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MAIN MEDICAL CLINIC LLC
NPI 1710758966
Nurse Practitioner - Family in Tishomingo, OK

Active since January 15, 2024
108 W MAIN ST, TISHOMINGO, OK 73460(580) 774-3548 Get Directions Write a Review

NPPES record last updated: January 15, 2024. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Main Medical Clinic Llc NPPES

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

MAIN MEDICAL CLINIC LLC (NPI 1710758966), doing business as Main Street Medical, is a healthcare organization registered as a family in Tishomingo, Oklahoma and active in the NPI registry since January 2024. The organization lists Sharon Marshall, Owner, as its authorized official.

NPPES Registry Identity

NPI1710758966
Entity TypeOrganization
Primary Taxonomy363LF0000X
Legal Business NameMAIN MEDICAL CLINIC LLC
Location Address108 W MAIN STTishomingo, OK 73460-1723
Mailing Address108 W Main StTishomingo, OK 73460-1723 · (580) 774-3548
Phone(580) 774-3548
Organization SubpartNo
Authorized OfficialSharon MarshallOwner · (817) 739-5848
Enumeration DateJanuary 15, 2024
NPPES CertifiedJanuary 15, 2024
✔ NPI 1710758966 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
108 W MAIN ST, Tishomingo, OK 73460
Open in Google Maps ↗

Other Names 1

Doing Business AsMain Street Medical

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arkansas Health & Wellness, Ambetter from Home State Health, Ambetter from Sunflower Health Plan and more.Insurance ›

Other Providers at the Same Location NPPES 8

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

MATTIE LYNN RILEY
Case Manager/Care Coordinator
108 W MAIN ST
TISHOMINGO, OK 73460
Johnston County (580) 371-3019
ELLEN CIERRA KLEINERT
Case Manager/Care Coordinator
108 W MAIN ST
TISHOMINGO, OK 73460
Johnston County (903) 267-4283
CHASTITY FAWN BAKEN
Case Manager/Care Coordinator
108 W MAIN ST
TISHOMINGO, OK 73460
Johnston County (580) 371-3019
JENNIFER CHAVEZ
Case Manager/Care Coordinator
108 W MAIN ST
TISHOMINGO, OK 73460
Johnston County (580) 371-3019
ASHLEY NICOLE STITES APRN, CNP
Nurse Practitioner (Family)
108 W MAIN ST
TISHOMINGO, OK 73460
Johnston County (580) 774-3548
CHASE WILLIAM DICKERSON
Case Manager/Care Coordinator
108 W MAIN ST
TISHOMINGO, OK 73460
Johnston County (580) 371-3019
KATELYN BUSH
Counselor (Mental Health)
108 W MAIN ST
TISHOMINGO, OK 73460
Johnston County (580) 371-3019
LIGHTHOUSE BEHAVIORAL WELLNESS CENTERS
Community/Behavioral Health
108 W MAIN ST
TISHOMINGO, OK 73460
Johnston County (580) 371-0011

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 Medical Clinic LLC's NPI number?

The NPI number for Main Medical Clinic LLC is 1710758966. It was assigned to this organization in the NPPES registry on January 15, 2024. The provider is doing business as Main Street Medical.

Where is Main Medical Clinic LLC located?

Main Medical Clinic LLC is located at 108 W Main St, Tishomingo, OK 73460. The listed phone number is (580) 774-3548.

What is Main Medical Clinic LLC's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

What insurance does Main Medical Clinic LLC accept?

Health plans from Ambetter from Arkansas Health & Wellness, Ambetter from Home State Health, Ambetter from Sunflower Health Plan, Ambetter from Superior HealthPlan and Ambetter of Oklahoma and 1 other insurer list Main Medical Clinic LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Main Medical Clinic LLC was last updated on January 15, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.