MAIN STREET FAMILY MEDICINE ,LLC (NPI# 1922163575) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1922163575 |
| Entity Type | Organization |
| Organization Name | MAIN STREET FAMILY MEDICINE ,LLC |
| Practice Address |
1336 E Main St Columbus OH 43205-2081 |
| Mailing Address |
881 E Main St Columbus OH 43205-1713 |
| Practice Telephone | 6142538537 |
| Practice Fax Number | 6142538539 |
| Mailing Telephone | 6142538537 |
| Mailing Fax Number | 6142538539 |
| Enumeration Date | 2006-12-26 |
| Last Update Date | 2015-05-14 |
| Authorized Official Name | DR. CHANDRE C GOWDA (PHYSICIAN) |
| Authorized Official Telephone | 6142538537 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 35085235 | OH | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OH | 2606415 | 05 |
| Street Address |
1336 E MAIN ST |
| City | COLUMBUS |
| State | OH |
| Zip Code | 43205-2081 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457399131 | Dba East Main Street Pharmacy | Pharmacy | 1336 E Main St, Columbus, OH 43205-2081 | 2006-06-03 |
| 1811596554 | Helen Marie Brushart | Case Manager/Care Coordinator | 1336 E Main St, Columbus, OH 43205-2081 | 2020-10-23 |
| 1013522796 | Ayomide David Gbenro | Case Manager/Care Coordinator | 1336 E Main St, Columbus, OH 43205-2081 | 2020-09-10 |
| 1619587680 | Thaddeus Rashad Gibson | Case Manager/Care Coordinator | 1336 E Main St, Columbus, OH 43205-2081 | 2020-08-05 |
| 1659919637 | Stefan Dunn | Case Manager/Care Coordinator | 1336 E Main St, Columbus, OH 43205-2081 | 2019-12-20 |
| 1568008621 | Helen Cain Jackson | Social Worker | 1336 E Main St, Columbus, OH 43205-2081 | 2019-11-25 |
| 1972154573 | Delbert Christopher Scott | Case Manager/Care Coordinator | 1336 E Main St, Columbus, OH 43205-2081 | 2019-09-25 |
| 1306497912 | Walter Jeffery Brewer | Case Manager/Care Coordinator | 1336 E Main St, Columbus, OH 43205-2081 | 2019-09-25 |
| 1396394441 | Fatma Mohamed Ismail | Case Manager/Care Coordinator | 1336 E Main St, Columbus, OH 43205-2081 | 2019-09-10 |
| 1639723034 | Duane Scott | Case Manager/Care Coordinator | 1336 E Main St, Columbus, OH 43205-2081 | 2019-07-24 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750909404 | Celine Richard | Otolaryngology | Pediatric Ent Department, Nationwide Children's Hospita, 700 Children's Dr., Columbus, OH 43205 | 2020-07-09 |
| 1295351872 | Christina Cotterman | Nurse Practitioner | 700 Children Dr, Columbus, OH 43205 | 2020-06-19 |
| 1740847946 | John M Williamson | Nurse Practitioner | 1441 Phale D. Hale, Columbus, OH 43205 | 2019-05-22 |
| 1811486699 | Kathy L Carter | Case Manager/Care Coordinator | 899 E. Broad Street Ste 150, Columbus, OH 43205 | 2018-05-07 |
| 1174012512 | Erin Crist | Genetic Counselor, MS | 700 Childrens Dr # T4d, Columbus, OH 43205 | 2018-05-01 |
| 1417451782 | Kimberly Banner | Case Manager/Care Coordinator | 1490 E Main Street, Columbus, OH 43205 | 2018-03-21 |
| 1336641539 | Nitisha Y Burkhead | Social Worker | 700 Chidren's Dr., Columbus, OH 43205 | 2018-03-02 |
| 1568981496 | Chris Allen York I | Counselor | 3035 W. Broad Steert, Arizona Counseling & Consultation, Columbus, OH 43205 | 2017-09-12 |
| 1144774407 | Tyler Rolfes | Nurse Practitioner | 444 Butterfly Gardens Dr., Columbus, OH 43205 | 2016-08-04 |
| 1902257876 | George Michael Ziegler | Pediatrics | 611 E Livingston Ave, Section of Neonatology, Columbus, OH 43205 | 2016-06-22 |
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| 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. |
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|---|---|---|---|---|
| 1386252757 | Eventus Wholehealth Midwest Inc | Family Medicine | 2100 Midway St # 3722, Columbus, IN 47201-3722 | 2020-07-21 |
| 1699320705 | Kelly Cephas-hill | Family Medicine | 2339 Linden Ave, Columbus, OH 43211-1631 | 2019-08-06 |
| 1043877962 | 1 On 1 Staffing and Wellness Clinic | Family Medicine | 1315 Delauney Ave Ste 201-a, Columbus, GA 31901-2367 | 2019-05-27 |
| 1952893950 | Midland Medical Group, LLC | Family Medicine | 1000 Georgesville Rd, Columbus, OH 43228 | 2018-06-05 |
| 1134635105 | 138 Med | Family Medicine | 30 Lakeridge Ct, Columbus, GA 31904-1800 | 2017-12-28 |
| 1689193922 | Timothy John Moore | Family Medicine | 180 Reinhard Ave, Columbus, OH 43206-2635 | 2017-09-19 |
| 1013437532 | Mission Medical Associates, Inc. | Family Medicine | 589 Peniel Rd, Columbus, NC 28722 | 2017-06-26 |
| 1942735287 | Dean Fordham | Family Medicine | 6886 Shadybrook Trl, Columbus, GA 31904-3802 | 2017-04-24 |
| 1487188587 | Steven Hanrahan | Family Medicine | 2000 10th Ave Ste 380, Columbus, GA 31901-3709 | 2017-04-14 |
| 1962935866 | Alexandra Blood | Family Medicine | 5868 N Hamilton Rd Ste 200, Columbus, OH 43230-1328 | 2017-04-07 |
| Find all providers in COLUMBUS | ||||
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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.