MEADVILLE PHYSICIAN SERVICES (NPI# 1093154924) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1093154924 |
| Entity Type | Organization |
| Organization Name | MEADVILLE PHYSICIAN SERVICES |
| Other Organization Name | MEADVILLE FAMILY PRACTICE & WELLNESS CENTER |
| Practice Address |
765 Liberty St Suite 310 Meadville PA 16335-2566 |
| Mailing Address |
1034 Grove St Meadville PA 16335-2945 |
| Practice Telephone | 8143337030 |
| Mailing Telephone | 8143732923 |
| Enumeration Date | 2013-06-25 |
| Last Update Date | 2014-07-28 |
| Authorized Official Name | CHRISTIAN MILES (CEO) |
| Authorized Official Telephone | 8143335267 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | PA | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Meadville Family Practice & Wellness Center | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831573146 | Meadville Physician Services | Internal Medicine | 751 Liberty St Ste G-19, Meadville, PA 16335-2559 | 2015-07-16 |
| 1043650989 | Meadville Physician Services | Family Medicine | 180 N Franklin St Ste B, Cochranton, PA 16314-9706 | 2013-06-25 |
| 1255691572 | Meadville Physician Services | Urology | 765 Liberty St Ste 207, Meadville, PA 16335-2568 | 2012-05-21 |
| 1124408604 | Meadville Physician Services | Internal Medicine | 765 Liberty St, Ste 309, Meadville, PA 16335-2566 | 2015-06-01 |
| 1801284054 | Meadville Physician Services | Otolaryngology | 505 Poplar Street, Suite 209, Meadville, PA 16335-3081 | 2014-12-22 |
| 1114287414 | Meadville Physician Services | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 765 Liberty St, Suite 105, Meadville, PA 16335-2566 | 2012-05-21 |
| 1396005799 | Meadville Physician Services | Neuromusculoskeletal Medicine & OMM | 31799 State Hwy 408, Townville, PA 16360-1903 | 2012-05-21 |
| 1467712901 | Meadville Physician Services | Internal Medicine | 765 Liberty St, Suite 105, Meadville, PA 16335-2566 | 2012-05-17 |
| 1770843294 | Meadville Physician Services | Psychiatry & Neurology | 461 Pine St, Meadville, PA 16335-2974 | 2012-05-17 |
| 1376802348 | Meadville Physician Services | Surgery | 765 Liberty St, Suite 105, Meadville, PA 16335-2566 | 2012-05-11 |
| Street Address |
765 LIBERTY ST SUITE 310 |
| City | MEADVILLE |
| State | PA |
| Zip Code | 16335-2566 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578566113 | Sharon Palotas | Nurse Practitioner | 765 Liberty St, Suite 309, Meadville, PA 16335-2566 | 2005-05-27 |
| 1124408604 | Meadville Physician Services | Internal Medicine | 765 Liberty St, Ste 309, Meadville, PA 16335-2566 | 2015-06-01 |
| 1225432545 | Emily Prenatt | Physician Assistant | 765 Liberty St, Meadville, PA 16335-2566 | 2014-10-15 |
| 1962804955 | French Creek Internal Medicine | Internal Medicine | 765 Liberty St, 307, Meadville, PA 16335-2566 | 2014-09-22 |
| 1801296470 | Oyler Internal Medicine, LLC | Internal Medicine | 765 Liberty St, Suite 307, Meadville, PA 16335-2566 | 2014-09-02 |
| 1255773784 | Dipesh Maan | Internal Medicine | 765 Liberty St, Meadville, PA 16335-2566 | 2013-07-25 |
| 1831534189 | Anthony Randolph | Internal Medicine | 765 Liberty St, Suite 307, Meadville, PA 16335-2566 | 2013-04-30 |
| 1538420658 | Meadville Medical Center | Psychiatry & Neurology | 765 Liberty St, Suite 303, Meadville, PA 16335-2566 | 2012-06-05 |
| 1114287414 | Meadville Physician Services | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 765 Liberty St, Suite 105, Meadville, PA 16335-2566 | 2012-05-21 |
| 1467712901 | Meadville Physician Services | Internal Medicine | 765 Liberty St, Suite 105, Meadville, PA 16335-2566 | 2012-05-17 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811533508 | Stacey Lynette Lantz | Physical Therapy Assistant | 11277 Vernon Place Road, Meadville, PA 16335 | 2019-11-18 |
| 1952874794 | Amy Lynn Weaver | Social Worker | Parkside Psychological Associates, 435 Chestnut Street, Meadville, PA 16335 | 2019-01-04 |
| 1013437789 | Raymond Walter Keller Jr. | Family Medicine | 735 Liberty St, Meadville, PA 16335 | 2017-06-23 |
| 1750735742 | Nicole Fies | Counselor | 201 Chestnut Street, Floor 2, Meadville, PA 16335 | 2016-04-16 |
| 1760894422 | Amie S Coffman | Psychiatry & Neurology | 765 Liberty St Ste 303, Meadville, PA 16335 | 2014-05-28 |
| 1649609710 | Gina Marie Michalak | Pharmacist | 379 North Street, Meadville, PA 16335 | 2013-11-08 |
| 1518396704 | Cassandra Lynn Ketler | Physician Assistant | 847 North Main Street, Meadville, PA 16335 | 2013-11-07 |
| 1194159913 | Judy Mcelwain | Speech-Language Pathologist | 31 N Park Ave, Meadville, PA 16335 | 2013-08-28 |
| 1649604463 | Jonelle Elizabeth Taylor | Occupational Therapist | 31 North Park Ave, Meadville, PA 16335 | 2013-08-28 |
| 1699046961 | James Richard Mclamb | Orthopaedic Surgery | 6060 Ehrgott Rd, Meadville, PA 16335 | 2012-01-19 |
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| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| 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. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013437789 | Raymond Walter Keller Jr. | Family Medicine | 735 Liberty St, Meadville, PA 16335 | 2017-06-23 |
| 1134399140 | Constantine Poolos | Family Medicine | 216 Chestnut St, Meadville, PA 16335-3407 | 2008-03-05 |
| 1174604318 | Bradley Bowlin | Family Medicine | 115b Hwy 556, Meadville, MS 39653 | 2006-10-17 |
| 1013947407 | Robert Gray Symons | Family Medicine | Vamc Clinic 18955 Park Ave.plaza, Meadville, PA 16335 | 2006-07-03 |
| 1811932072 | Calvin P. Poole | Family Medicine | 595 Main St E, Meadville, MS 39653-9233 | 2006-06-19 |
| 1831152099 | Martin Joseph Decker | Family Medicine | 901 Water St, Meadville, PA 16335-3434 | 2006-04-10 |
| 1164499570 | Gregory R Murray | Family Medicine | 16954 Conneaut Lake Rd, Meadville, PA 16335-3738 | 2006-03-03 |
| 1053305219 | Rebecca D Lashbrook | Family Medicine | 280 Clinton Ct, Meadville, PA 16335-3362 | 2005-09-02 |
| 1275532830 | Kenneth Unice | Family Medicine | 495 Pine St, Meadville, PA 16335-2974 | 2005-07-18 |
| 1629071931 | John B. Zinnamosca | Family Medicine | 1009 Water St, Meadville, PA 16335-3445 | 2005-05-31 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.