Meadville Area Free Clinic

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

MEADVILLE AREA FREE CLINIC

Practice address

216 Chestnut Street
Meadville, PA 16335

Phone

(814) 337-7166

Fax

(814) 337-7167

NPI assigned

Jan 10, 2007

Last updated

Aug 22, 2020By 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

Mrs. Jacquelyn A Johnson

Title

Office Manager

Phone

(814) 337-7166

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Constantine Poolos

  • Family Medicine Physician
  • Meadville, PA
  • NPI 1134399140
  NPD (past)

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

{
    "created_epoch": "1168387200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1598814253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1363",
            "city": "MEADVILLE",
            "state": "PA",
            "postal_code": "16335",
            "telephone_number": "814-337-7166",
            "fax_number": "814-337-7167"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "216 CHESTNUT STREET",
            "city": "MEADVILLE",
            "state": "PA",
            "postal_code": "16335",
            "telephone_number": "814-337-7166",
            "fax_number": "814-337-7167"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEADVILLE AREA FREE CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-10",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "JACQUELYN",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "814-337-7166",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BUREAU OF CHARITABLE ORGA",
            "identifier": "14568",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Me Again Boutique
• Mead Avenue Family Dentistry PC
• Anthony Mead, OTR
• Leslie M. Mead, DPT
• Meadville Area Ambulance Service LLC
• Meadville Clinical Pathologists, Inc
• Meadville Counseling Center LLC
• Meadville Diagnostic Medical Imaging Inc
• Meadville Diagnostic Medical Imaging, Inc
• Meadville Emergency Phys PC

• Clinic/Center in Meadville, PA
• Providers in Meadville, PA by specialty
• Clinic/Center in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.