<unavail> in Mountain Grove, MO - Medicare Clinic/Center

is a medicare enrolled primary clinic (Clinic/center - Rural Health) in Mountain Grove, Missouri. The current practice location for is 120 W 16th St, Mountain Grove, Missouri. For appointments, you can reach them via phone at (417) 926-6111. The mailing address for is 645 Maryville Centre Dr Fl 3, Saint Louis, Missouri and phone number is (417) 820-7133.

is licensed to practice in Missouri (license number ). The clinic also participates in the medicare program and its NPI number is 1457480188. This medical practice accepts medicare insurance (which means this clinic accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance). However, please confirm if they accept your insurance at (417) 926-6111.

Contact Information


	120 W 16th St Mountain Grove MO 65711
	(417) 926-6111
	(417) 926-6115

Map and Direction

Primary Care Clinic Profile

Full Name
Speciality	Clinic/Center
Location	120 W 16th St, Mountain Grove, Missouri
Authorized Official Name and Position	Robert Cavagnol (CHIEF PHYSICIAN OFFICER)
Authorized Official Contact	4178202705
Accepts Medicare Insurance	Yes. This clinic participates in medicare program and accept medicare insurance.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
645 Maryville Centre Dr Fl 3 Saint Louis MO 63141-5855 Ph: (417) 820-7133	120 W 16th St Mountain Grove MO 65711 Ph: (417) 926-6111

NPI Details:

NPI Number	1457480188
Provider Enumeration Date	03/06/2007
Last Update Date	12/04/2018

Medicare PECOS Information:

Medicare PECOS PAC ID	7416865845
Medicare Enrollment ID	O20081029000377

Medical Identifiers

Medical identifiers for such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1457480188	NPI	-	NPPES
597932300	Medicaid	MO

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
207Q00000X	Family Medicine	R9C21 (Missouri)	Secondary
261QR1300X	Clinic/center - Rural Health	(Missouri)	Primary
363LF0000X	Nurse Practitioner - Family	130675 (Missouri)	Secondary
363LF0000X	Nurse Practitioner - Family	119291 (Missouri)	Secondary

Reviews and Comments

Clinic/Center in Mountain Grove, MO

Mountain Grove Medical And Laser Center Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 601 N Busch Ave, Mountain Grove, MO 65711 Phone: 417-926-6643 Fax: 417-926-6317
Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 205 W 3rd St Ste 3, Mountain Grove, MO 65711 Phone: 417-926-3743 Fax: 417-926-7625
Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1905 West 19th Street, Mountain Grove, MO 65711 Phone: 417-926-1770 Fax: 417-926-1785
Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1905 West 19th Street, Mountain Grove, MO 65711 Phone: 417-926-1770 Fax: 417-926-1785
Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 500 East 19th Street, Suite A, Mountain Grove, MO 65711 Phone: 417-926-6563 Fax: 417-926-5820
Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1604 C. North Main Street, Mountain Grove, MO 65711 Phone: 417-926-1713 Fax: 417-926-1209

- Medicare Primary Care in Mountain Grove, MO