| Tcmh - Mountain Grove Clinic | |
|
1905 West 19th Street Mountain Grove MO 65711 | |
| (417) 926-1770 | |
| (417) 926-1785 |
| Full Name | Tcmh - Mountain Grove Clinic |
|---|---|
| Speciality | Clinic/Center |
| Location | 1905 West 19th Street, Mountain Grove, Missouri |
| Authorized Official Name and Position | Linda J. Pamperien (CHIEF FINANCIAL OFFICER) |
| Authorized Official Contact | 4179673311 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Tcmh - Mountain Grove Clinic 1905 West 19th Street Mountain Grove MO 65711 Ph: (417) 926-1770 | Tcmh - Mountain Grove Clinic 1905 West 19th Street Mountain Grove MO 65711 Ph: (417) 926-1770 |
| NPI Number | 1285957001 |
|---|---|
| Provider Enumeration Date | 03/08/2010 |
| Last Update Date | 09/16/2010 |
| Medicare PECOS PAC ID | 9436041696 |
|---|---|
| Medicare Enrollment ID | O20100813000720 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285957001 | NPI | - | NPPES |
| 1285957001 | Medicaid | MO | |
| 26D2006074 | Other | MO | CLIA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
| Provider Name | Jose A Atiles |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1871580241 PECOS PAC ID: 2860398708 Enrollment ID: I20031229000096 |
| Provider Name | Christopher O Baldwin |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1164483921 PECOS PAC ID: 3173629961 Enrollment ID: I20070511000351 |
| Provider Name | Jennifer A Groner |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1598978710 PECOS PAC ID: 6507918471 Enrollment ID: I20090723000641 |
| Provider Name | Jessica Renee King |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1649434200 PECOS PAC ID: 6608907977 Enrollment ID: I20100630000472 |
| Provider Name | Elton W Hoerning |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1629142476 PECOS PAC ID: 3971637604 Enrollment ID: I20100817001294 |
| Provider Name | Sara A Openshaw |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467822650 PECOS PAC ID: 3971813668 Enrollment ID: I20151109002357 |
| Provider Name | Charles C Scott |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1871635730 PECOS PAC ID: 1153626346 Enrollment ID: I20160225002269 |
| Provider Name | Sheena C Painter |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760834378 PECOS PAC ID: 9032403233 Enrollment ID: I20160811000254 |
| Provider Name | Lynsey R Sullivan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417492539 PECOS PAC ID: 1951684851 Enrollment ID: I20170217001991 |
| Provider Name | Christy Lin Bramwell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093086761 PECOS PAC ID: 6204091804 Enrollment ID: I20170417001598 |
| Provider Name | Samantha D Welch |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932734092 PECOS PAC ID: 7517397573 Enrollment ID: I20200415002855 |
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 | |
Family Walk-in Clinic Of Mtn. Grove, Inc. 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 | |
Tcmh - Mountain Grove Clinic Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1905 West 19th Street, Mountain Grove, MO 65711 Phone: 417-926-1770 Fax: 417-926-1785 | |
Ozarks Healthcare Mountain Grove 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 | |
Mercy Clinic Family Medicine-mountain Grove Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 120 W 16th St, Mountain Grove, MO 65711 Phone: 417-926-6111 Fax: 417-926-6115 | |
Missouri Ozarks Community Health 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 |