| Douglas County Public Health Services Group, Inc. | |
|
804 N Highway 5 Mansfield MO 65704-7301 | |
| (417) 924-8809 | |
| (417) 924-8870 |
| Full Name | Douglas County Public Health Services Group, Inc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 804 N Highway 5, Mansfield, Missouri |
| Authorized Official Name and Position | Richard R Sims (CEO) |
| Authorized Official Contact | 4176834831 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Douglas County Public Health Services Group, Inc. Po Box 257 Mansfield MO 65704-0257 Ph: (417) 924-8809 | Douglas County Public Health Services Group, Inc. 804 N Highway 5 Mansfield MO 65704-7301 Ph: (417) 924-8809 |
| NPI Number | 1912904004 |
|---|---|
| Provider Enumeration Date | 07/05/2005 |
| Last Update Date | 01/09/2008 |
| Medicare PECOS PAC ID | 3072423052 |
|---|---|
| Medicare Enrollment ID | O20050301000128 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1912904004 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
| Provider Name | Ida N Junge |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841283868 PECOS PAC ID: 4789660705 Enrollment ID: I20040629000531 |
| Provider Name | Charlene Bryan Furr |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245285139 PECOS PAC ID: 7810963238 Enrollment ID: I20040908000260 |
| Provider Name | Mina K Higgins |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285721043 PECOS PAC ID: 1456440411 Enrollment ID: I20071129000218 |
| Provider Name | Kathy Domiano |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265627970 PECOS PAC ID: 9335238633 Enrollment ID: I20071210000533 |
| Provider Name | Michael Ball |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1700980174 PECOS PAC ID: 6002995396 Enrollment ID: I20080512000732 |
| Provider Name | Robert C Doneski |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1033245758 PECOS PAC ID: 6204980972 Enrollment ID: I20090814000049 |
| Provider Name | Robert C Nielsen |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1407835085 PECOS PAC ID: 3375710528 Enrollment ID: I20120111000793 |
| Provider Name | Joshua P Wolfe |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1316262280 PECOS PAC ID: 4385878784 Enrollment ID: I20131017000726 |
| Provider Name | Mary K Pendergrass |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1457616872 PECOS PAC ID: 5193966406 Enrollment ID: I20140929002487 |
| Provider Name | Brenda Taylor |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417350380 PECOS PAC ID: 4789909730 Enrollment ID: I20150213001468 |
| Provider Name | Augusta E Hays |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1700986270 PECOS PAC ID: 0345146700 Enrollment ID: I20181106003189 |
| Provider Name | Shari Ranee Cook |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487210969 PECOS PAC ID: 3678808748 Enrollment ID: I20190711001169 |
| Provider Name | Hannah Paul |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1083223101 PECOS PAC ID: 4486072501 Enrollment ID: I20200922000533 |
| Provider Name | Kody Johnson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710559018 PECOS PAC ID: 3971908609 Enrollment ID: I20210818003857 |
| Provider Name | Taylour Paige Emery |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982229381 PECOS PAC ID: 1951708460 Enrollment ID: I20210927001817 |
| Provider Name | Renee Sons |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548783400 PECOS PAC ID: 1052656576 Enrollment ID: I20220413001600 |
| Provider Name | Melissa Dawn Crawford |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801462551 PECOS PAC ID: 0143607655 Enrollment ID: I20220520002059 |
| Provider Name | Sabo Uba |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508106873 PECOS PAC ID: 4385889849 Enrollment ID: I20220603002295 |
| Provider Name | Kaysha Michaele Ousley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295414464 PECOS PAC ID: 8022472620 Enrollment ID: I20230915000383 |
| Provider Name | David Evans |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1194927087 PECOS PAC ID: 4688903677 Enrollment ID: I20250128001874 |
| Provider Name | Carla M Trick |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1891076089 PECOS PAC ID: 3476082868 Enrollment ID: I20250130001076 |
| Provider Name | Shane Rau |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1811925803 PECOS PAC ID: 7113925512 Enrollment ID: I20250208000178 |
Mansfield Chiropractic Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 101b N Business 60, Mansfield, MO 65704 Phone: 417-924-3302 Fax: 417-924-8684 | |
Mansfield Clinic, Inc. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 304 West Commercial Street, Mansfield, MO 65704 Phone: 417-924-3066 Fax: 417-924-3925 |