Jefferson County Fourth Street Health Center

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

License

AN1558329 Issued in OH

Legal business name

JEFFERSON COUNTY FOURTH STREET HEALTH CENTER

Practice address

1 Ross Park Blvd Ste 202
380 Summit Avenue
Steubenville, OH 43952-2671

Phone

(740) 283-2856

NPI assigned

Sep 29, 2014

Last updated

Sep 29, 2014By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ann Quillen

Title

Executive Director

Phone

(740) 283-2856

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1411948800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1411948800000",
    "number": "1255734711",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 ROSS PARK BLVD STE 202",
            "address_2": "380 SUMMIT AVENUE",
            "city": "STEUBENVILLE",
            "state": "OH",
            "postal_code": "439522671",
            "telephone_number": "740-283-2856"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 ROSS PARK BLVD STE 202",
            "address_2": "380 SUMMIT AVENUE",
            "city": "STEUBENVILLE",
            "state": "OH",
            "postal_code": "439522671",
            "telephone_number": "740-283-2856"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JEFFERSON COUNTY FOURTH STREET HEALTH CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-09-29",
        "last_updated": "2014-09-29",
        "status": "A",
        "authorized_official_last_name": "QUILLEN",
        "authorized_official_first_name": "ANN",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "740-283-2856"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "OH",
            "license": "AN1558329",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jefferson Behavioral Health System
• Jefferson Behavioral Health System
• Jefferson County Auditor (Jefferson Co Health Center)
• Jefferson County Board of MRDD
• Jefferson County Educational Service Center
• Conner Jellum, CT
• Shelby Jenkins
• Donna Jensen, DO
• Gretchen Ann Jesick, MD
• Dwight Jeter

• Primary Care Clinic/Center in Steubenville, OH
• Providers in Steubenville, OH by specialty
• Primary Care Clinic/Center in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2014; 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.