THIRD STREET COMMUNITY CLINIC, INC
NPI 1720407554
Clinic/Center - Federally Qualified Health Center (FQHC) in Mansfield, OH
About Third Street Community Clinic, Inc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
THIRD STREET COMMUNITY CLINIC, INC (NPI 1720407554), doing business as Cline Avenue Health And Wellness, is a healthcare organization registered as a federally qualified health center (fqhc) in Mansfield, Ohio and active in the NPI registry since April 2014. The organization maintains a secondary practice location in Mansfield and lists Peggy Anderson, Ceo, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Names 2
Secondary Practice Location 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment and revalidation status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Third Street Community Clinic, Inc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Revalidation Due Date
Revalidation due by December 31, 2026
Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.
Other Providers at the Same Location NPPES 20
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
MANSFIELD, OH 44907
MANSFIELD, OH 44907
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 Third Street Community Clinic, Inc's NPI number?
The NPI number for Third Street Community Clinic, Inc is 1720407554. It was assigned to this organization in the NPPES registry on April 9, 2014. The provider is doing business as Cline Avenue Health and Wellness and Mansfield Family Health 2.
Where is Third Street Community Clinic, Inc located?
Third Street Community Clinic, Inc is located at 270 Sterkel Blvd Suite A, Mansfield, OH 44907. The listed phone number is (419) 775-1141.
What is Third Street Community Clinic, Inc's specialty?
The primary specialty registered for this NPI is Clinic/Center, specializing in Federally Qualified Health Center (FQHC), with taxonomy code 261QF0400X.
Is Third Street Community Clinic, Inc enrolled in Medicare?
Yes. Third Street Community Clinic, Inc is registered in the Medicare PECOS enrollment system.
When is Third Street Community Clinic, Inc's Medicare revalidation due?
According to the CMS Revalidation Due Date List (October 2026 release), the Medicare Part A enrollment for this organization (Ohio, Federally Qualified Health Center (FQHC)) is due for revalidation by December 31, 2026. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.
What insurance does Third Street Community Clinic, Inc accept?
Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Meridian, Anthem Blue Cross and Blue Shield and CareSource and 2 other insurers list Third Street Community Clinic, Inc 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 Third Street Community Clinic, Inc was last updated on October 19, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 days 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.
# Third Street Community Clinic, Inc · NPI 1720407554
Federally Qualified Health Center (FQHC) organization in Mansfield, Ohio. Organization record, active in the CMS NPPES registry since April 9, 2014.
## Identity
- **NPI:** 1720407554 (Entity type: Organization)
- **Enumerated:** April 9, 2014
- **Primary specialty:** Clinic/Center - Federally Qualified Health Center (FQHC) · taxonomy 261QF0400X
- **Also known as:** Cline Avenue Health and Wellness (Doing Business As); Mansfield Family Health 2 (Doing Business As)
- **Organization subpart:** No
- **Authorized official:** Peggy Anderson, CEO
## Practice location
- **Address:** 270 STERKEL BLVD, SUITE A, Mansfield, OH 44907-1508
- **Phone:** (419) 775-1141 · **Fax:** (419) 525-6723
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Medicare revalidation due:** December 31, 2026 (Part A, Ohio, Federally Qualified Health Center (FQHC)) · CMS Revalidation Due Date List, October 2026 release
## Record status
- **NPPES last updated:** October 19, 2026
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Source: [NPI Profile](https://npiprofile.com/npi/1720407554) · Data from the CMS NPPES public registry.