| Texas County Memorial Hospital | |
| 
					1905 West 19th Street Mountain Grove MO 65711  | |
| (417) 926-1770 | |
| (417) 926-1785 | 
| Full Name | Texas County Memorial Hospital | 
|---|---|
| Speciality | Clinic/Center | 
| Location | 1905 West 19th Street, Mountain Grove, Missouri | 
| Authorized Official Name and Position | Linda J. Pamperien (CHIEF FINANCIAL OFFICER) | 
| Authorized Official Contact | 4179673311 | 
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. | 
| Mailing Address | Practice Location Address | 
|---|---|
| Texas County Memorial Hospital 1905 West 19th Street Mountain Grove MO 65711 Ph: (417) 926-1770  | Texas County Memorial Hospital 1905 West 19th Street Mountain Grove MO 65711 Ph: (417) 926-1770  | 
| NPI Number | 1285957001 | 
|---|---|
| Provider Enumeration Date | 03/08/2010 | 
| Last Update Date | 09/16/2010 | 
| Medicare PECOS PAC ID | 9436041696 | 
|---|---|
| Medicare Enrollment ID | O20100813000720 | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1285957001 | NPI | - | NPPES | 
| 1285957001 | Medicaid | MO | |
| 26D2006074 | Other | MO | CLIA | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary | 
| Provider Name | Jose A Atiles | 
|---|---|
| Provider Type | Practitioner - General Practice | 
| Provider Identifiers | NPI Number: 1871580241 PECOS PAC ID: 2860398708 Enrollment ID: I20031229000096  | 
| Provider Name | Christopher O Baldwin | 
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology | 
| Provider Identifiers | NPI Number: 1164483921 PECOS PAC ID: 3173629961 Enrollment ID: I20070511000351  | 
| Provider Name | Jennifer A Groner | 
|---|---|
| Provider Type | Practitioner - Family Practice | 
| Provider Identifiers | NPI Number: 1598978710 PECOS PAC ID: 6507918471 Enrollment ID: I20090723000641  | 
| Provider Name | Jessica Renee King | 
|---|---|
| Provider Type | Practitioner - Family Practice | 
| Provider Identifiers | NPI Number: 1649434200 PECOS PAC ID: 6608907977 Enrollment ID: I20100630000472  | 
| Provider Name | Elton W Hoerning | 
|---|---|
| Provider Type | Practitioner - Family Practice | 
| Provider Identifiers | NPI Number: 1629142476 PECOS PAC ID: 3971637604 Enrollment ID: I20100817001294  | 
| Provider Name | Sara A Openshaw | 
|---|---|
| Provider Type | Practitioner - Nurse Practitioner | 
| Provider Identifiers | NPI Number: 1467822650 PECOS PAC ID: 3971813668 Enrollment ID: I20151109002357  | 
| Provider Name | Charles C Scott | 
|---|---|
| Provider Type | Practitioner - Family Practice | 
| Provider Identifiers | NPI Number: 1871635730 PECOS PAC ID: 1153626346 Enrollment ID: I20160225002269  | 
| Provider Name | Sheena C Painter | 
|---|---|
| Provider Type | Practitioner - Nurse Practitioner | 
| Provider Identifiers | NPI Number: 1760834378 PECOS PAC ID: 9032403233 Enrollment ID: I20160811000254  | 
| Provider Name | Lynsey R Sullivan | 
|---|---|
| Provider Type | Practitioner - Nurse Practitioner | 
| Provider Identifiers | NPI Number: 1417492539 PECOS PAC ID: 1951684851 Enrollment ID: I20170217001991  | 
| Provider Name | Christy Lin Bramwell | 
|---|---|
| Provider Type | Practitioner - Nurse Practitioner | 
| Provider Identifiers | NPI Number: 1093086761 PECOS PAC ID: 6204091804 Enrollment ID: I20170417001598  | 
| Provider Name | Samantha D Welch | 
|---|---|
| Provider Type | Practitioner - Nurse Practitioner | 
| Provider Identifiers | NPI Number: 1932734092 PECOS PAC ID: 7517397573 Enrollment ID: I20200415002855  | 
Mountain Grove Medical And Laser Center Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 601 N Busch Ave, Mountain Grove, MO 65711 Phone: 417-926-6643 Fax: 417-926-6317  | |
Family Walk In Clinic Of Mountain Grove Inc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 205 W 3rd St Ste 3, Mountain Grove, MO 65711 Phone: 417-926-3743 Fax: 417-926-7625  | |
Texas County Memorial Hospital Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1905 West 19th Street, Mountain Grove, MO 65711 Phone: 417-926-1770 Fax: 417-926-1785  | |
Ozarks Medical Center Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 500 E 19th St, Mountain Grove, MO 65711 Phone: 417-926-6563 Fax: 417-926-5820  | |
Mercy Clinic Springfield Communities Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 120 W 16th St, Mountain Grove, MO 65711 Phone: 417-926-6111 Fax: 417-926-6115  | |
Douglas County Public Health Services Group, Inc. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1604 C. North Main Street, Mountain Grove, MO 65711 Phone: 417-926-1713 Fax: 417-926-1209  |