MEDICAL CLINIC P.C. (NPI# 1871566265) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1871566265 |
| Entity Type | Organization |
| Organization Name | MEDICAL CLINIC P.C. |
| Practice Address |
313 Main St Sidney IA 51652 |
| Mailing Address |
1219 Main St Hamburg IA 51640-1300 |
| Practice Telephone | 7123742649 |
| Practice Fax Number | 7123742467 |
| Mailing Telephone | 7123822626 |
| Mailing Fax Number | 7123821931 |
| Enumeration Date | 2006-02-08 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | THOMAS HOMER LARGEN (OWNER/PRESIDENT) |
| Authorized Official Telephone | 7123822626 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IA | 0018507 | 05 | |
| IA | WELLMARK BC/BS OF IA | 13046 | 01 |
| IA | 0638338 | 05 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | MEDICAL CLINIC PHARMACY, INC. | 315 E Elm St Ste 150, Caldwell, ID 83605-4864 |
| Street Address |
313 MAIN ST |
| City | SIDNEY |
| State | IA |
| Zip Code | 51652 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992906366 | Faith In Action Volunteers, Inc. | Taxi | 1003 Indiana St., Sidney, IA 51652 | 2007-05-31 |
| 1972643914 | Consultant Pharmacists Inc | Durable Medical Equipment & Medical Supplies | 714 Illinois Street, Sidney, IA 51652 | 2007-02-07 |
| 1265582589 | Fremont County Community Services | Case Manager/Care Coordinator | 414 Clay, Sidney, IA 51652 | 2007-01-11 |
| 1801964739 | David M Dettman | Dentist | 804 Illinois Street, Sidney, IA 51652 | 2006-11-30 |
| 1659395275 | Sidney Csd | Local Education Agency (LEA) | 2754 Knox Rd, Sidney, IA 51652 | 2006-07-27 |
| 1356690887 | Melissa Spencer Marshall | Nurse Practitioner | 802 Illinois St, Sidney, IA 51652 | 2012-08-30 |
| 1700941648 | Shenandoah Medical Center | Clinic/Center | 802 Illinois St, Sidney, IA 51652-0217 | 2006-12-22 |
| 1891137436 | Americare Support Services | Assisted Living Facility | 2009 320th Ave, Sidney, IA 51652-6059 | 2013-07-24 |
| 1427570902 | Katrina Marie-ybay Lerette | Occupational Therapist | 115 Main St, Sidney, IA 51652-6069 | 2017-07-17 |
| 1902811276 | The Ambassador Sidney, Inc. | Occupational Therapist | 115 Main St, Sidney, IA 51652-6069 | 2006-07-29 |
| Find all providers in zip 51652 | ||||
| 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 |
|---|---|---|---|---|
| 1801296843 | Stephen S. Benham,mdpc | Family Medicine | 41a Delaware Ave, Sidney, NY 13838-1336 | 2014-08-27 |
| 1942551106 | Jerome Andrew Kessler | Family Medicine | 214 14th Ave Sw Ste 104, Sidney, MT 59270-3521 | 2012-09-27 |
| 1780965848 | Timothy G. Baumann | Family Medicine | 660 Westover Dr, Sidney, OH 45365-1958 | 2011-09-02 |
| 1720239064 | Rakesh Nanda | Family Medicine | 661 N Vandemark Rd, Sidney, OH 45365-3552 | 2008-10-06 |
| 1285717116 | Carlos F Trevino | Family Medicine | 181 12th Ave Sw, Sidney, MT 59270-3613 | 2006-10-23 |
| 1164523882 | Sidney Medical Group Inc | Family Medicine | 322 Second Avenue, Sidney, OH 45365 | 2006-09-26 |
| 1992800601 | Robert J Miller | Family Medicine | 322 Second Ave, Sidney, OH 45365 | 2006-09-14 |
| 1578571527 | Carl John Cornelius Jr. | Family Medicine | 1116 10th Avenue, Sidney, NE 69162 | 2006-08-04 |
| 1477503928 | Frederick R Simpson | Family Medicine | 1103 Fairington Dr Ste 100, Sidney, OH 45365-8130 | 2006-05-12 |
| 1821064635 | Rebecca L Allard | Family Medicine | 1000 Pole Creek Xing Ste 1, Sidney, NE 69162-2902 | 2006-02-23 |
| Find all providers in SIDNEY | ||||
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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.