NPIMap

Organization Active NPI

Great Mines Health Center

  • Federally Qualified Health Center (FQHC)
  • Park Hills, MO
National Provider Identifier
1497478283
Registry record updated Sep 26, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
GREAT MINES HEALTH CENTER
Practice address
412 W Fite St RM 5
Park Hills, MO 63601-3712
Phone
(573) 438-9355
NPI assigned
Sep 26, 2022
Organization subpart
No

Authorized official

NPPES NPI Registry
Name
Gregory A Roeback
Title
Ceo
Phone
(573) 438-8380

Corporate family (same tax ID) 21

Organizations that report the same tax identification number in the National Provider Directory.

View all 21

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

National Provider Directory

National Provider Directory
Tax ID family
Great Mines Health Center (22 organizations share this tax ID)

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X Primary

Addresses

NPPES NPI Registry

Primary practice location

412 W Fite St RM 5
Park Hills, MO 63601-3712

Mailing address

1 Southtowne Dr
Potosi, MO 63664-5729

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Sep 26, 2022.

{
    "created_epoch": "1664150400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1664150400000",
    "number": "1497478283",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 SOUTHTOWNE DR",
            "city": "POTOSI",
            "state": "MO",
            "postal_code": "636645729"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "412 W FITE ST RM 5",
            "city": "PARK HILLS",
            "state": "MO",
            "postal_code": "636013712",
            "telephone_number": "573-438-9355"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREAT MINES HEALTH CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-09-26",
        "last_updated": "2022-09-26",
        "certification_date": "2022-09-22",
        "status": "A",
        "authorized_official_last_name": "ROEBACK",
        "authorized_official_first_name": "GREGORY",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "573-438-8380"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Park Hills, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.