Main Street Family Practice Inc

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

MAIN STREET FAMILY PRACTICE INC

Practice address

9000 North Main Street
Suite 403
Dayton, OH 45415-1180

Phone

(937) 836-5171

Fax

(937) 832-0728

NPI assigned

Jan 9, 2007

Organization subpart

No

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

Authorized official

Name

Martin K Fujimura, MD

Title

President

Phone

(937) 836-5171

Specialties & licenses 1

Addresses

Other identifiers 2

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 2

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

• Carmelite Ruskowski

  • Adult Medicine Physician
  • Kettering, OH
  • NPI 1871238592
  NPD
• Elliot B Davidson, MD

  • Family Medicine Physician
  • Akron, OH
  • NPI 1215043807
  NPD (past)

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

{
    "created_epoch": "1168300800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1093864035",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9000 NORTH MAIN STREET",
            "address_2": "SUITE 403",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454151180",
            "telephone_number": "937-836-5171",
            "fax_number": "937-832-0728"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9000 NORTH MAIN STREET",
            "address_2": "SUITE 403",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454151180",
            "telephone_number": "937-836-5171",
            "fax_number": "937-832-0728"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAIN STREET FAMILY PRACTICE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-09",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "FUJIMURA",
        "authorized_official_first_name": "MARTIN",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "937-836-5171",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "OH",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS",
            "identifier": "00000013156",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0668433",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Andrew Maigur, MD
• Henry N Maimon, M.D.
• Walter Ned Maimon, M.D.
• Main Home Healthcare Services LLC
• Main Medical Supply
• Carol Marie Maines, APRN
• Rachael Mainord, MPH
• Gianni Paul Maione, MD
• Abby Maiorano, PTA
• Rakesia Major, SOCIAL WORKER

• Family Medicine Physician in Dayton, OH
• Providers in Dayton, OH by specialty
• Family Medicine Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.