NPIMap

Organization Active NPI

Eastside Ventures, Inc.

Doing business as Cleveland Family Healthcare

  • Family Medicine Physician
  • Cleveland, AL
National Provider Identifier
1609900406
Registry record updated Feb 3, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
EASTSIDE VENTURES, INC.
Doing business as
Cleveland Family Healthcare
Practice address
6945 County Highway 1
Cleveland, AL 35049
Phone
(205) 625-3667
NPI assigned
Mar 15, 2007
Last updated
Feb 3, 2011By the provider in NPPES
Organization subpart
Yes
Parent organization
EASTSIDE VENTURES, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 3, 2011

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

Authorized official

Name
Mrs. Vicki H Parks, CPA
Title
Chief Accounting Officer
Phone
(205) 838-3718

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X NU Primary

Addresses

Primary practice location

6945 County Highway 1
Cleveland, AL 35049

Mailing address

PO Box 232
Oneonta, AL 35121-0004
Phone (205) 625-3667

Other identifiers 2

IdentifierTypeStateIssuer
529703160MedicaidAL
E892OtherMEDICARE PT B

Other names 1

  • Cleveland Family Healthcare Doing business as

National Provider Directory

National Provider Directory
Part of
Eastside Ventmce Fam HLT

Locations

7130 6th Ave
Altoona, AL 35952
Phone (205) 589-1092

48 Medical Park Dr E
Ste 354
Birmingham, AL 35235
Phone (205) 838-3800

48 Medical Park Dr E
Ste 455
Birmingham, AL 35235
Phone (205) 838-3200

501 Huffman Rd
Birmingham, AL 35215
Phone (205) 836-2998

52 Medical Park Dr E
Ste 101
Birmingham, AL 35235
Phone (205) 838-3759

9823 Parkway E
Birmingham, AL 35215
Phone (205) 854-6556

69115 Main St
Blountsville, AL 35031
Phone (205) 429-2002

700 Sunhill Rd NW
Ste 204
Center Point, AL 35215
Phone (205) 854-8100

1127 Pecan Ave
Gardendale, AL 35071
Phone (205) 631-2273

150 Gilbreath Dr
#102
Oneonta, AL 35121
Phone (205) 274-3322

3500 Blue Lake Dr
Ste 1
Vestavia, AL 35243

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 12

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": "1173916800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1296691200000",
    "number": "1609900406",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 232",
            "city": "ONEONTA",
            "state": "AL",
            "postal_code": "351210004",
            "telephone_number": "205-625-3667"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6945 COUNTY HIGHWAY 1",
            "city": "CLEVELAND",
            "state": "AL",
            "postal_code": "35049",
            "telephone_number": "205-625-3667"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EASTSIDE VENTURES, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "EASTSIDE VENTURES, INC.",
        "enumeration_date": "2007-03-15",
        "last_updated": "2011-02-03",
        "status": "A",
        "authorized_official_last_name": "PARKS",
        "authorized_official_first_name": "VICKI",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "CHIEF ACCOUNTING OFFICER",
        "authorized_official_telephone_number": "205-838-3718",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "CPA"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "529703160",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PT B",
            "identifier": "E892",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Cleveland Family Healthcare",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Cleveland, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2011; 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.