MAIN STREET MEDICAL CLINIC LLC (NPI# 1306145289) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1306145289 |
| Entity Type | Organization |
| Organization Name | MAIN STREET MEDICAL CLINIC LLC |
| Practice Address |
1508 Cogswell Ave Pell City AL 35125-1243 |
| Practice Telephone | 2058141598 |
| Practice Fax Number | 2058141587 |
| Mailing Telephone | 2058141598 |
| Mailing Fax Number | 2058141587 |
| Enumeration Date | 2011-03-18 |
| Last Update Date | 2011-03-18 |
| Authorized Official Name | MARY SUE SUGGS (OWNER) |
| Authorized Official Telephone | 2058141598 |
| Authorized Official Credential | CRNP |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QR1300X |
Clinic/Center Specialization: Rural Health |
113466 | AL | Ambulatory Health Care Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649345125 | Main Street Medical Clinic LLC | Nurse Practitioner | 505 N Main St, Benton, IL 62812-1102 | 2006-11-21 |
| Street Address |
1508 COGSWELL AVE |
| City | PELL CITY |
| State | AL |
| Zip Code | 35125-1243 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154317758 | Mary Sue Suggs | Family Medicine | 1508 Cogswell Ave, Pell City, AL 35125-1243 | 2005-09-20 |
| 1952917502 | Miranda Eddy Talmage | Nurse Practitioner | 1508 Cogswell Ave, Pell City, AL 35125-1243 | 2020-09-18 |
| 1740895291 | Main Street Clinic, LLC | Pediatrics | 1508 Cogswell Ave, Pell City, AL 35125-1243 | 2020-09-11 |
| 1003242678 | Laura Paige Farris | Nurse Practitioner | 1508 Cogswell Ave, Pell City, AL 35125-1243 | 2013-09-16 |
| 1205854544 | Linda J Schultz | Internal Medicine | 1508 Cogswell Ave, Pell City, AL 35125-1243 | 2006-07-17 |
| 1861472219 | Jana Gail Zeitvogel | Nurse Practitioner | 1508 Cogswell Ave, Pell City, AL 35125-1243 | 2006-01-20 |
| 1447246053 | Mary Sue Suggs | Family Medicine | 1508 Cogswell Ave, Pell City, AL 35125-1243 | 2005-09-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629507082 | Christoph Scott Koogler | Pharmacist | 165 Vaughn Lane, Pell City, AL 35125 | 2017-06-08 |
| 1104133693 | State of Alabama Department of Public Health | Nurse Practitioner | 1175 23rd Street North, St. Clair County Health Department, Pell City, AL 35125 | 2010-09-07 |
| 1801918776 | David Timothy Sawyer | Dentist | 402a Cogswell Ave, Pell City, AL 35125 | 2007-04-04 |
| 1528106341 | Patricia Yvonne Hamilton | Counselor | 1540 Center Point Pkway, Suite 102, Birmingham, AL 35125 | 2007-02-02 |
| 1316028566 | Glenn Hendrick Magargee | Counselor | 8 16th Street, Pell City, AL 35125 | 2006-10-17 |
| 1508965633 | Derek Matthew Morris | Pharmacist | 505 Martin Street, Pell City, AL 35125 | 2006-09-22 |
| 1699882738 | Hasmukh Nagindas Jariwala | Internal Medicine | 2811 Dr John Haynes Dr, Suite 102, Pell City, AL 35125 | 2006-08-24 |
| 1912914185 | Sara V Thompson | Nurse Practitioner | 70 Plaza Drive, Pell City, AL 35125 | 2006-08-01 |
| 1972547636 | Elisabeth May Douglass | Physical Therapist | 85 Plaza Drive, Pell City, AL 35125 | 2006-06-15 |
| 1851376610 | Barry G Collins | Internal Medicine | 7067 Veterans Parkway, Suite 200, Pell City, AL 35125 | 2005-12-14 |
| Find all providers in zip 35125 | ||||
| Taxonomy Code | 261QR1300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rural Health |
| Definition to come... |
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| 1205294428 | Red Bay Hospital Outpatient Clinics LLC | Clinic/Center | 14490 County Line Road, Suite A, Muscle Shoals, AL 35661 | 2016-02-02 |
| 1972985968 | Athens Limestone Pediatric Center LLC | Clinic/Center | 101 Fitness Way Ste 2100, Athens, AL 35611-2494 | 2015-06-25 |
| 1396125258 | D W Mcmillan Memorial Hospital | Clinic/Center | 1674 Cleveland Ave, Castleberry, AL 36432 | 2015-06-05 |
| Find all providers with the same taxonomy | ||||
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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.