THIRD STREET COMMUNITY CLINIC INC (NPI# 1447619788) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1447619788 |
Entity Type | Organization |
Organization Name | THIRD STREET COMMUNITY CLINIC INC |
Other Organization Name | THIRD STREET FAMILY HEALTH SERVICES |
Practice Address |
600 W 3rd St Mansfield OH 44906-2633 |
Practice Telephone | 4195226191 |
Enumeration Date | 2016-02-15 |
Last Update Date | 2019-07-10 |
Authorized Official Name | JARED POLLICK (CEO) |
Authorized Official Telephone | 4195226191 |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 261QD0000X |
Clinic/Center Specialization: Dental |
Ambulatory Health Care Facilities | ||
N | 261QM0801X |
Clinic/Center Specialization: Mental Health (Including Community Mental Health Center) |
Ambulatory Health Care Facilities | ||
N | 261QM0850X |
Clinic/Center Specialization: Adult Mental Health |
Ambulatory Health Care Facilities | ||
N | 261QM0855X |
Clinic/Center Specialization: Adolescent and Children Mental Health |
Ambulatory Health Care Facilities | ||
Y | 261QP2300X |
Clinic/Center Specialization: Primary Care |
Ambulatory Health Care Facilities | ||
N | 261QP1100X |
Clinic/Center Specialization: Podiatric |
Ambulatory Health Care Facilities |
Other Name | Type Code |
---|---|
Third Street Family Health Services | Doing Business As Name - Organization |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1245858950 | Third Street Community Clinic Inc | Clinic/Center | 200 Park Ave W, Mansfield, OH 44902-1608 | 2020-07-09 |
1972053452 | Third Street Community Clinic Inc | Clinic/Center | 200 Park Ave W, Mansfield, OH 44902-1608 | 2016-10-10 |
1588119598 | Third Street Community Clinic Inc | Clinic/Center | 124 N Linden Rd, Mansfield, OH 44906-2616 | 2016-08-19 |
1700250511 | Third Street Community Clinic Inc | Clinic/Center | 199 W Main St, 2nd Floor, Shelby, OH 44875-1490 | 2015-11-17 |
1811364706 | Third Street Community Clinic Inc | Clinic/Center | 31 E Main St, Shelby, OH 44875-1262 | 2015-08-26 |
Street Address |
600 W 3RD ST |
City | MANSFIELD |
State | OH |
Zip Code | 44906-2633 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1417951781 | Michael Jay Raizen | Dentist | 600 W 3rd St, Mansfield, OH 44906-2633 | 2005-06-02 |
1639788417 | Robyn Stone | Family Medicine | 600 W 3rd St, Mansfield, OH 44906-2633 | 2020-07-28 |
1134618978 | Bryce Steindl | Dentist | 600 W 3rd St, Mansfield, OH 44906 | 2018-05-08 |
1386153971 | Amani Alsaery | Dentist | 600 W 3rd St, Mansfield, OH 44906-2633 | 2017-09-26 |
1417489725 | Danielle Kreais | Nurse Practitioner | 600 W 3rd St, Mansfield, OH 44906-2633 | 2017-03-28 |
1215475462 | Young Mi Britton | Nurse Practitioner | 600 W 3rd St, Mansfield, OH 44906-2633 | 2017-02-08 |
1609327378 | Kristin Elyse Cooper | Nurse Practitioner | 600 W 3rd St, Mansfield, OH 44906-2633 | 2016-10-18 |
1144778499 | Courtney Brooks | Nurse Practitioner | 600 W 3rd St, Mansfield, OH 44906-2633 | 2016-09-15 |
1144778754 | Emily Bowman | Nurse Practitioner | 600 W 3rd St, Mansfield, OH 44906-2633 | 2016-09-13 |
1871944108 | Jennifer Schroeder | Nurse Practitioner | 600 W 3rd St, Mansfield, OH 44906-2633 | 2016-06-28 |
Find all providers in the same location |
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 | 261QP2300X |
Grouping | Ambulatory Health Care Facilities |
Classification | Clinic/Center |
Specialization | Primary Care |
Definition to come... |
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1295340024 | Pressley Pediatrics, LLC | Clinic/Center | 1306 Brittany Ln, Mansfield, TX 76063-4012 | 2020-09-09 |
1790309284 | Emerika Mobile Health LLC | Clinic/Center | 28 Park Ave W Ste 701, Mansfield, OH 44902-1640 | 2020-06-01 |
1194376863 | Careatc | Clinic/Center | 1770 E Broad St Ste 102, Mansfield, TX 76063-9145 | 2019-09-24 |
1881888907 | Clinical Practice Support Services | Clinic/Center | 1811 Highway 287 N Ste 150, Mansfield, TX 76063-7595 | 2007-08-31 |
1497373864 | Delanys Healthcare | Clinic/Center | 680 Park Ave W, Mansfield, OH 44906-3706 | 2020-07-11 |
1780226092 | Ritenour Medical LLC | Clinic/Center | 380 Cline Ave Ste 1, Mansfield, OH 44907-1056 | 2019-10-09 |
1073878716 | Nangha Md Pllc | Clinic/Center | 309 Regency Pkwy, Suite 107, Mansfield, TX 76063-5165 | 2012-07-09 |
1972864486 | Pannaben H Nangha Md Pllc | Clinic/Center | 221 Regency Pkwy, Suite 125, Mansfield, TX 76063-5165 | 2012-05-31 |
1669799458 | Peter T Roemer Md | Clinic/Center | 120 Sturges Ave, Mansfield, OH 44903-2399 | 2010-05-03 |
1346419744 | Ontario Children's Health | Clinic/Center | 2003 W 4th St, Mansfield, OH 44906-1787 | 2008-02-29 |
Find all providers in MANSFIELD |
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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.