NORTHSIDE PEDIATRICS PSC NPI 1295894137

NPI Information

  • NPI: 1295894137
  • Provider Name: NORTHSIDE PEDIATRICS PSC
  • Classification: Pediatrics - 208000000X
  • Entity Type: Organization
  • Address: 290 OLD JACKSON HWY 31E LOOP
    GLASGOW, KY
    ZIP 42141
  • Phone: (270) 678-5740

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NPI Details

NORTHSIDE PEDIATRICS PSC is a pediatrics in Glasgow, KY. The provider is a pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. NORTHSIDE PEDIATRICS PSC NPI is 1295894137. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

290 OLD JACKSON HWY 31E LOOP
GLASGOW, KY
ZIP 42141-089
Phone: (270) 678-5740

The provider's authorized official is Sandra Dotson Moss .
The authorized official title is President and has the following contact phone number (270) 678-5740.

The enumeration date for this NPI number is 12/6/2006 and was last updated on 8/22/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1208000000XPediatrics19876KENTUCKYYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
164198765MEDICAIDKENTUCKY
2000000057724OTHERKENTUCKYBLUE CROSS BLUE SHIELD

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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