Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Main Street Medical, PLLC

Organization Specialist · NPI 1417230129

Main Street Medical, PLLC is a Specialist in Ooltewah, Tennessee. Registered with an NPI since 2011.

In the registry since
2011
What do these letters mean?
PLLC — Professional limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

1667 Ooltewah Ringgold Rd
Ooltewah, TN 37363-9830
Phone: (423) 886-7545
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Specialist (primary) Taxonomy 174400000X

Record details

NPI number1417230129
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Paul Miranda — Authorized User · (423) 521-5404
Other names Main Street Medicine; Main Street Medicine
NPI enumeratedSeptember 20, 2011
Last updated in NPPESFebruary 9, 2020
Certification dateFebruary 9, 2020
Mailing address326 Creekshire Dr, Signal Mtn, TN 37377-2086

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