GREAT MINES HEALTH CENTER (NPI# 1922446384) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1922446384 |
| Entity Type | Organization |
| Organization Name | GREAT MINES HEALTH CENTER |
| Practice Address |
508 W Pine St Farmington MO 63640-1426 |
| Practice Telephone | 5736641100 |
| Mailing Telephone | 5736641100 |
| Enumeration Date | 2013-06-07 |
| Last Update Date | 2013-06-07 |
| Authorized Official Name | MR. MICHAEL L JOHNSON (CEO) |
| Authorized Official Telephone | 5734388321 |
| Authorized Official Credential | MBA |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
Ambulatory Health Care Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790332757 | Great Mines Health Center | Clinic/Center | 625 Charlton Avenue, Room 103, Park Hills, MO 63601-9356 | 2019-08-23 |
| 1891341665 | Great Mines Health Center | Clinic/Center | 512 State St Rm 101, Mineral Point, MO 63660-8208 | 2019-08-16 |
| 1922562172 | Great Mines Health Center | Clinic/Center | 10788 State Highway A Rm 128, Richwoods, MO 63071-2548 | 2019-01-22 |
| 1548750847 | Great Mines Health Center | Clinic/Center | 10047 Diamond Rd Rm 809, Cadet, MO 63630-9581 | 2018-05-14 |
| 1669654638 | Great Mines Health Center | Family Medicine | 123 W Pratt St, De Soto, MO 63020-2107 | 2007-12-03 |
| 1376536953 | Great Mines Health Center | Clinic/Center | #1 Southtowne Drive, Potosi, MO 63664-1455 | 2005-08-29 |
| 1801446109 | Great Mines Health Center | Clinic/Center | 206 Church Street, Room4, Leadwood, MO 63653-1132 | 2019-09-18 |
| 1750563722 | Great Mines Health Center | Family Medicine | 530 N Middle St, Farmington, MO 63640-1570 | 2007-12-03 |
| Street Address |
508 W PINE ST |
| City | FARMINGTON |
| State | MO |
| Zip Code | 63640-1426 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316053028 | Gina Heberlie | Nurse Practitioner | 508 W Pine St, Farmington, MO 63640-1426 | 2006-08-23 |
| 1568088045 | Tanner Lorenz | Dentist | 508 W Pine St, Farmington, MO 63640-1426 | 2020-06-22 |
| 1568860641 | Parkcrest Orthopedics LLC | Orthopaedic Surgery | 508 W Pine St, Farmington, MO 63640-1426 | 2014-12-05 |
| 1760754386 | Midwest Health Group, LLC | Non-Pharmacy Dispensing Site | 508 W Pine St, Farmington, MO 63640-1426 | 2012-01-27 |
| 1356629430 | Christine A Herrington | Nurse Practitioner | 508 W Pine St, Farmington, MO 63640-1426 | 2011-07-24 |
| 1841584737 | Charles Justus Elkington | Dentist | 508 W Pine St, Farmington, MO 63640-1426 | 2011-06-08 |
| 1992884183 | Diane Marie Radosevich | Nurse Practitioner | 508 W Pine St, Farmington, MO 63640-1426 | 2006-11-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316545254 | Brenda S Halton | Nurse Practitioner | 1010 West Columbia Street, Farmington, MO 63640 | 2020-10-13 |
| 1619519089 | Stacey Nicole Gillette | Counselor | 17885 Hart Pinkston Rd, Farmington, MO 63640 | 2019-10-17 |
| 1346890696 | Christopher Ryan Massey | Social Worker | 607 Pine St., Farmington, MO 63640 | 2019-09-18 |
| 1457909376 | Clarice Ogden | Social Worker | 203 South Washington Street, Farmington, MO 63640 | 2019-09-04 |
| 1861979718 | Clint Thebeau | In Home Supportive Care | 1276 W Liberty St, Farmington, MO 63640 | 2018-07-24 |
| 1023500600 | Lynn Machelle Knox | Counselor | 219 W Columbia St, Farmington, MO 63640 | 2018-05-31 |
| 1235620576 | Kim Bazzell | Registered Nurse | 1565 Ste. Genevieve Ave., Farmington, MO 63640 | 2018-05-22 |
| 1164919742 | Lincare Inc. | Durable Medical Equipment & Medical Supplies | 774 Market St, Farmington, MO 63640 | 2018-04-18 |
| 1184127813 | Michelle Lynette Corvallis | Chiropractor | 17 South Franklin St., Farmington, MO 63640 | 2018-03-08 |
| 1992206213 | Farmington Vision Care LLC | Optometrist | 110 E Harrison St, Farmington, MO 63640 | 2018-02-22 |
| Find all providers in zip 63640 | ||||
| Taxonomy Code | 261QF0400X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Federally Qualified Health Center (FQHC) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285646455 | Presbyterian Medical Services | Clinic/Center | 1001 W Broadway Ste D&e, Farmington, NM 87401-5638 | 2006-08-13 |
| 1093117251 | Presbyterian Medical Services | Clinic/Center | 744 W Animas St, Farmington, NM 87401-5617 | 2014-09-19 |
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|---|---|---|---|---|
| 1952909079 | Northwest Health Services Inc | Clinic/Center | 202 S East St, Albany, MO 64402-1836 | 2020-10-12 |
| 1912505041 | Northwest Health Services Inc | Clinic/Center | 10500 State Route T, Savannah, MO 64485-2456 | 2020-10-12 |
| 1407469570 | Family Care Health Centers | Clinic/Center | 2717 Sidney Street, St. Louis, MO 63104 | 2020-08-28 |
| 1407478399 | Big Springs Medical Association | Clinic/Center | 2879 James Blvd, Poplar Bluff, MO 63901-3395 | 2020-05-13 |
| 1295356731 | Health Care Coalition of Lafayette County | Clinic/Center | 811 S Business Highway 13, Lexington, MO 64067-1515 | 2020-05-06 |
| 1376164699 | East Central Missouri Behavioral Health Services, Inc | Clinic/Center | 896 S Sturgeon St, Montgomery City, MO 63361-2716 | 2020-04-27 |
| 1750912044 | Northwest Health Services, Inc. | Clinic/Center | 418 E 2nd St, Maryville, MO 64468-1703 | 2020-01-27 |
| 1669003950 | Northwest Health Services, Inc. | Clinic/Center | 525 W South Hills Dr, Maryville, MO 64468-3653 | 2020-01-27 |
| 1063052553 | Compass Health, Inc. | Clinic/Center | 1319 E Highway 24 Ste B, Moberly, MO 65270-3682 | 2020-01-13 |
| 1407490741 | Advocates for A Healthy Community Inc | Clinic/Center | 2238 W Kingsley St, Springfield, MO 65807-5456 | 2019-10-30 |
| Find all providers with the same taxonomy | ||||
| City | FARMINGTON |
| Zip Code | 63640 |
Please comment or provide details below to improve the information on GREAT MINES HEALTH CENTER.
| 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.