FAMILY WALK IN CLINIC OF MOUNTAIN GROVE INC (NPI# 1083705529) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1083705529 |
Entity Type | Organization |
Organization Name | FAMILY WALK IN CLINIC OF MOUNTAIN GROVE INC |
Other Organization Name | FAMILY WALK-IN CLINIC OF MTN. GROVE, INC. |
Practice Address |
205 W 3rd St Ste 3 Mountain Grove MO 65711-1600 |
Practice Telephone | 4179263743 |
Practice Fax Number | 4179267625 |
Mailing Telephone | 4179263743 |
Mailing Fax Number | 4179267625 |
Enumeration Date | 2006-09-28 |
Last Update Date | 2014-11-12 |
Authorized Official Name | DR. KENNETH H DUGAN (VICE-PRESIDENT) |
Authorized Official Telephone | 4179263743 |
Authorized Official Credential | M.D. |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 261QR1300X |
Clinic/Center Specialization: Rural Health |
Ambulatory Health Care Facilities |
State | Issuer | Identifier | Type Code |
---|---|---|---|
MO | 596020800 | 05 | |
MO | RIVERBEND | 263939 | 01 |
Other Name | Type Code |
---|---|
FAMILY WALK-IN CLINIC OF MTN. GROVE, INC. | Doing Business As Name - Organization |
Street Address |
205 W 3RD ST STE 3 |
City | MOUNTAIN GROVE |
State | MO |
Zip Code | 65711-1600 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1093086761 | Christy Lin Bramwell | Nurse Practitioner | 205 W 3rd St Ste 3, Mountain Grove, MO 65711-1600 | 2012-01-26 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1912476300 | Spurling and White LLC | Nurse Practitioner | 100 W. 17th Street, Ste D, Mountain Grove, MO 65711 | 2018-11-15 |
1699255299 | Regional Services | Nurse Practitioner | 320 E 9th St, Mountain Grove, MO 65711 | 2018-08-14 |
1518342153 | Douglas County Public Health Services Group, Inc. | Clinic/Center | 1604 C. North Main Street, Mountain Grove, MO 65711 | 2015-07-24 |
1265754501 | Texas County Memorial Hospital | Clinic/Center | 1905 West 19th Street, Mountain Grove, MO 65711 | 2010-02-26 |
1376679423 | Ozarks Medical Center | Clinic/Center | 500 East 19th Street, Suite A, Mountain Grove, MO 65711 | 2007-02-25 |
1508917949 | Connie Armstrong | Nurse Practitioner | 1604 N. Main, Mountain Grove, MO 65711 | 2007-01-14 |
1659474930 | Cheryl J Bell | Nurse Practitioner | 1602-a N. Main, Mtn. Grove, MO 65711 | 2006-09-05 |
1114035870 | Tommy Dean Todd | Dentist | 901 North Main, Mountain Grove, MO 65711 | 2006-08-25 |
1376505230 | Community Hospices of America, LLC | Hospice Care, Community Based | 1602c N Main St, Mountain Grove, MO 65711 | 2006-04-05 |
1972573699 | Mountain Grove Medical and Laser Center Inc | General Practice | 601 N Busch Ave, Mountain Grove, MO 65711 | 2006-01-25 |
Find all providers in zip 65711 |
Taxonomy Code | 261QR1300X |
Grouping | Ambulatory Health Care Facilities |
Classification | Clinic/Center |
Specialization | Rural Health |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1265754501 | Texas County Memorial Hospital | Clinic/Center | 1905 West 19th Street, Mountain Grove, MO 65711 | 2010-02-26 |
1376679423 | Ozarks Medical Center | Clinic/Center | 500 East 19th Street, Suite A, Mountain Grove, MO 65711 | 2007-02-25 |
1639517832 | Mercy St Francis Hospital | Clinic/Center | 120 W 16th St, Mountain Grove, MO 65711-1039 | 2013-06-10 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1871102137 | Washington County Memorial Hospital | Clinic/Center | 14206 Hwy C, Belgrade, MO 63622 | 2020-07-23 |
1891325072 | Scotland County Memorial Hospital | Clinic/Center | 55682 State Highway 6 Ste A, Edina, MO 63537-4268 | 2020-01-16 |
1639736457 | Southeast Health Center of Stoddard County LLC | Clinic/Center | 800 Us Highway 61, New Madrid, MO 63869-1106 | 2019-05-28 |
1134633456 | Pike County Memorial Hospital | Clinic/Center | 1420 S Business 61 Unit Fde, Bowling Green, MO 63334-5230 | 2017-11-22 |
1720505894 | Perry County Health System | Clinic/Center | 210 Hospital Ln Ste 202, Perryville, MO 63775-4200 | 2017-08-29 |
1427572007 | Missouri Delta Medical Center | Clinic/Center | 209 W Yoakum Ave, Chaffee, MO 63740-1138 | 2017-07-26 |
1790213676 | Jackson Primary Care LLC | Clinic/Center | 2685 E Main St Ste A, Jackson, MO 63755-2474 | 2017-05-23 |
1972050581 | Sgoh Acquisition, Inc. | Clinic/Center | 912b State Highway 59, Goodman, MO 64843-8252 | 2016-09-01 |
1144605312 | Nevada City Hospital | Clinic/Center | 627 S Ash St Ste B, Nevada, MO 64772 | 2015-07-29 |
1669856829 | Ssm Regional Health Services | Clinic/Center | 2511 W Edgewood Dr Ste F, Jefferson City, MO 65109-5869 | 2015-07-16 |
Find all providers with the same taxonomy |
City | MOUNTAIN GROVE |
Zip Code | 65711 |
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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.