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MAIN STREET MEDICINE
NPI 1417230129
Specialist in Ooltewah, TN

Active since September 20, 2011
1667 OOLTEWAH RINGGOLD RD, OOLTEWAH, TN 37363(423) 886-7545 Get Directions Write a Review

NPPES record last updated: February 9, 2020. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Main Street Medicine NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MAIN STREET MEDICINE (NPI 1417230129) is a healthcare organization registered as a specialist in Ooltewah, Tennessee and active in the NPI registry since September 2011. The organization lists Paul A Miranda, Authorized User, as its authorized official.

NPPES Registry Identity

NPI1417230129
Entity TypeOrganization
Primary Taxonomy174400000X
Legal Business NameMAIN STREET MEDICAL, PLLC
Location Address1667 OOLTEWAH RINGGOLD RDOoltewah, TN 37363-9830
Mailing Address326 Creekshire DrSignal Mtn, TN 37377-2086 · (423) 243-8196 · Fax (417) 429-2893
Phone(423) 886-7545
Organization SubpartNo
Authorized OfficialPaul A MirandaAuthorized User · (423) 521-5404
Enumeration DateSeptember 20, 2011
Last NPPES UpdateFebruary 9, 2020
✔ NPI 1417230129 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySpecialistOther Service Providers
Taxonomy Code174400000X
Definition
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
1667 OOLTEWAH RINGGOLD RD, Ooltewah, TN 37363
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Other Names 1

Doing Business AsMain Street Medicine

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Other Providers at the Same Location NPPES 4

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

CROSSROADS CLINIC PLLC
Nurse Practitioner (Primary Care)
1667 OOLTEWAH RINGGOLD RD, SUITE 111
OOLTEWAH, TN 37363
Hamilton County (423) 825-4881
K-VA-T FOOD STORES INC
Pharmacy (Community/Retail Pharmacy)
1667 OOLTEWAH RINGGOLD RD
OOLTEWAH, TN 37363
Hamilton County (423) 893-1917
MICHAEL D BOOTH RPH
Pharmacist
1667 OOLTEWAH RINGGOLD RD
OOLTEWAH, TN 37363
Hamilton County (423) 893-6275
DR. DANIEL JAMES PLATT PHARM. D.
Pharmacist
1667 OOLTEWAH RINGGOLD RD
OOLTEWAH, TN 37363
Hamilton County (423) 893-6275

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Main Street Medical, PLLC's NPI number?

The NPI number for Main Street Medical, PLLC is 1417230129. It was assigned to this organization in the NPPES registry on September 20, 2011. The provider is doing business as Main Street Medicine.

Where is Main Street Medical, PLLC located?

Main Street Medical, PLLC is located at 1667 Ooltewah Ringgold Rd, Ooltewah, TN 37363. The listed phone number is (423) 886-7545.

What is Main Street Medical, PLLC's specialty?

The primary specialty registered for this NPI is Specialist with taxonomy code 174400000X.

When was this NPI record last updated?

The NPPES record for Main Street Medical, PLLC was last updated on February 9, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.