| Great Mines Health Center | |
|
#1 Southtowne Drive Potosi MO 63664-1455 | |
| (573) 438-9355 | |
| (573) 438-7892 |
| Full Name | Great Mines Health Center |
|---|---|
| Speciality | Clinic/Center |
| Location | #1 Southtowne Drive, Potosi, Missouri |
| Authorized Official Name and Position | Michael L Johnson (CEO) |
| Authorized Official Contact | 5734389355 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Great Mines Health Center #1 Southtowne Drive Potosi MO 63664-1455 Ph: (573) 438-9355 | Great Mines Health Center #1 Southtowne Drive Potosi MO 63664-1455 Ph: (573) 438-9355 |
| NPI Number | 1376536953 |
|---|---|
| Provider Enumeration Date | 08/29/2005 |
| Last Update Date | 06/23/2009 |
| Medicare PECOS PAC ID | 3072598143 |
|---|---|
| Medicare Enrollment ID | O20041004000035 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1376536953 | NPI | - | NPPES |
| 26-1878 | Other | MO | UNITED GOVERNMENT SERVICE |
| 509215109 | Medicaid | MO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
| Provider Name | Michael P Henry |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1629014766 PECOS PAC ID: 8729984513 Enrollment ID: I20031211000554 |
| Provider Name | Mary Susan Campbell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346321577 PECOS PAC ID: 5698760940 Enrollment ID: I20040416001070 |
| Provider Name | John S Pearson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1639215478 PECOS PAC ID: 5193705192 Enrollment ID: I20040721000793 |
| Provider Name | James D Robart Jr |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1003981895 PECOS PAC ID: 3476533894 Enrollment ID: I20040724000264 |
| Provider Name | John E Emmons |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1437275948 PECOS PAC ID: 7517939010 Enrollment ID: I20040806000111 |
| Provider Name | Shannon M Jennings |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1285715847 PECOS PAC ID: 8224003017 Enrollment ID: I20040826000272 |
| Provider Name | Michael L Yankowitz |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1790719128 PECOS PAC ID: 1456316884 Enrollment ID: I20041129000000 |
| Provider Name | Patricia E Yount |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528067493 PECOS PAC ID: 4486604428 Enrollment ID: I20050127000043 |
| Provider Name | Matthew Gibfried |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1104887728 PECOS PAC ID: 7618985920 Enrollment ID: I20060329000021 |
| Provider Name | Constance Young |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891767125 PECOS PAC ID: 9537168539 Enrollment ID: I20061219000585 |
| Provider Name | Jason Dee Butler |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417073297 PECOS PAC ID: 7113023128 Enrollment ID: I20070509000021 |
| Provider Name | Jill Wolk |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1588725337 PECOS PAC ID: 2062518558 Enrollment ID: I20070605000538 |
| Provider Name | Laura L Lukowski |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1164681755 PECOS PAC ID: 8729142807 Enrollment ID: I20090204000577 |
| Provider Name | Ann Schumacher |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1750322335 PECOS PAC ID: 9537238506 Enrollment ID: I20100130000006 |
| Provider Name | Deirdre L Nivens |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225260532 PECOS PAC ID: 6800931460 Enrollment ID: I20100306000357 |
| Provider Name | Elizabeth Abraham |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1467654293 PECOS PAC ID: 1355466244 Enrollment ID: I20100915000998 |
| Provider Name | Donald J Curran |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1922056746 PECOS PAC ID: 2961315031 Enrollment ID: I20111212000320 |
| Provider Name | John Joseph Grechus |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1831171560 PECOS PAC ID: 1254470438 Enrollment ID: I20111227000533 |
| Provider Name | Moses Tabe Ambilichu |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1073774238 PECOS PAC ID: 8224205307 Enrollment ID: I20120112000211 |
| Provider Name | Osler J Guzon |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1285683888 PECOS PAC ID: 1850467721 Enrollment ID: I20121008000439 |
| Provider Name | Shawn L Geile |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164863775 PECOS PAC ID: 8426292897 Enrollment ID: I20130925000464 |
| Provider Name | Rushaniya A Khairova |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1013243476 PECOS PAC ID: 0648404103 Enrollment ID: I20131016001142 |
| Provider Name | Casey L Eaton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922542943 PECOS PAC ID: 0840571345 Enrollment ID: I20161221000414 |
| Provider Name | Angela M Kearns |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1881089324 PECOS PAC ID: 0547535924 Enrollment ID: I20171011001540 |
| Provider Name | Michelle Hoff |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801336243 PECOS PAC ID: 4486929759 Enrollment ID: I20171012001685 |
| Provider Name | Ashley Reese |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477063253 PECOS PAC ID: 6507124237 Enrollment ID: I20171229000419 |
| Provider Name | Jana Ethel Reid |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033619077 PECOS PAC ID: 7719248434 Enrollment ID: I20180220003130 |
| Provider Name | Syed Noman Zaidi |
|---|---|
| Provider Type | Practitioner - Geriatric Psychiatry |
| Provider Identifiers | NPI Number: 1932549250 PECOS PAC ID: 8527360957 Enrollment ID: I20180609000152 |
| Provider Name | Michelle R Daubendiek |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1154781821 PECOS PAC ID: 2668726746 Enrollment ID: I20181107002919 |
| Provider Name | Shannon M Bay |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992367213 PECOS PAC ID: 8022347285 Enrollment ID: I20190912002764 |
| Provider Name | Emily Morgan Kelley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447893003 PECOS PAC ID: 5799108478 Enrollment ID: I20200714001894 |
| Provider Name | Timothy Will Christopher Bass |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1760914980 PECOS PAC ID: 8325465206 Enrollment ID: I20200825000539 |
| Provider Name | Penny Kaye Grechus |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124648423 PECOS PAC ID: 9931527660 Enrollment ID: I20200914000195 |
| Provider Name | Tabitha Jewel Pinkley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346866316 PECOS PAC ID: 3274951330 Enrollment ID: I20200922001910 |
| Provider Name | Kristin R Jennings |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144831124 PECOS PAC ID: 5890113989 Enrollment ID: I20200922002961 |
| Provider Name | Rackel Elizabeth Sexton-alfaro |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1881232791 PECOS PAC ID: 3971915174 Enrollment ID: I20201211001845 |
| Provider Name | Rachel M Rayburn |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821689910 PECOS PAC ID: 9830507292 Enrollment ID: I20210423000570 |
| Provider Name | Bethany Renae Aubuchon |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1689275992 PECOS PAC ID: 2567865462 Enrollment ID: I20210729003543 |
| Provider Name | Brenda S Halton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316545254 PECOS PAC ID: 6709278732 Enrollment ID: I20220124002424 |
| Provider Name | Jessica Lynn Holland |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184108920 PECOS PAC ID: 1355733346 Enrollment ID: I20220125002326 |
| Provider Name | Emily Mccullough |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730829078 PECOS PAC ID: 9335527191 Enrollment ID: I20220607001217 |
| Provider Name | Rex Dator De Asis |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1891875514 PECOS PAC ID: 6507222593 Enrollment ID: I20230517001906 |
| Provider Name | Heather Renee Mathieson |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1902676810 PECOS PAC ID: 8628420874 Enrollment ID: I20240123004276 |
| Provider Name | Kayla Webb |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1770352882 PECOS PAC ID: 5597118992 Enrollment ID: I20240201003072 |
Austin Plaza Primary Care Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 108 Frizzell St Ste 5, Potosi, MO 63664 Phone: 573-438-8500 Fax: 573-438-8787 | |
Healthway Primary Care Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 200 Health Way Dr, Potosi, MO 63664 Phone: 573-438-2977 Fax: 573-438-2874 | |
Wcmh Urgent Care Clinic Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 300 Health Way Dr, Potosi, MO 63664 Phone: 573-438-5451 | |
Dr. Gregory K. Terpstra D.o., Family Practice, L.l.c. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 612 E High St Ste 210, Potosi, MO 63664 Phone: 573-438-3660 Fax: 573-438-1140 | |
Austin Plaza Primary Care Clinic Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 108 Frizzell Street, Potosi, MO 63664 Phone: 573-438-8500 Fax: 573-438-8787 | |
Midwest Rural Convenient Care Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 612 E High St Ste 110, Potosi, MO 63664 Phone: 573-438-7333 Fax: 573-438-0046 |