THIRD STREET COMMUNITY CLINIC, INC. (NPI# 1427492271) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1427492271 |
| Entity Type | Organization |
| Organization Name | THIRD STREET COMMUNITY CLINIC, INC. |
| Other Organization Name | HAWKINS MEDICAL CENTER |
| Practice Address |
2131 Park Ave W Suite 200 Ontario OH 44906-1226 |
| Mailing Address |
600 W 3rd St Mansfield OH 44906-2633 |
| Practice Telephone | 4195267869 |
| Practice Fax Number | 4195220493 |
| Mailing Telephone | 4195267869 |
| Mailing Fax Number | 4195220493 |
| Enumeration Date | 2013-04-23 |
| Last Update Date | 2017-09-05 |
| Authorized Official Name | MR. JARED POLLICK (CEO) |
| Authorized Official Telephone | 4195267869 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians | ||
| Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Hawkins Medical Center | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710517339 | Third Street Community Clinic, Inc. | Dentist | 431 E 9th St, Ashland, OH 44805-1903 | 2020-01-23 |
| 1629620109 | Third Street Community Clinic, Inc. | Clinic/Center | 2458 Stetzer Rd Ste A, Bucyrus, OH 44820-2066 | 2019-07-15 |
| 1104461805 | Third Street Community Clinic, Inc. | Clinic/Center | 309 Arthur St, Ashland, OH 44805-3206 | 2019-11-18 |
| 1306499314 | Third Street Community Clinic, Inc. | Clinic/Center | 205 W Cook Rd, Mansfield, OH 44907-2405 | 2019-07-18 |
| 1649599119 | Third Street Community Clinic, Inc. | Clinic/Center | 770 Balgreen Drive, Suite 207, Mansfield, OH 44906-2633 | 2010-05-24 |
| 1336252519 | Third Street Community Clinic, Inc. | Clinic/Center | 600 W. Third Street, Mansfield, OH 44906-2633 | 2006-08-15 |
| Street Address |
2131 PARK AVE W SUITE 200 |
| City | ONTARIO |
| State | OH |
| Zip Code | 44906-1226 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871627331 | Ujwala Pagedar | Internal Medicine | 2131 Park Ave W, Ontario, OH 44906-1226 | 2007-03-15 |
| 1083044564 | Lab One of Ohio Inc | Clinical Medical Laboratory | 2131 Park Ave W, Ontario, OH 44906-1226 | 2013-11-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154920155 | Jonathan Clevenger | Pharmacist | 1455 North Lexington-springmill Road, Ontario, OH 44906 | 2020-10-21 |
| 1366083297 | Jennifer Robin Young | Technician | 60 Sherman Ave, Mansfield, OH 44906 | 2019-10-02 |
| 1639721905 | Lora Harris | Nurse Practitioner | 1029 S. Trimble Rd, Mansfield, OH 44906 | 2019-07-16 |
| 1871098855 | Med Gear Plus, LLC | Durable Medical Equipment & Medical Supplies | 1041 Park Ave W, Mansfield, OH 44906 | 2018-03-29 |
| 1912401209 | Bradley Anderson | Dietitian, Registered | 1025 South Trimble Rd., Mansfield, OH 44906 | 2018-03-21 |
| 1104325182 | Nancy Labaki | Speech-Language Pathologist | 2011 W. Fourth St., Mansfield, OH 44906 | 2018-02-06 |
| 1720518319 | Stephen Anderson | Counselor | 680 Park Ave W., Mansfield, OH 44906 | 2017-06-15 |
| 1427422518 | Jill A Waite | Counselor | 33 S. Lexington-springmill Road, Mansfield, OH 44906 | 2015-11-30 |
| 1992125397 | Taryn Boyd | Physical Therapist | 1025 S Trimble, Mansfield, OH 44906 | 2014-04-24 |
| 1356760870 | Sarah Brandyberry | Social Worker | 1025 S. Trimble Rd., Mansfield, OH 44906 | 2014-04-11 |
| Find all providers in zip 44906 | ||||
| Taxonomy Code | 261QF0400X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Federally Qualified Health Center (FQHC) |
| Definition to come... |
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|---|---|---|---|---|
| 1093369340 | Unicare Community Health Center Inc | Clinic/Center | 123 W E St, Ontario, CA 91762-3400 | 2019-07-25 |
| 1215494257 | Unicare Community Health Center Inc | Clinic/Center | 1151 E Walnut St, Ontario, CA 91761-6155 | 2019-02-26 |
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| 1336777077 | Shawnee Mental Health Center Inc | Clinic/Center | 1225 Gallia St Rm 121, Portsmouth, OH 45662-4216 | 2020-03-30 |
| 1376177303 | Erie County Office of Auditor | Clinic/Center | 1925 Hayes Ave Ste B, Sandusky, OH 44870-4737 | 2020-02-28 |
| 1407480593 | Erie County Office of Auditor | Clinic/Center | 333 Buckeye Blvd Ste B, Port Clinton, OH 43452-2475 | 2020-02-27 |
| 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.