MAIN STREET CLINIC (NPI# 1093217846) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1093217846 |
| Entity Type | Organization |
| Organization Name | MAIN STREET CLINIC |
| Other Organization Name | WELLS MEDICAL SERVICES |
| Practice Address |
117 S Main St Bluffton IN 46714-2047 |
| Practice Telephone | 2608249265 |
| Practice Fax Number | 2608249267 |
| Mailing Telephone | 2608249265 |
| Enumeration Date | 2018-03-07 |
| Last Update Date | 2018-03-07 |
| Authorized Official Name | JOHN J. GREENMAN (M.D/CEO-PRESIDENT) |
| Authorized Official Telephone | 2608249265 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2080A0000X |
Pediatrics Specialization: Adolescent Medicine |
01034958 | IN | Allopathic & Osteopathic Physicians |
| Y | 207Q00000X | Family Medicine | 01034958 | IN | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IN | 100101710A | 05 |
| Other Name | Type Code |
|---|---|
| Wells Medical Services | Former Legal Business Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427294792 | Main Street Clinic | Clinic/Center | 11 W Main St, Suite 225, Belgrade, MT 59714-3700 | 2008-12-16 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Alabama Business Registrations | Main street clinic LLC |
| Street Address |
117 S MAIN ST |
| City | BLUFFTON |
| State | IN |
| Zip Code | 46714-2047 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346208311 | Ma. Luisa S Sumabat | Family Medicine | 117 S Main St, Bluffton, IN 46714-2047 | 2006-05-01 |
| 1114985181 | Wells Medical Services, P.C. | Clinic/Center | 117 S Main St, Bluffton, IN 46714-2047 | 2006-05-01 |
| 1104884162 | Washington Ocampo Sumabat | Pediatrics | 117 S Main St, Bluffton, IN 46714-2047 | 2006-05-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700262953 | Emily Lyn Perkins | Physical Therapist | 2170 Commerce Drive, Bluffton, IN 46714 | 2015-08-10 |
| 1861871170 | Mercy Seat Dentistry | Dental Hygienist | 2155 Commerce Drive, Bluffton, IN 46714 | 2015-05-20 |
| 1396145363 | Shanel G Petty | Pharmacist | 1975 North Main Street, Bluffton, IN 46714 | 2014-08-27 |
| 1740479427 | Erica Jane Roberts | Occupational Therapist | 1100 South Main Street, Bluffton, IN 46714 | 2007-10-18 |
| 1023176575 | Pamela Jane Johnson | Dentist | 1417 Baker Place, Bluffton, IN 46714 | 2006-12-05 |
| 1285698225 | Donald August Dian | Pediatrics | 303 South Main Street, Bluffton, IN 46714 | 2006-04-14 |
| 1306819735 | Juanita E Bryan | Physician Assistant | 125 E Cherry St, Bluffton, IN 46714 | 2006-02-08 |
| 1447231832 | Adams County Memorial Hospital | Skilled Nursing Facility | 720 E Dustman Road, Bluffton, IN 46714 | 2005-11-11 |
| 1720420748 | Kristin Ruth Toliver | Podiatrist | 303 S. Main Street, Bluffton, IN 46714 | 2013-07-18 |
| 1780967125 | Mark William Toetz | Pharmacist | 1975 N Main St, Bluffton, IN 46714 | 2011-09-22 |
| Find all providers in zip 46714 | ||||
| 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 |
|---|---|---|---|---|
| 1427674043 | Ralinson Alcius | Family Medicine | 2180 Blakers Blvd, Bluffton, SC 29909-7804 | 2020-06-19 |
| 1154824530 | Marie Jarmulowicz | Family Medicine | 14 Oak Forest Rd Ste D, Bluffton, SC 29910-4988 | 2018-03-13 |
| 1477940450 | Melinda Harper | Family Medicine | 45 Point West Dr, Bluffton, SC 29910-6255 | 2015-04-17 |
| 1710115605 | Mary Ann Hanna Horn | Family Medicine | 400 Buckwalter Place Blvd., Bluffton, SC 29910 | 2009-06-30 |
| 1477715712 | Peter Craig Rippey | Family Medicine | 10 Oak Forest Drive, Suite C, Bluffton, SC 29910-4974 | 2008-06-27 |
| 1740441757 | Nikki A Keisler | Family Medicine | Beaufort Memorial May River Primary Care, 1 Burnt Church Rd, Ste B, Bluffton, SC 29910 | 2008-06-23 |
| 1548464084 | Soldrea L Thompson | Family Medicine | 7 Arley Way Ste 101, Bluffton, SC 29910-4301 | 2007-06-11 |
| 1023238771 | Bluffton Physicians | Family Medicine | 132 Garau St, Bluffton, OH 45817-1028 | 2007-04-26 |
| 1134271000 | Todd Eric Johnson | Family Medicine | 6 Haddington Ct, Bluffton, SC 29910-6199 | 2007-01-18 |
| 1558429746 | Marion I Shelly | Family Medicine | 132 Garau Street, Bluffton Physicians Inc, Bluffton, OH 45817-0069 | 2006-12-04 |
| Find all providers in BLUFFTON | ||||
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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.