THIRD STREET COMMUNITY CLINIC, INC. (NPI# 1629620109) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629620109 |
| Entity Type | Organization |
| Organization Name | THIRD STREET COMMUNITY CLINIC, INC. |
| Practice Address |
2458 Stetzer Rd Ste A Bucyrus OH 44820-2066 |
| Mailing Address |
600 W 3rd St Mansfield OH 44906-2633 |
| Practice Telephone | 4195226191 |
| Practice Fax Number | 4195256723 |
| Mailing Telephone | 4195226191 |
| Mailing Fax Number | 4195256723 |
| Enumeration Date | 2019-07-15 |
| Last Update Date | 2019-07-15 |
| Authorized Official Name | THERESA JEREMY (CREDENTIALING) |
| Authorized Official Telephone | 4195226191 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Bucyrus Health and Wellness | 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 |
| 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 |
| 1427492271 | Third Street Community Clinic, Inc. | Family Medicine | 2131 Park Ave W, Suite 200, Ontario, OH 44906-1226 | 2013-04-23 |
| 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 |
2458 STETZER RD STE A |
| City | BUCYRUS |
| State | OH |
| Zip Code | 44820-2066 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942744974 | Danielle Nichole Adkins | Counselor | 137 Stetzer Road South, Bucyrus, OH 44820 | 2016-12-09 |
| 1720466576 | Mia Knapp | Licensed Practical Nurse | 3792 Ridgeton-annapolis Rd., Bucyrus, OH 44820 | 2015-05-13 |
| 1275963092 | Teena Lohr | Licensed Practical Nurse | 1493 Rosedale Ave, Bucyrus, OH 44820 | 2013-11-14 |
| 1043646276 | Malinda Elizabeth Wells | Licensed Practical Nurse | 359 Arch Dr, Bucyrus, OH 44820 | 2013-09-19 |
| 1811321409 | Lindsey A Powers | Licensed Practical Nurse | 1387 Rosedale Ave., Bucyrus, OH 44820 | 2013-08-30 |
| 1841539475 | Stephen P Mclaughlin | Counselor | 2458 Stetzer Road, Bucyrus, OH 44820 | 2013-02-01 |
| 1780928788 | Georgette Lynn Ball | Registered Nurse | 1355 Lakewood Drive, Bucyrus, OH 44820 | 2012-11-15 |
| 1114106929 | Glen Arthur Mcmurray | Dentist | 126 Hill Street, Bucyrus, OH 44820 | 2007-10-29 |
| 1427245737 | Assisted Living Concepts Inc | Assisted Living Facility | 1721 Whetstone Street, Bucyrus, OH 44820 | 2007-10-01 |
| 1437364874 | Jason D Mease | Home Health Aide | 718 S Spring, Bucyrus, OH 44820 | 2007-05-11 |
| Find all providers in zip 44820 | ||||
| Taxonomy Code | 261QF0400X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Federally Qualified Health Center (FQHC) |
| Definition to come... |
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| 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.