NPIMap

Organization Active NPI

Northside Medical Services Corporation

  • Occupational Medicine Clinic/Center
  • Washington, DC
National Provider Identifier
1639290398
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Medicine Clinic/CenterTaxonomy code 261QX0100X
License
MD25334 Issued in DC
Legal business name
NORTHSIDE MEDICAL SERVICES CORPORATION
Practice address
4121 Minnesota Ave NE
Washington, DC 20019-3572
Phone
(202) 388-6000
Fax
(202) 388-6001
NPI assigned
Apr 2, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Ralph E. Greene, M.D.
Title
Medical Director
Phone
(202) 388-6000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Medicine Clinic/Center 261QX0100X MD25334 DC Primary

Addresses

Primary practice location

4121 Minnesota Ave NE
Washington, DC 20019-3572

Mailing address

4121 Minnesota Ave NE
Washington, DC 20019-3572
Phone (202) 388-6000

National Provider Directory

National Provider Directory
Tax ID family
Northside Medical Services Corporation3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1175472000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1639290398",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4121 MINNESOTA AVE NE",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200193572",
            "telephone_number": "202-388-6000",
            "fax_number": "202-388-6001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4121 MINNESOTA AVE NE",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200193572",
            "telephone_number": "202-388-6000",
            "fax_number": "202-388-6001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHSIDE MEDICAL SERVICES CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-02",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GREENE",
        "authorized_official_first_name": "RALPH",
        "authorized_official_middle_name": "E.",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "202-388-6000",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QX0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Occupational Medicine",
            "state": "DC",
            "license": "MD25334",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Washington, DC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.