NPIMap

Organization Active NPI

Mainstreet and Kidsstreet of North Carolina PLLC

Doing business as MainStreet Family Care

  • Rural Health Clinic/Center
  • Liberty, NC
National Provider Identifier
1689460438
Registry record updated Mar 20, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
MAINSTREET AND KIDSSTREET OF NORTH CAROLINA PLLC
Doing business as
MainStreet Family Care
Practice address
246 W Swannanoa Ave
Liberty, NC 27298-3214
Phone
(336) 795-2016
NPI assigned
Apr 17, 2025
Last updated
Mar 20, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 20, 2026

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

Authorized official

Name
Krista Rock
Title
VP
Phone
(205) 545-5090

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X Primary

Addresses

Primary practice location

246 W Swannanoa Ave
Liberty, NC 27298-3214

Mailing address

1500 1St Ave N Unit 3
Birmingham, AL 35203-1866
Phone (205) 545-5085

Other names 1

  • MainStreet Family Care Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20251204001452 NC Part A Provider - Rural Health Clinic 6901290238 Practice locations: Liberty, NC

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1689460438. Details of each certification follow.

Rural health clinic certification: CCN 343899

Legal name
MAINSTREET AND KIDSSTREET OF NORTH CAROLINA PLLC
Doing business as
MAINSTREET FAMILY CARE - LIBERTY
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Dec 31, 2025
Last certification
Dec 31, 2025
Ownership / control type
1B
Organization structure
LLCProprietary
Enrollment address
246 W Swannanoa Ave
Liberty, NC 27298-3214

Other NPIs with the same Medicare PAC ID 8

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Mainstreet and Kidsstreet of North Carolina PLLC35 organizations share this tax ID, including this one

Other organizations with this tax ID 34

Organizations that report the same tax identification number in the National Provider Directory.

View all 34

Ownership & related parties

All disclosed owners & managing parties 2

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Timothy Pattison Taylor Individual 5% Or Greater Direct Ownership Interest Sep 1, 2015 100%
Corporate Officer Sep 4, 2025
Corporate Director Sep 4, 2025
W-2 Managing EmployeeMD; Sep 4, 2025
Rural Urgent Care LLC Organization, Birmingham, AL LLC Operational/Managerial Control Apr 15, 2021 100%

Owners & managing parties with NPI records 22

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

View all 22

Facilities with the same owner 3

Facilities that share an organizational owner with 5% or greater ownership or operational control.

NPI Registry JSON

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

{
    "created_epoch": "1744848000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1773964800000",
    "number": "1689460438",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 1ST AVE N UNIT 3",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352031866",
            "telephone_number": "205-545-5085"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "246 W SWANNANOA AVE",
            "city": "LIBERTY",
            "state": "NC",
            "postal_code": "272983214",
            "telephone_number": "336-795-2016"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAINSTREET AND KIDSSTREET OF NORTH CAROLINA PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-04-17",
        "last_updated": "2026-03-20",
        "certification_date": "2026-03-20",
        "status": "A",
        "authorized_official_last_name": "ROCK",
        "authorized_official_first_name": "KRISTA",
        "authorized_official_title_or_position": "VP",
        "authorized_official_telephone_number": "205-545-5090"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MainStreet Family Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Liberty, NC

Sources for this page

Verify at the official NPI Registry.