Northside Pediatrics PC

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

0101231186 Issued in VA

Legal business name

NORTHSIDE PEDIATRICS PC

Practice address

2008 Bremo Rd
Suite 100
Richmond, VA 23226-2443

Phone

(804) 288-0814

Fax

(877) 331-0645

NPI assigned

Jul 19, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Lakeita Lynne Smith, MD

Title

Physician

Phone

(804) 432-4631

Specialties & licenses 1

Addresses

Other identifiers 3

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

{
    "created_epoch": "1153267200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1242777600000",
    "number": "1992724181",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 28690",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232288690",
            "telephone_number": "804-432-4631",
            "fax_number": "877-331-0645"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2008 BREMO RD",
            "address_2": "SUITE 100",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232262443",
            "telephone_number": "804-288-0814",
            "fax_number": "877-331-0645"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHSIDE PEDIATRICS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-19",
        "last_updated": "2009-05-20",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "LAKEITA",
        "authorized_official_middle_name": "LYNNE",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "804-432-4631",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": "VA",
            "license": "0101231186",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VA LICENSE NUMBER",
            "identifier": "0101231186",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010167175",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LAKEITA L. SMITH'S NPI",
            "identifier": "1710963582",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jena Gross Northen, MS, OTR/L, BCN, SIPT
• Northern Virginia Behavioral Therapeutic Consultation
• Northland Hearing Centers, Inc
• Michelle Joyce Northrop, LCSW
• Northside Dental Company, PLLC
• Northside Wellness Solutions, LLC
• Kristen Eleanor Norton, LCSW
• Lucy Norton
• Marie P Norton
• Melinda Dawn Norton, DDS

• Pediatrics Physician in Richmond, VA
• Providers in Richmond, VA by specialty
• Pediatrics Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2009; 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.