GREAT MINES HEALTH CENTER (NPI# 1376536953) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1376536953 |
| Entity Type | Organization |
| Organization Name | GREAT MINES HEALTH CENTER |
| Practice Address |
#1 Southtowne Drive Potosi MO 63664-1455 |
| Practice Telephone | 5734389355 |
| Practice Fax Number | 5734387892 |
| Mailing Telephone | 5734389355 |
| Mailing Fax Number | 5734387892 |
| Enumeration Date | 2005-08-29 |
| Last Update Date | 2009-06-23 |
| Authorized Official Name | MR. MICHAEL L JOHNSON (CEO) |
| Authorized Official Telephone | 5734389355 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MO | 509215109 | 05 | |
| MO | UNITED GOVERNMENT SERVICE | 26-1878 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790332757 | Great Mines Health Center | Clinic/Center | 625 Charlton Avenue, Room 103, Park Hills, MO 63601-9356 | 2019-08-23 |
| 1891341665 | Great Mines Health Center | Clinic/Center | 512 State St Rm 101, Mineral Point, MO 63660-8208 | 2019-08-16 |
| 1922562172 | Great Mines Health Center | Clinic/Center | 10788 State Highway A Rm 128, Richwoods, MO 63071-2548 | 2019-01-22 |
| 1548750847 | Great Mines Health Center | Clinic/Center | 10047 Diamond Rd Rm 809, Cadet, MO 63630-9581 | 2018-05-14 |
| 1669654638 | Great Mines Health Center | Family Medicine | 123 W Pratt St, De Soto, MO 63020-2107 | 2007-12-03 |
| 1801446109 | Great Mines Health Center | Clinic/Center | 206 Church Street, Room4, Leadwood, MO 63653-1132 | 2019-09-18 |
| 1922446384 | Great Mines Health Center | Clinic/Center | 508 W Pine St, Farmington, MO 63640-1426 | 2013-06-07 |
| 1750563722 | Great Mines Health Center | Family Medicine | 530 N Middle St, Farmington, MO 63640-1570 | 2007-12-03 |
| Street Address |
#1 SOUTHTOWNE DRIVE |
| City | POTOSI |
| State | MO |
| Zip Code | 63664-1455 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083017461 | Carolyn Coyne Maryan | Specialist/Technologist | 400 Mine St., Citadel School, Potosi, MO 63664 | 2014-09-30 |
| 1205073665 | Potosi Chiropractic Life Center | Chiropractor | 502 North Missouri St., Potosi, MO 63664 | 2009-01-07 |
| 1932385952 | Simpelo Medical Clinic, P.C. | Internal Medicine | 108 Frizzell, Suite 6, Potosi, MO 63664 | 2008-01-22 |
| 1760696918 | Brett T Snodgrass | General Practice | 1 Southtowne Dr., Great Mines Health Center, Potosi, MO 63664 | 2007-05-09 |
| 1710032297 | Washington County Handicapped Services Adult Day Health Care | Day Training, Developmentally Disabled Services | 10604 West Highway E, Potosi, MO 63664 | 2007-01-24 |
| 1578629473 | Greenlee Chiropractic Inc. | Chiropractor | Greenlee Chiropractic, 417 East High St, Potosi, MO 63664 | 2006-12-28 |
| 1003981895 | James Daley Robart Jr. | Chiropractor | 912 N Missouri St, Potosi, MO 63664 | 2006-11-21 |
| 1225063407 | Seth Paskon | Internal Medicine | Potosi Medical Clinic, #1 Kwan Plaza, Potosi, MO 63664 | 2006-07-12 |
| 1346295607 | Donna Yates | Nurse Practitioner | 600 Purcell Dr, Suite B, Potosi, MO 63664 | 2006-05-24 |
| 1467424788 | Washington County Memorial Hospital | Clinic/Center | 108 Frizzell Street, Potosi, MO 63664 | 2006-02-02 |
| Find all providers in zip 63664 | ||||
| Taxonomy Code | 261QF0400X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Federally Qualified Health Center (FQHC) |
| Definition to come... |
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| 1063052553 | Compass Health, Inc. | Clinic/Center | 1319 E Highway 24 Ste B, Moberly, MO 65270-3682 | 2020-01-13 |
| 1407490741 | Advocates for A Healthy Community Inc | Clinic/Center | 2238 W Kingsley St, Springfield, MO 65807-5456 | 2019-10-30 |
| Find all providers with the same taxonomy | ||||
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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.