Northside,P.C.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

NORTHSIDE,P.C.

Doing business as

Northside Clinic

Practice address

1020 Cleveland Rd
Saraland, AL 36571

Phone

(251) 675-4733

Fax

(251) 679-9874

NPI assigned

Dec 19, 2006

Organization subpart

No

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

Authorized official

Name

Debbie Kruse

Title

Office Manager

Phone

(251) 675-4733

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Northside Clinic Doing business as

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

{
    "created_epoch": "1166486400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1209945600000",
    "number": "1851454946",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1020 CLEVELAND RD",
            "city": "SARALAND",
            "state": "AL",
            "postal_code": "36571",
            "telephone_number": "251-675-4733",
            "fax_number": "251-679-9874"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1020 CLEVELAND RD",
            "city": "SARALAND",
            "state": "AL",
            "postal_code": "36571",
            "telephone_number": "251-675-4733",
            "fax_number": "251-679-9874"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHSIDE,P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-19",
        "last_updated": "2008-05-05",
        "status": "A",
        "authorized_official_last_name": "KRUSE",
        "authorized_official_first_name": "DEBBIE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "251-675-4733"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "529101630",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Northside Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Neighbors & Associates
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• North Mobile Dental Medicaid, LLC
• Northern Mobile Medical Diagnostics
• Christopher Alan O'Laire, D.C.
• Olaire Health Solutions, Inc
• One Coast Medical, Inc
• Optometry Exchange of Alabama, Inc
• Stephanie Beahn Overstreet, RN

• Family Medicine Physician in Saraland, AL
• Providers in Saraland, 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 May 5, 2008; 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.