Eastside Family Medicine

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

EASTSIDE FAMILY MEDICINE

Practice address

22289 Medical Village Dr
Athens, AL 35613-2896

Phone

(256) 232-1414

NPI assigned

Dec 9, 2016

Organization subpart

No

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

Authorized official

Name

Sebrina B Holt

Title

Executive Director

Phone

(256) 216-9648

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AL

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Philip Preston Stewart, D.O.

  • Internal Medicine Physician
  • Cullman, AL
  • NPI 1457639650
  Medicare reassignment Care Compare group NPD
• Max R Boone, M.D.

  • Family Medicine Physician
  • Athens, AL
  • NPI 1346352317

  Single Specialty

  Medicare reassignment NPD
• Maria Czarins Onoya, M.D.

  • Internal Medicine Physician
  • Athens, AL
  • NPI 1801237946
  Medicare reassignment NPD
• Sherry Mayes Clounch, AGACNP

  • Acute Care Nurse Practitioner
  • Athens, AL
  • NPI 1538617741
  Care Compare group

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

{
    "created_epoch": "1481241600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1704412800000",
    "number": "1962946970",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22289 MEDICAL VILLAGE DR",
            "city": "ATHENS",
            "state": "AL",
            "postal_code": "356132896",
            "telephone_number": "256-232-1414"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22289 MEDICAL VILLAGE DR",
            "city": "ATHENS",
            "state": "AL",
            "postal_code": "356132896",
            "telephone_number": "256-232-1414"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EASTSIDE FAMILY MEDICINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-12-09",
        "last_updated": "2024-01-05",
        "certification_date": "2024-01-05",
        "status": "A",
        "authorized_official_last_name": "HOLT",
        "authorized_official_first_name": "SEBRINA",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "256-216-9648"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Garrett Dunn, MD
• Jimmy Wayne Dunn, MD
• Rebekah Duran, MS, CCC-SLP
• Dva Healthcare Renal Care Inc
• East Limestone Family Dental, PC
• Eastside Pharmacy and Custom Compounding, Inc.
• Caitlin Edgmon
• Christopher E. Edwards, MD
• Devin Eernisse, DC
• Ej&M Homes

• Family Medicine Physician in Athens, AL
• Providers in Athens, 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 Jan 5, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.