Organization Active NPI

Main Street Family Practice, Inc

  • Family Medicine Physician
  • Logan, WV
National Provider Identifier
1073542809
Registry record updated Apr 24, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
016632 Issued in WV
Legal business name
MAIN STREET FAMILY PRACTICE, INC
Practice address
533 Main St
Logan, WV 25601-3809
Phone
(304) 752-3400
Fax
(304) 752-8138
NPI assigned
Jul 2, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Kenneth Sells, DO
Title
President
Phone
(304) 752-3400

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X 016632 WV Primary

Addresses

Primary practice location

533 Main St
Logan, WV 25601-3809

Mailing address

533 Main St
Logan, WV 25601-3809
Phone (304) 752-3400

National Provider Directory

National Provider Directory

Locations

204 Main St
Ste 204
Logan, WV 25601
Phone (304) 752-3400

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1151798400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1776988800000",
    "number": "1073542809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "533 MAIN ST",
            "city": "LOGAN",
            "state": "WV",
            "postal_code": "256013809",
            "telephone_number": "304-752-3400",
            "fax_number": "304-752-8138"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "533 MAIN ST",
            "city": "LOGAN",
            "state": "WV",
            "postal_code": "256013809",
            "telephone_number": "304-752-3400",
            "fax_number": "304-752-8138"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAIN STREET FAMILY PRACTICE, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-02",
        "last_updated": "2026-04-24",
        "certification_date": "2026-04-24",
        "status": "A",
        "authorized_official_last_name": "SELLS",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "304-752-3400",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "WV",
            "license": "016632",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Logan, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.