Northside Surgical Specialists, PC

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

Legal business name

NORTHSIDE SURGICAL SPECIALISTS, PC

Practice address

8424 Naab Rd
Suite #2F
Indianapolis, IN 46260-5918

Phone

(317) 875-0112

NPI assigned

Aug 25, 2006

Last updated

Jul 25, 2008By 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

Joel Hammond, MD

Title

Owner

Phone

(317) 875-0112

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1156464000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1216944000000",
    "number": "1902913767",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 68952",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462680952",
            "telephone_number": "317-802-3112",
            "fax_number": "317-870-0499"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8424 NAAB RD",
            "address_2": "SUITE #2F",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462605918",
            "telephone_number": "317-875-0112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHSIDE SURGICAL SPECIALISTS, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-25",
        "last_updated": "2008-07-25",
        "status": "A",
        "authorized_official_last_name": "HAMMOND",
        "authorized_official_first_name": "JOEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "317-875-0112",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100441520",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Surgery Physician in Indianapolis, IN
• Providers in Indianapolis, IN by specialty
• Surgery Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 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.