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EASTSIDE FAMILY MEDICINE
NPI 1962946970
Family Medicine in Athens, AL

Active since December 09, 2016CLIA 01D0887485 · Microscopy
22289 MEDICAL VILLAGE DR, ATHENS, AL 35613(256) 232-1414 Get Directions Write a Review

NPPES record last updated: January 5, 2024. Verified against the NPPES registry weekly; last sync: November 08, 2026.

About Eastside Family Medicine NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

EASTSIDE FAMILY MEDICINE (NPI 1962946970) is a healthcare organization registered as a family medicine in Athens, Alabama and active in the NPI registry since December 2016. The organization holds a CLIA Microscopy certificate valid through February 19, 2028 and lists Sebrina B Holt, Executive Director, as its authorized official.

NPPES Registry Identity

NPI1962946970
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameEASTSIDE FAMILY MEDICINE
Location Address22289 MEDICAL VILLAGE DRAthens, AL 35613-2896
Mailing Address22289 Medical Village DrAthens, AL 35613-2896 · (256) 232-1414
Phone(256) 232-1414
Organization SubpartNo
Authorized OfficialSebrina B HoltExecutive Director · (256) 216-9648
Enumeration DateDecember 9, 2016
Last NPPES UpdateJanuary 5, 2024
NPPES CertifiedJanuary 5, 2024
✔ NPI 1962946970 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
22289 MEDICAL VILLAGE DR, Athens, AL 35613
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Eastside Family Medicine is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

4

Medicare enrollment records show 4 clinicians reassign Medicare billing to Eastside Family Medicine, which bills Medicare for the services they deliver. Of these, 1 practice within 10 miles. They are listed nearest first.

Clinicians, nearest first (4)

Sherry Clounch, AGACNP
Nurse Practitioner
NPI 1538617741
725 W MARKET ST STE B
Athens, AL 35611
(256) 787-2924
✔ PECOS✔ Accepts Medicare3.5 mi
Maria Onoya, M.D.
Internal Medicine
NPI 1801237946
201 SIVLEY RD SW STE 500
Huntsville, AL 35801
(256) 265-3880
✔ PECOS✔ Accepts Medicare20 mi
Phillip Stewart, D.O.
Internal Medicine
NPI 1457639650
1912 AL HIGHWAY 157
Cullman, AL 35058
(256) 737-2682
✔ PECOS✔ Accepts Medicare41 mi
Uma Davuluri
Internal Medicine
NPI 1477249225
3080 COLLEGE ST
Beaumont, TX 77701
(409) 212-7463
✔ PECOS✔ Accepts Medicare531 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate for Provider-Performed Microscopy Procedures (PPMP) 01D0887485

Eastside Family Medicine · Athens, AL
Active · expires Feb 19, 2028
CLIA Number01D0887485
Laboratory TypeCommunity Clinic
Certificate Effective DateFebruary 20, 2026
Certificate Expiration DateFebruary 19, 2028
Laboratory DirectorMax R. Boone
Laboratory Phone(256) 232-1414
Laboratory LocationEastside Family Medicine22289 Medical Village Drive, Athens, AL 35613
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Eastside Family Medicine's NPI number?

The NPI number for Eastside Family Medicine is 1962946970. It was assigned to this organization in the NPPES registry on December 9, 2016.

Where is Eastside Family Medicine located?

Eastside Family Medicine is located at 22289 Medical Village Dr, Athens, AL 35613. The listed phone number is (256) 232-1414.

What is Eastside Family Medicine's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Eastside Family Medicine enrolled in Medicare?

Yes. Eastside Family Medicine is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Eastside Family Medicine?

According to the CMS Revalidation Reassignment List (October 2026 release), 4 clinicians in 2 Medicare specialties reassign their Medicare billing to Eastside Family Medicine. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Internal Medicine (3) and Nurse Practitioner (1). Of these, 1 practice within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Eastside Family Medicine hold a CLIA laboratory certificate?

Yes. A Certificate for Provider-Performed Microscopy Procedures (PPMP) (number 01D0887485) is associated with this NPI, valid through February 19, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Eastside Family Medicine was last updated on January 5, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.