NORTHSIDE PEDIATRICS PC NPI 1598232944

NPI Information

  • NPI: 1598232944
  • Provider Name: NORTHSIDE PEDIATRICS PC
  • Classification: Pediatrics - 2080A0000X
  • Specialization: Adolescent Medicine
  • Entity Type: Organization
  • CLIA Number: 11D0264280
  • Address: 3888 NORTHSIDE DR
    MACON, GA
    ZIP 31210
  • Phone: (478) 477-4044

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NPI Details

NORTHSIDE PEDIATRICS PC is an adolescent medicine pediatrics in Macon, GA. The provider is a pediatrician who specializes in adolescent medicine is a multi-disciplinary healthcare specialist trained in the unique physical, psychological and social characteristics of adolescents, their healthcare problems and needs. NORTHSIDE PEDIATRICS PC NPI is 1598232944. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

3888 NORTHSIDE DR
MACON, GA
ZIP 31210-417
Phone: (478) 477-4044
Fax: (478) 477-7076

The provider's authorized official is Emmett R Berry .
The authorized official title is President and has the following contact phone number (478) 477-4044.

The CLIA number assigned to this NPI record is 11D0264280 - physician office with a certificate type of Certificate of Compliance.

The enumeration date for this NPI number is 10/24/2018 and was last updated on 10/24/2018.

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
12080A0000XPediatricsAdolescent MedicineYes

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: 3/30/2025

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