Eastside Family Care LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

EASTSIDE FAMILY CARE LLC

Practice address

14 Mitylene Park LN
Montgomery, AL 36117

Phone

(334) 524-3266

NPI assigned

Mar 27, 2014

Last updated

Aug 8, 2018By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Sai S Namburu, MDNPI 1205894003

Title

Partner

Phone

(334) 524-3266

Specialties & licenses 2

Addresses

Other names 1

• Eastside Urgent Care LLC Other name

Medicare fee-for-service enrollment

Enrolled in AL

Enrollment records 1

Locations

Practitioners 6

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.

• Sai Shankar Namburu, M.D.

  • Family Medicine Physician
  • Selma, AL
  • NPI 1205894003
  Medicare reassignment NPD Authorized official
• Deborah Lynn McCollum, FNP

  • Family Nurse Practitioner
  • Montgomery, AL
  • NPI 1437695681
  Medicare reassignment NPD
• Lisa Rae Miller, CRNP

  • Family Nurse Practitioner
  • Opelika, AL
  • NPI 1588022784
  Medicare reassignment NPD
• Vijay Tirumalasetty, MD

  • Family Medicine Physician
  • Canton, GA
  • NPI 1760618003

  AL

  Medicare reassignment NPD
• Thang Quoc An, DO

  • Family Medicine Physician
  • Montgomery, AL
  • NPI 1972580744
  Medicare reassignment
• Jaisingh Rajput, M.D.

  • Family Medicine Physician
  • Montgomery, AL
  • NPI 1770987943
  NPD (past)

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

{
    "created_epoch": "1395878400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1533686400000",
    "number": "1689091548",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14 MITYLENE PARK LN",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361177306",
            "telephone_number": "334-213-4433"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14 MITYLENE PARK LN",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "36117",
            "telephone_number": "334-524-3266"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EASTSIDE FAMILY CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-03-27",
        "last_updated": "2018-08-08",
        "status": "A",
        "authorized_official_last_name": "NAMBURU",
        "authorized_official_first_name": "SAI",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "334-524-3266",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Eastside Urgent Care LLC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Heather Echols, MD

• Family Medicine Physician in Montgomery, AL
• Providers in Montgomery, AL by specialty
• Family Medicine Physician in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.