MAIN STREET FAMILY MEDICINE, PA (NPI# 1467510008) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1467510008 |
| Entity Type | Organization |
| Organization Name | MAIN STREET FAMILY MEDICINE, PA |
| Practice Address |
111 Vine St Hammonton NJ 08037-1447 |
| Practice Telephone | 6095612518 |
| Mailing Telephone | 6095612518 |
| Enumeration Date | 2006-12-05 |
| Last Update Date | 2008-04-18 |
| Authorized Official Name | DR. WALTER D CRANE (PHYSICIAN) |
| Authorized Official Telephone | 6095612518 |
| Authorized Official Credential | D.O. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | MB42970 | NJ | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NJ | 3411001 | 05 |
| Street Address |
111 VINE ST |
| City | HAMMONTON |
| State | NJ |
| Zip Code | 08037-1447 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801130349 | Loretta A. Sernekos | Nurse Practitioner | 111 Vine St, Hammonton, NJ 08037-1447 | 2012-11-21 |
| 1326223074 | Advocare, LLC | Family Medicine | 111 Vine St, Hammonton, NJ 08037-1447 | 2007-12-31 |
| 1942417803 | Donna De Melia | Nurse Practitioner | 111 Vine St, Hammonton, NJ 08037-1447 | 2007-05-17 |
| 1942328125 | Katie Robine | Physical Therapist | 111 Vine St, Hammonton, NJ 08037-1447 | 2007-03-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497312532 | Hope On Wheels LLC | Transportation Broker | 882 12th Street, 882 12th Street D5, Hammonton, NJ 08037 | 2019-05-23 |
| 1679050389 | Lori's Wellness Loft | Massage Therapist | 240 S White House Pike, Suite B4, Hammonton, NJ 08037 | 2018-07-25 |
| 1306364773 | Elwyn New Jersey | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 2404 4th Road, Folsom, NJ 08037 | 2017-09-06 |
| 1376070003 | Elwyn New Jersey | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1204 11th Street, Folsom, NJ 08037 | 2017-05-12 |
| 1881138154 | Kennedy Medical Group Practice P.C. | Family Medicine | 630 B South White Horse Pike, Hammonton, NJ 08037 | 2016-12-06 |
| 1467908350 | John Lloyd Jr. | Counselor | 63 Laurel Lane, Hammonton, NJ 08037 | 2016-08-30 |
| 1407218019 | Karon Ross | Counselor | 44 Fern Lane, Hammonton, NJ 08037 | 2016-03-23 |
| 1396106548 | Helen Durham | Counselor | 61 Laurel Lane, Hammonton, NJ 08037 | 2016-03-16 |
| 1972994481 | Person First New Jersey LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 14 Heggan Ln, Heggan Ln, Hammonton, NJ 08037 | 2015-02-05 |
| 1659702298 | Alienta Limited Liability Company | Community/Behavioral Health | 425 N Third Street, Hammonton, NJ 08037 | 2013-12-09 |
| Find all providers in zip 08037 | ||||
| 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 |
|---|---|---|---|---|
| 1881138154 | Kennedy Medical Group Practice P.C. | Family Medicine | 630 B South White Horse Pike, Hammonton, NJ 08037 | 2016-12-06 |
| 1336595925 | Sonia Sharma | Family Medicine | 219 N White Horse Pike Ste 101, Hammonton, NJ 08037-1896 | 2016-05-12 |
| 1417106782 | Karen Wasleski | Family Medicine | 118 Poplar St, Hammonton, NJ 08037-1153 | 2008-09-11 |
| 1225179773 | Alexander E Rodi Sr. | Family Medicine | 425 12th St & Madison Ave, Hammonton, NJ 08037-1382 | 2007-02-09 |
| 1306907886 | Cedar Brook Family Practice PC | Family Medicine | 187 S Route 73, Suite B, Hammonton, NJ 08037-9423 | 2006-12-12 |
| 1265507214 | Donald Krachman | Family Medicine | 777 S White Horse Pike Ste D1, Hammonton, NJ 08037-2029 | 2006-11-22 |
| 1689751646 | Parag S Patel | Family Medicine | 75 S White Horse Pike Frnt, Hammonton, NJ 08037-1872 | 2006-11-01 |
| 1447346788 | Family Medicine, Pa | Family Medicine | 425 12th St Madison Ave, Hammonton, NJ 08037 | 2006-10-05 |
| 1841213279 | A.c.miranda M.d.pa | Family Medicine | 630 Bellevue Ave, Hammonton, NJ 08037-1935 | 2006-07-26 |
| 1568418101 | Herbert M Jung | Family Medicine | 893 S White Horse Pike, Hammonton, NJ 08037-2012 | 2006-05-25 |
| Find all providers in HAMMONTON | ||||
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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.