_name": "SIDES",
        "authorized_official_first_name": "YVONNE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "256-601-1990"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DRIVER'S LICENSE",
            "identifier": "6979358",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Madison, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2022; 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.