| South Central Missouri Community Health Center | |
|
1081 E 18th St Rolla MO 65401-2448 | |
| (573) 426-2407 | |
| Not Available |
| Full Name | South Central Missouri Community Health Center |
|---|---|
| Speciality | Clinic/Center |
| Location | 1081 E 18th St, Rolla, Missouri |
| Authorized Official Name and Position | Elizabeth Sparks (HR MANAGER) |
| Authorized Official Contact | 5734262407 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| South Central Missouri Community Health Center 1081 E 18th St Rolla MO 65401-2448 Ph: (573) 426-2407 | South Central Missouri Community Health Center 1081 E 18th St Rolla MO 65401-2448 Ph: (573) 426-2407 |
| NPI Number | 1164669172 |
|---|---|
| Provider Enumeration Date | 01/13/2009 |
| Last Update Date | 02/06/2023 |
| Medicare PECOS PAC ID | 1355513581 |
|---|---|
| Medicare Enrollment ID | O20111013000097 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164669172 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
| Provider Name | Dawn R Tope |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366644320 PECOS PAC ID: 9335047901 Enrollment ID: I20031222000266 |
| Provider Name | Shaundelle A Olusanya |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801090444 PECOS PAC ID: 3779481650 Enrollment ID: I20031230000298 |
| Provider Name | Debra A Mccaul |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1376692939 PECOS PAC ID: 1153300033 Enrollment ID: I20040714001610 |
| Provider Name | Tony Lam |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1093742314 PECOS PAC ID: 4284603176 Enrollment ID: I20040928000486 |
| Provider Name | Oluyomi Olusanya |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1457302937 PECOS PAC ID: 7315996394 Enrollment ID: I20050117000467 |
| Provider Name | Kimberly D Johnson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1396717104 PECOS PAC ID: 9032186036 Enrollment ID: I20060818000019 |
| Provider Name | Sonja Williams |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1609836857 PECOS PAC ID: 3870590946 Enrollment ID: I20061102000305 |
| Provider Name | Yvonne M Prince |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1538150222 PECOS PAC ID: 7618012055 Enrollment ID: I20100309000891 |
| Provider Name | Patrick Sporleder |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1922099506 PECOS PAC ID: 6406992445 Enrollment ID: I20101011000658 |
| Provider Name | Elaine Briggs |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700105673 PECOS PAC ID: 1456545326 Enrollment ID: I20101104000750 |
| Provider Name | Michaela Muehlbach |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1083921381 PECOS PAC ID: 3971741836 Enrollment ID: I20130604000879 |
| Provider Name | Katie E Cameron |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1942511753 PECOS PAC ID: 5597993410 Enrollment ID: I20140122000706 |
| Provider Name | Shawna R Middleton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104104090 PECOS PAC ID: 7911177282 Enrollment ID: I20140403001343 |
| Provider Name | Nancy S Brown |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558347666 PECOS PAC ID: 0648588988 Enrollment ID: I20151006001164 |
| Provider Name | Alexis R West |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083083042 PECOS PAC ID: 7618286592 Enrollment ID: I20151015000275 |
| Provider Name | Sean L Harris |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356696942 PECOS PAC ID: 9739302357 Enrollment ID: I20161018000801 |
| Provider Name | Matthew T Porter |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1477791606 PECOS PAC ID: 4880827252 Enrollment ID: I20161018002934 |
| Provider Name | Mandi Nicole Parks |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760966188 PECOS PAC ID: 9638413925 Enrollment ID: I20181127001566 |
| Provider Name | Barbara A Appleman Graham |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922566777 PECOS PAC ID: 9032451018 Enrollment ID: I20190423000222 |
| Provider Name | Johnnie W Parker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073051942 PECOS PAC ID: 5597710699 Enrollment ID: I20190509002556 |
| Provider Name | Amanda Stites |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508510298 PECOS PAC ID: 0042605115 Enrollment ID: I20220328002087 |
| Provider Name | Elizabeth A Bland |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306568738 PECOS PAC ID: 8729455894 Enrollment ID: I20221102000344 |
| Provider Name | Jordan C Calabrese |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1366949976 PECOS PAC ID: 7810379104 Enrollment ID: I20231016000400 |
| Provider Name | Hallie Davis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366283269 PECOS PAC ID: 5698216422 Enrollment ID: I20240920000735 |
| Provider Name | Dawn Cavender-erangey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548921943 PECOS PAC ID: 6305370412 Enrollment ID: I20241112003948 |
| Provider Name | Mary Kathleen Zielke |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467841338 PECOS PAC ID: 2365767704 Enrollment ID: I20250409000278 |
| Provider Name | Margaret Ann Matlock |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427680008 PECOS PAC ID: 6305276338 Enrollment ID: I20250609000314 |
Goodman Medical Center Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 715 State Route Cc, Rolla, MO 65401 Phone: 573-308-5044 Fax: 573-341-5300 | |
Pcrmc Medical Group, Inc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1050 W 10th St, Rolla, MO 65401 Phone: 573-364-9000 Fax: 573-458-3952 | |
Phelps County Regional Medical Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1000 W 10th St, Rolla, MO 65401 Phone: 573-458-8899 | |
Miracl, Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1000 W 10th St, Rolla, MO 65401 Phone: 573-364-9000 | |
Choudhrymd, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 604 W 6th St, Rolla, MO 65401 Phone: 573-202-3969 Fax: 573-341-8581 | |
South Central Missouri Community Health Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 200 N Main St, Suite 51g, Rolla, MO 65401 Phone: 573-426-6712 Fax: 573-426-6735 |