THIRD STREET COMMUNITY CLINIC, INC. (NPI# 1649599119) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1649599119 |
| Entity Type | Organization |
| Organization Name | THIRD STREET COMMUNITY CLINIC, INC. |
| Other Organization Name | THIRD STREET OB/GYN |
| Practice Address |
770 Balgreen Drive Suite 207 Mansfield OH 44906-2633 |
| Mailing Address |
600 W 3rd St Mansfield OH 44906-2633 |
| Practice Telephone | 4195226800 |
| Practice Fax Number | 4195226816 |
| Mailing Telephone | 4195226191 |
| Mailing Fax Number | 4195220493 |
| Enumeration Date | 2010-05-24 |
| Last Update Date | 2019-01-15 |
| Authorized Official Name | MR. JARED POLLICK (CEO) |
| 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 |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OH | 3111957 | 05 |
| Other Name | Type Code |
|---|---|
| Cornerstone OB/GYN | Doing Business As Name - Organization |
| Third Street OB/GYN | 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 |
| 1427492271 | Third Street Community Clinic, Inc. | Family Medicine | 2131 Park Ave W, Suite 200, Ontario, OH 44906-1226 | 2013-04-23 |
| 1336252519 | Third Street Community Clinic, Inc. | Clinic/Center | 600 W. Third Street, Mansfield, OH 44906-2633 | 2006-08-15 |
| Street Address |
770 BALGREEN DRIVE SUITE 207 |
| City | MANSFIELD |
| State | OH |
| Zip Code | 44906-2633 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497818058 | Patti A Sprang | Nurse Practitioner | 770 Balgreen Drive, Cornestone Ob Gyn Inc Suite 207, Mansfield, OH 44906 | 2006-12-18 |
| 1699151555 | Jacob Kessler | Nurse Practitioner | 770 Balgreen Drive, Suite #209, Mansfield, OH 44906-0770 | 2015-08-03 |
| 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... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336411156 | Third Street Community Clinic, Inc | Clinic/Center | 741 Scholl Rd Ste A, Mansfield, OH 44907-1571 | 2012-02-09 |
| 1912904004 | Douglas County Public Health Services Group, Inc. | Clinic/Center | 804 N Highway 5, Mansfield, MO 65704-7301 | 2005-07-05 |
| 1306499314 | Third Street Community Clinic, Inc. | Clinic/Center | 205 W Cook Rd, Mansfield, OH 44907-2405 | 2019-07-18 |
| 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 |
| 1285942284 | Council for Advancement of Social Service and Education | Clinic/Center | 907 Polk St, Mansfield, LA 71052-2520 | 2010-09-24 |
| 1548594526 | Third Street Dental Mobile Van | Clinic/Center | 600 W 3rd St, Mansfield, OH 44906-2633 | 2009-09-24 |
| 1750461455 | North Penn Comprehensive Health Services | Clinic/Center | 416 S Main St, Mansfield Laurel Health Center, Mansfield, PA 16933-1510 | 2006-10-17 |
| 1336252519 | Third Street Community Clinic, Inc. | Clinic/Center | 600 W. Third Street, Mansfield, OH 44906-2633 | 2006-08-15 |
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|---|---|---|---|---|
| 1699380725 | Family Health Services of Erie County | Clinic/Center | 209 Lowell St, Castalia, OH 44824-9332 | 2020-09-15 |
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| 1669087649 | Community Health Centers of Greater Dayton | Clinic/Center | 2900 Shiloh Springs Rd, Ste Studio A, Trotwood, OH 45426-2139 | 2020-09-15 |
| 1639783996 | Erie County Office of Auditor | Clinic/Center | 34 Executive Dr Ste A, Norwalk, OH 44857-2490 | 2020-09-03 |
| 1083231872 | Health Partners of Western Ohio | Clinic/Center | 550 S Collett St Ste 1, Lima, OH 45805-3210 | 2020-06-29 |
| 1366068405 | Muskingum Valley Health Centers | Clinic/Center | 225 W Union Ave Ste 100, West Lafayette, OH 43845-1150 | 2020-06-24 |
| 1205452331 | Muskingum Valley Health Centers | Clinic/Center | 58601 Marietta Rd Ste 100, Byesville, OH 43723-9452 | 2020-06-24 |
| 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.