Katy Trail - Green Ridge R-viii is a medicare enrolled primary clinic (Clinic/center - Federally Qualified Health Center (fqhc)) in Green Ridge, Missouri. The current practice location for Katy Trail - Green Ridge R-viii is 401 W Pettis St, Green Ridge, Missouri. For appointments, you can reach them via phone at
(877) 733-5824. The mailing address for Katy Trail - Green Ridge R-viii is 821 Westwood Dr, Sedalia, Missouri and phone number is (660) 826-4774.
Katy Trail - Green Ridge R-viii is licensed to practice in * (Not Available) (license number ). The clinic also participates in the medicare program and its
NPI number is 1417599556. This medical practice
accepts medicare insurance (which means this clinic accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance). However, please confirm if they accept your insurance at
(877) 733-5824.
Primary Care Clinic Profile
| Full Name | Katy Trail - Green Ridge R-viii |
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| Speciality | Clinic/Center |
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| Location | 401 W Pettis St, Green Ridge, Missouri |
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| Authorized Official Name and Position | Michael Waller (CEO) |
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| Authorized Official Contact | 8777335824 |
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| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
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Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
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Katy Trail - Green Ridge R-viii
821 Westwood Dr
Sedalia
MO 65301-2102
Ph: (660) 826-4774 | Katy Trail - Green Ridge R-viii
401 W Pettis St
Green Ridge
MO 65332-1160
Ph: (877) 733-5824 |
NPI Details:
| NPI Number | 1417599556 |
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| Provider Enumeration Date | 10/10/2019 |
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| Last Update Date | 02/21/2024 |
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Medicare PECOS Information:
| Medicare PECOS PAC ID | 8224926092 |
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| Medicare Enrollment ID | O20200401001100 |
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Medical Identifiers
Medical identifiers for Katy Trail - Green Ridge R-viii such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1417599556 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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