NPIMap

Organization Active NPI

Great Mines Health Center

Doing business as Farmington R-VII - Jefferson Elementary

  • Federally Qualified Health Center (FQHC)
  • Farmington, MO
National Provider Identifier
1659946036
Registry record updated Jun 1, 2021
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
Doing business as
Farmington R-VII - Jefferson Elementary
Practice address
9 Summit Dr Ofc B14
Farmington, MO 63640-1641
Phone
(573) 438-9355
NPI assigned
May 26, 2021
Last updated
Jun 1, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 1, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Gregory A RoebackNPI 1033683354
Title
Ceo
Phone
(573) 438-8359

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

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

Addresses

Primary practice location

9 Summit Dr Ofc B14
Farmington, MO 63640-1641

Mailing address

PO Box 761
Potosi, MO 63664-0761
Phone (573) 438-9355

Other names 1

  • Farmington R-VII - Jefferson Elementary Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Great Mines Health Center22 organizations share this tax ID, including this one

Other organizations with this tax ID 21

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

View all 21

Locations

9 Summit Dr
Ofc B14
Farmington, MO 63640

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1621987200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1622505600000",
    "number": "1659946036",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 761",
            "city": "POTOSI",
            "state": "MO",
            "postal_code": "636640761",
            "telephone_number": "573-438-9355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9 SUMMIT DR OFC B14",
            "city": "FARMINGTON",
            "state": "MO",
            "postal_code": "636401641",
            "telephone_number": "573-438-9355"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREAT MINES HEALTH CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-05-26",
        "last_updated": "2021-06-01",
        "certification_date": "2021-06-01",
        "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": "573-438-8359"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Farmington R-VII - Jefferson Elementary",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Farmington, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2021; 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.