- Medicare Primary Care in Mansfield, MO

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is a medicare enrolled primary clinic (Clinic/center - Federally Qualified Health Center (fqhc)) in Mansfield, Missouri. The current practice location for is 804 N Highway 5, Mansfield, Missouri. For appointments, you can reach them via phone at (417) 924-8809. The mailing address for is Po Box 257, Mansfield, Missouri and phone number is (417) 924-8809.

is licensed to practice in * (Not Available) (license number ). The clinic also participates in the medicare program and its NPI number is 1912904004. 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) 924-8809.

Contact Information

804 N Highway 5
Mansfield
MO 65704-7301
(417) 924-8809
(417) 924-8870

Map and Direction


Primary Care Clinic Profile

Full Name
SpecialityClinic/Center
Location804 N Highway 5, Mansfield, Missouri
Authorized Official Name and PositionRichard R Sims (CEO)
Authorized Official Contact4176834831
Accepts Medicare InsuranceYes. This clinic participates in medicare program and accept medicare insurance.

Mailing Address and Practice Location

Mailing AddressPractice Location Address

Po Box 257
Mansfield
MO 65704-0257

Ph: (417) 924-8809
804 N Highway 5
Mansfield
MO 65704-7301

Ph: (417) 924-8809

NPI Details:

NPI Number1912904004
Provider Enumeration Date07/05/2005
Last Update Date01/09/2008

Medicare PECOS Information:

Medicare PECOS PAC ID3072423052
Medicare Enrollment IDO20050301000128

Medical Identifiers

Medical identifiers for such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1912904004NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
261QF0400XClinic/center - Federally Qualified Health Center (fqhc) (* (Not Available))Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. acts as a billing entity for following providers:
Provider NameIda N Junge
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1841283868
PECOS PAC ID: 4789660705
Enrollment ID: I20040629000531
Provider NameCharlene Bryan Furr
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1245285139
PECOS PAC ID: 7810963238
Enrollment ID: I20040908000260
Provider NameMina K Higgins
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1285721043
PECOS PAC ID: 1456440411
Enrollment ID: I20071129000218
Provider NameKathy Domiano
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1265627970
PECOS PAC ID: 9335238633
Enrollment ID: I20071210000533
Provider NameMichael Ball
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1700980174
PECOS PAC ID: 6002995396
Enrollment ID: I20080512000732
Provider NameRobert C Nielsen
Provider TypePractitioner - Obstetrics/gynecology
Provider IdentifiersNPI Number: 1407835085
PECOS PAC ID: 3375710528
Enrollment ID: I20120111000793
Provider NameJoshua P Wolfe
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1316262280
PECOS PAC ID: 4385878784
Enrollment ID: I20131017000726
Provider NameMary K Pendergrass
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1457616872
PECOS PAC ID: 5193966406
Enrollment ID: I20140929002487
Provider NameBrenda Taylor
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1417350380
PECOS PAC ID: 4789909730
Enrollment ID: I20150213001468
Provider NameAugusta E Hays
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1700986270
PECOS PAC ID: 0345146700
Enrollment ID: I20181106003189
Provider NameHannah Paul
Provider TypePractitioner - Clinical Social Worker
Provider IdentifiersNPI Number: 1083223101
PECOS PAC ID: 4486072501
Enrollment ID: I20200922000533
Provider NameKody Johnson
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1710559018
PECOS PAC ID: 3971908609
Enrollment ID: I20210818003857
Provider NameTaylour Paige Emery
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1982229381
PECOS PAC ID: 1951708460
Enrollment ID: I20210927001817
Provider NameRenee Sons
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1548783400
PECOS PAC ID: 1052656576
Enrollment ID: I20220413001600
Provider NameMelissa Dawn Crawford
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1801462551
PECOS PAC ID: 0143607655
Enrollment ID: I20220520002059
Provider NameSabo Uba
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1508106873
PECOS PAC ID: 4385889849
Enrollment ID: I20220603002295
Provider NameKaysha Michaele Ousley
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1295414464
PECOS PAC ID: 8022472620
Enrollment ID: I20230915000383

Reviews and Comments


Clinic/Center in Mansfield, MO

Mansfield Chiropractic Center
Primary Care Clinic
Medicare: Not Enrolled in Medicare
Practice Location: 101b N Business 60, Mansfield, MO 65704
Phone: 417-924-3302    Fax: 417-924-8684
Mansfield Clinic, Inc.
Primary Care Clinic
Medicare: Medicare Enrolled
Practice Location: 304 West Commercial Street, Mansfield, MO 65704
Phone: 417-924-3066    Fax: 417-924-3925

Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.