MANSFIELD CLINIC, INC. (NPI# 1285687509) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1285687509 |
| Entity Type | Organization |
| Organization Name | MANSFIELD CLINIC, INC. |
| Other Organization Name | PRIME CARE OF AVA |
| Practice Address |
120 Sw 2nd Avenue Ava MO 65608 |
| Mailing Address |
Po Box 108 Mansfield MO 65704-0108 |
| Practice Telephone | 4176836790 |
| Practice Fax Number | 4176836770 |
| Mailing Telephone | 4179243066 |
| Mailing Fax Number | 4179243925 |
| Enumeration Date | 2006-05-18 |
| Last Update Date | 2011-04-21 |
| Authorized Official Name | DR. KENNETH H DUGAN (VICE PRESIDENT) |
| Authorized Official Telephone | 4179243066 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | Y |
| Parent Organization Name | MANSFIELD CLINIC, INC. |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QR1300X |
Clinic/Center Specialization: Rural Health |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MO | 508809506 | 05 |
| Other Name | Type Code |
|---|---|
| PRIME CARE OF AVA | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811036791 | Mansfield Clinic, Inc. | Clinic/Center | 304 West Commercial Street, Mansfield, MO 65704 | 2007-02-06 |
| Street Address |
120 SW 2ND AVENUE |
| City | AVA |
| State | MO |
| Zip Code | 65608 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306326871 | Regional Services | Nurse Practitioner | 507 Ne 3rd St, Ava, MO 65608 | 2018-08-15 |
| 1629558168 | Smith Management Services, LLC | Durable Medical Equipment & Medical Supplies | 916 N.w. Springfield Ave, Suite F, Ava, MO 65608 | 2018-08-15 |
| 1235639592 | Carolyn Marie Myers | Occupational Therapist | 223 South Jefferson Street, Ava, MO 65608 | 2018-02-13 |
| 1114386497 | Judy King | Counselor | 202 Nw Str Str 1, Ava, MO 65608 | 2016-02-16 |
| 1548653009 | Grace Smith | Pharmacist | 124 West Washington Avenue, Ava, MO 65608 | 2015-03-09 |
| 1427397769 | Rebecca L Mcbride | Nurse Practitioner | 120 W Lincoln Ave, Ava, MO 65608 | 2013-02-06 |
| 1154695716 | Medical Equipment Inspection & Repair | Durable Medical Equipment & Medical Supplies | 122 East Washington Ave, Ava, MO 65608 | 2012-02-29 |
| 1932471695 | Lacinda Kaye Higley | Mechanotherapist | 603 North West 10th Ave, Ava, MO 65608 | 2012-01-27 |
| 1972812592 | Douglas County Public Health Services Group, Inc. | Clinic/Center | 603 Nw 10th Ave., Ava, MO 65608 | 2010-09-30 |
| 1013224047 | Family Pharmacy Inc. | Durable Medical Equipment & Medical Supplies | 916 N.w. 12th Ave, Suite F, Ava, MO 65608 | 2010-09-13 |
| Find all providers in zip 65608 | ||||
| Taxonomy Code | 261QR1300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rural Health |
| Definition to come... |
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|---|---|---|---|---|
| 1871102137 | Washington County Memorial Hospital | Clinic/Center | 14206 Hwy C, Belgrade, MO 63622 | 2020-07-23 |
| 1891325072 | Scotland County Memorial Hospital | Clinic/Center | 55682 State Highway 6 Ste A, Edina, MO 63537-4268 | 2020-01-16 |
| 1639736457 | Southeast Health Center of Stoddard County LLC | Clinic/Center | 800 Us Highway 61, New Madrid, MO 63869-1106 | 2019-05-28 |
| 1134633456 | Pike County Memorial Hospital | Clinic/Center | 1420 S Business 61 Unit Fde, Bowling Green, MO 63334-5230 | 2017-11-22 |
| 1720505894 | Perry County Health System | Clinic/Center | 210 Hospital Ln Ste 202, Perryville, MO 63775-4200 | 2017-08-29 |
| 1427572007 | Missouri Delta Medical Center | Clinic/Center | 209 W Yoakum Ave, Chaffee, MO 63740-1138 | 2017-07-26 |
| 1790213676 | Jackson Primary Care LLC | Clinic/Center | 2685 E Main St Ste A, Jackson, MO 63755-2474 | 2017-05-23 |
| 1972050581 | Sgoh Acquisition, Inc. | Clinic/Center | 912b State Highway 59, Goodman, MO 64843-8252 | 2016-09-01 |
| 1144605312 | Nevada City Hospital | Clinic/Center | 627 S Ash St Ste B, Nevada, MO 64772 | 2015-07-29 |
| 1669856829 | Ssm Regional Health Services | Clinic/Center | 2511 W Edgewood Dr Ste F, Jefferson City, MO 65109-5869 | 2015-07-16 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.