CASPER Report 0006D Name and Address Listing For Rural Health Clinic

Run Date: 10/08/2015
Job # 41303463
Last Update: 10/07/2015
Page 1 of 2
CASPER Report 0006D
Name and Address Listing
For Rural Health Clinic
Based on Current Survey
Maine
CCN
Provider Name
Address
City, State and ZIP
Telephone # County Name
208502
ACADIA FAMILY HEALTH CENTER
460 MAIN STREET SUITE 104
MADAWASKA, ME 04756
(207)728-6359
Aroostook
203849
ARNOLD MEMORIAL MEDICAL CENTER
70 SNARE CREEK LANE
JONESPORT, ME 04649
(207)497-5614
Washington
203983
ARTHUR JEWELL COMMUNITY HEALTH CENTER 55 REYNOLDS RD
BROOKS, ME 04921
(207)338-2500
Waldo
208509
CALAIS REGIONAL MEDICAL SERVICES
37 PALMER STREET, SUITE 3
CALAIS, ME 04619
(207)454-8195
Washington
208522
CORINTH MEDICAL ASSOCIATES
492 MAIN STREET
CORINTH, ME 04427
(207)285-3312
Penobscot
203835
DEXTER FAMILY HEALTH
51 HIGH STREET SUITE A
DEXTER, ME 04930
(207)924-7349
Penobscot
203992
DEXTER INTERNAL MEDICINE
41 HIGH ST
DEXTER, ME 04930
(207)924-5226
Penobscot
203993
DOVER-FOXCROFT FAMILY PRACTICE
891 W MAIN ST
DOVER FOXCROFT, ME 04426
(207)924-3424
Piscataquis
203988
ELSEMORE-DIXFIELD FAMILY MEDICINE
146 WELD STREET
DIXFIELD, ME 04224
(207)562-4226
Oxford
203881
FAMILY MEDICINE
6 FACTORY RD
EAST MACHIAS, ME 04630
(207)255-3338
Washington
203890
FAMILY PLANNING ASSOCIATION OF MAINE INC 147 WALDO AVE
BELFAST, ME 04915
(207)338-3736
Waldo
203889
FULL CIRCLE HEALTH CARE, LLC
1063 ALLAGASH RD
ALLAGASH, ME 04774
(207)398-1022
Aroostook
203994
GUILFORD MEDICAL ASSOCIATES
3 PARK ST
GUILFORD, ME 04443
(207)876-3547
Piscataquis
208501
HOULTON FAMILY PRACTICE
20 HARTFORD ST
HOULTON, ME 04730
(207)532-3289
Aroostook
203825
ISLESBORO HEALTH CENTER
150 MAIN ROAD
ISLESBORO, ME 04848
(207)734-2213
Waldo
203975
LMP FAMILY CARE CENTER
19 ST ANDREWS LANE
BOOTHBAY HARBOR, ME 04538
(207)633-7820
Lincoln
208510
LMP FAMILY MEDICINE DAMARISCOTTA
79 SCHOONER STREET
DAMARISCOTTA, ME 04543
(207)563-4321
Lincoln
208511
LMP FAMILY MEDICINE WALDOBORO
592 WEST MAIN STREET
WALDOBORO, ME 04572
(207)832-6394
Lincoln
208507
MILBRIDGE MEDICAL CENTER (RHC)
5 SCHOOL ST
MILBRIDGE, ME 04658
(207)546-2391
Washington
208521
MILLINOCKET FAMILY MEDICINE RHC
200 SOMERSET STREET, SUITE 3
MILLINOCKET, ME 04462
(207)723-5161
Penobscot
208520
MILLINOCKET PRIMARY CARE RHC
200 SOMERSET STREET
MILLINOCKET, ME 04462
(207)723-5173
Penobscot
203991
MILO FAMILY PRACTICE
135 PARK STREET - PO BOX 7
MILO, ME 04463
(207)943-7752
Piscataquis
208513
N M M C MEDICAL OFFICE BUILDING
194 E. MAIN ST.
FORT KENT, ME 04743
(207)834-3155
Aroostook
208504
NEW HORIZONS HEALTHCARE
80 MAIN ST
UNITY, ME 04988
(207)984-2100
Waldo
208506
NEW HORIZONS HEALTHCARE
344 LAKEWOOD ROAD
MADISON, ME 04950
(207)474-2994
Somerset
208505
NEW HORIZONS HEALTHCARE
167 MAIN STREET
NORTH ANSON, ME 04958
(207)635-2330
Somerset
203857
NEWPORT FAMILY PRACTICE
26 MAIN STREET, SUITE 2, PO BOX J
NEWPORT, ME 04953
(207)368-5747
Penobscot
203987
NORTHWOODS HEALTHCARE
PRITHAM AVE
GREENVILLE, ME 04441
(207)695-2084
Piscataquis
208517
OXFORD HILLS FAMILY PRACTICE
34 WINTER ST
NORWAY, ME 04268
(207)743-8031
Oxford
208516
PENOBSCOT VALLEY PRIMARY CARE
252 ENFIELD RD SUITE 2
LINCOLN, ME 04457
(207)794-3321
Penobscot
208515
RIVER VALLEY INTERNAL MEDICINE
431 FRANKLIN STREET
RUMFORD, ME 04276
(207)269-1032
Oxford
203839
SEAPORT FAMILY PRACTICE, P A
41 WIGHT ST
BELFAST, ME 04915
(207)338-6900
Waldo
208514
SEBASTICOOK VALLEY HEALTH
470 SOMERSET AVE
PITTSFIELD, ME 04967
(207)487-5141
Somerset
208508
SIGRID E TOMPKINS HEALTH CENTER
20 HARTFORD STREET
HOULTON, ME 04730
(207)532-2234
Aroostook
208512
STATION HILL MEDICAL OFFICE BUILDING
104 EAST MAIN STREET
FORT KENT, ME 04743
(207)834-3101
Aroostook
Run Date: 10/08/2015
Job # 41303463
Last Update: 10/07/2015
Page 2 of 2
CASPER Report 0006D
Name and Address Listing
For Rural Health Clinic
Based on Current Survey
Maine
CCN
Provider Name
Address
City, State and ZIP
Telephone # County Name
203985
MILL ROAD PO BOX 309
STOCKTON SPRINGS, ME 04981
(207)567-4000
Waldo
203989
STOCKTON SPRINGS REGIONAL HEALTH
CENTER
SWIFT RIVER HEALTH CARE
430 FRANKLIN ST
RUMFORD, ME 04276
(207)369-0146
Oxford
208503
VALLEY MEDICAL ASSOCIATION
194 E MAIN ST
FORT KENT, ME 04743
(207)834-5877
Aroostook
208518
WESTERN MAINE FAMILY PRACTICE
193 MAIN STREET
NORWAY, ME 04268
(207)743-9292
Oxford
208519
WESTERN MAINE PEDIATRICS
193 MAIN STREET
NORWAY, ME 04268
(207)743-8766
Oxford
Total Providers for this State = 40
Run Date: 10/08/2015
Job # 41303463
Last Update: 10/07/2015
Page 1 of 1
CASPER Report 0006D
Name and Address Listing
For Rural Health Clinic
Based on Current Survey
Massachusetts
CCN
Provider Name
Address
City, State and ZIP
Telephone # County Name
223800
ISLAND HEALTH CARE
245 VINEYARD HAVEN ROAD
EDGARTOWN, MA 02539
(508)693-5090
Total Providers for this State = 1
Dukes
Run Date: 10/08/2015
Job # 41303463
Last Update: 10/07/2015
Page 1 of 1
CASPER Report 0006D
Name and Address Listing
For Rural Health Clinic
Based on Current Survey
New Hampshire
CCN
Provider Name
Address
City, State and ZIP
Telephone # County Name
303992
ANTRIM MEDICAL GROUP
12 ELM ST
ANTRIM, NH 03440
(603)588-4200
Hillsboro
303989
COTTAGE HOSPITAL INTERNAL MEDICINE
79 SWIFTWATER RD, SUITE 2
WOODSVILLE, NH 03785
(603)747-2900
Grafton
303816
DARTMOUTH HITCHCOCK PLYMOUTH
71 HIGHLAND STREET
PLYMOUTH, NH 03264
(603)536-3700
Grafton
303984
NEWFOUND FAMILY PRACTICE
5 SCHOOL STREET
BRISTOL, NH 03222
(603)744-5441
Grafton
303978
NEWPORT HEALTH CENTER
11 JOHN STARK HIGHWAY
NEWPORT, NH 03773
(603)863-4100
Sullivan
303988
NORTH COUNTRY PRIMARY CARE
580 ST JOHNSBURY RD
LITTLETON, NH 03561
(603)444-7070
Grafton
303990
PLYMOUTH OB/GYN
16 HOSPITAL RD
PLYMOUTH, NH 03264
(603)536-1104
Grafton
303814
SACO RIVER MEDICAL GROUP
7 GREENWOOD AVENUE
CONWAY, NH 03818
(603)447-3500
Carroll
303987
SPEARE PRIMARY CARE
103 BOULDER POINTE DR
PLYMOUTH, NH 03264
(603)536-6355
Grafton
303991
WEEKS MEDICAL CENTER
43 MAIN STREET
NORTH STRATFORD, NH 03590
(603)922-5039
Coos
303977
WEEKS MEDICAL CENTER - GROVETON
47 CHURCH STREET
GROVETON, NH 03582
(603)788-2521
Coos
303975
WEEKS MEDICAL CENTER - LANCASTER
170 MIDDLE STREET
LANCASTER, NH 03584
(603)788-2521
Coos
303976
WEEKS MEDICAL CENTER WHITEFIELD
8 CLOVER LANE
WHITEFIELD, NH 03598
(603)837-9005
Coos
303980
WESTSIDE HEALTH CARE
125 SOUTH MAIN STREET
FRANKLIN, NH 03235
(603)934-4259
Merrimack
Total Providers for this State = 14
Run Date: 10/08/2015
Job # 41303463
Last Update: 10/07/2015
Page 1 of 1
CASPER Report 0006D
Name and Address Listing
For Rural Health Clinic
Based on Current Survey
Vermont
CCN
Provider Name
Address
City, State and ZIP
Telephone # County Name
473824
COLD HOLLOW FAMILY PRACTICE
84 WATER TOWER ROAD
ENOSBURG FALLS, VT 05450
(802)933-6664
Franklin
473981
GRACE COTTAGE FAMILY HEALTH
185 GRAFTON RD, PO BOX 216
TOWNSHEND, VT 05353
(802)365-4331
Windham
473829
MOUNTAIN VALLEY MEDICAL CLINIC
PO BOX 310 38 ROUTE 11
LONDONDERRY, VT 05148
(802)824-6901
Windham
473982
NORTH COUNTRY OB/GYN SERVICES
81 MEDICAL VILLAGE DRIVE SUITE 2
NEWPORT, VT 05855
(802)334-5007
Orleans
473814
NORTH COUNTRY PEDIATRICS
121 MEDICAL VILLAGE DRIVE
NEWPORT, VT 05855
(802)334-5929
Orleans
473979
NORTH COUNTRY PRIMARY CARE NEWPORT
186 MEDICAL VILLAGE DRIVE
NEWPORT, VT 05855
(802)334-3522
Orleans
473988
NVRH CORNER MEDICAL
195 INDUSTRIAL PARKWAY
LYNDONVILLE, VT 05851
(802)748-9501
Caledonia
473991
NVRH KINGDOM INTERNAL MEDICINE
714 BREEZY HILL ROAD
SAINT JOHNSBURY, VT 05819
(802)748-7500
Caledonia
473989
NVRH ST JOHNSBURY PEDIATRICS
97 SHERMAN DRIVE
SAINT JOHNSBURY, VT 05819
(802)748-5131
Caledonia
473992
NVRH-WOMENS WELLNESS CENTER
1315 HOSPITAL DRIVE
SAINT JOHNSBURY, VT 05819
(802)748-7520
Caledonia
473827
RYDER BROOK PEDIATRICS
PO BOX 608
MORRISVILLE, VT 05661
(802)888-2448
Lamoille
473987
THE BARTON HEALTH CLINIC
488 ELM STREET
BARTON, VT 05822
(802)525-3539
Orleans
Total Providers for this State = 12
Run Date: 10/08/2015
Job # 41303463
Last Update: 10/07/2015
Page 1 of 1
CASPER Report 0006D
Name and Address Listing
For Rural Health Clinic
Based on Current Survey
New York
CCN
Provider Name
Address
City, State and ZIP
Telephone # County Name
333805
COMMUNITY HEALTH CENTER
2 MAIN STREET
CHERRY VALLEY, NY 13320
(607)264-3036
Otsego
333835
FAMILY HEALTH CENTER OF CMH - HAMILTON
164 BROAD STREET
HAMILTON, NY 13346
(315)824-8447
Madison
333834
FAMILY HEALTH CENTER OF CMH MORRISVILLE
FAMILY HEALTH CENTER OF CMH WATERVILLE
GREENVILLE FAMILY HEALTH CARE CENTER
3460 SOUTH STREET
MORRISVILLE, NY 13408
(315)684-9848
Madison
117 WEST MAIN STREET
WATERVILLE, NY 13480
(315)841-4566
Oneida
20 BRYANT'S COUNTRY SQUARE, ROUTE 32
GREENVILLE, NY 12083
(518)966-8786
Greene
333833
333831
333803
TRI-COUNTY FAMILY COHOCTON
PARK AVENUE
COHOCTON, NY 14826
(518)384-5310
Steuben
333829
TRI-COUNTY FAMILY MEDICINE
RED JACKET STREET BOX 339
DANSVILLE, NY 14437
(585)335-6041
Livingston
333808
TRI-COUNTY FAMILY NUNDA
61 NORTH STATE STREET
NUNDA, NY 14517
(585)468-2528
Livingston
333830
TRI-COUNTY FAMILY WAYLAND
106 SOUTH LACKAWANA STREET
WAYLAND, NY 14572
(585)728-5131
Steuben
Total Providers for this State = 9
Run Date: 10/08/2015
Job # 41303463
Last Update: 10/07/2015
Page 1 of 3
CASPER Report 0006D
Name and Address Listing
For Rural Health Clinic
Based on Current Survey
Pennsylvania
CCN
Provider Name
Address
City, State and ZIP
Telephone # County Name
393899
AC VALLEY MEDICAL CENTER
855 ROUTE 58 SUITE 1
PARKER, PA 16049
(724)659-5601
Armstrong
393414
ALLEGHENY HEALTH CENTER
22 INDUSTRIAL PARK ROAD
BROOKVILLE, PA 15825
(814)849-0990
Jefferson
393977
ARMSTRONG PRIMARY CARE CENTER
116 MAIN STREET
LEECHBURG, PA 15656
(412)845-1211
Armstrong
393428
260 SOUTH JEFFERSON STREET
KITTANNING, PA 16201
(724)543-5919
Armstrong
10261 STATE ROUTE 85
KITTANNING, PA 16201
(412)783-7124
Armstrong
102 SOUTH STREET
NEW BETHLEHEM, PA 16242
(814)275-2264
Clarion
393416
ARMSTRONG PRIMARY CARE CENTER KITTANING
ARMSTRONG PRIMARY CARE CENTER - RURAL
VALLEY
ARMSTRONG PRIMARY CARE CENTER SOUTH
BETHLEHEM
BOWMAN HEALTH CENTER
83 SOUTH MARVIN STREET
SMETHPORT, PA 16749
(814)887-5395
Mckean
393422
BRMC FAMILY PRACTICE
116 INTERSTATE PARKWAY, SUITE 41
BRADFORD, PA 16701
(814)363-9484
Mckean
393421
406 FRANKLIN STREET
SMETHPORT, PA 16749
(717)999-9999
Mckean
116 INTERESTATE PARKWAY 42
BRADFORD, PA 16701
(717)999-9999
Mckean
393913
BRMC RURAL HEALTH CLINIC SMETHPORT
FAMILY MEDICINE
BRMC RURAL HLTH CLINIC PEDIATRIC ASSOC
OF BRADFORD
CAMBRIDGE SPRINGS HEALTH CENTER
118 RAILROAD STREET
CAMBRIDGE SPRINGS, PA 16403
(814)398-4313
Crawford
393921
CARING HEALTHCARE NETWORK
601 NORTH FRONT STREET
PHILIPSBURG, PA 16866
(814)342-2333
Centre
393418
CENTRAL POTTER HEALTH CENTER
71 ELK STREET
COUDERSPORT, PA 16915
(814)274-5577
Potter
393855
COMMUNITY HEALTH CARE
550 W WALNUT STREET
SHAMOKIN, PA 17872
(717)644-2222
Northumberland
393922
1611 W PITT STREET
JENNERSTOWN, PA 15547
(717)999-9999
Somerset
207 WOODSTOWN HIGHWAY
HOLLSOPPLE, PA 15935
(814)479-4034
Somerset
393898
CONEMAUGH HEALTH INITIATIVES RURAL
HEALTH CLINIC
CONEMAUGH HEALTH INITIATIVES RURAL
HEALTH CLINIC
CONNEAUT LAKE HEALTH CENTER
10926 ST HWY 18
CONNEAUT LAKE, PA 16316
(814)382-0446
Crawford
393800
CONNEAUT VALLEY HEALTH CENTER
906 WASHINGTON STREET
CONNEAUTVILLE, PA 16406
(814)373-2276
Crawford
393920
40 WEST FRACK STREET
FRACKVILLE, PA 17931
(570)794-6123
Schuylkill
393989
CORNERSTONE COORDINATED HEALTH CARE
LLC
COUDERSPORT FAMILY MEDICINE
1001 EAST SECOND STREET SUITE S
COUDERSPORT, PA 16915
(814)274-9198
Potter
393910
CRESSON FAMILY PRACTICE RHC
225 KEYSTONE AVENUE
CRESSON, PA 16630
(814)886-4635
Cambria
393992
ELDERTON PRIMARY CARE CENTER
116 MAIN STREET BOX 148
ELDERTON, PA 15736
(412)354-5258
Armstrong
393978
ELDRED HEALTH CENTER
139 MAIN STREET
ELDRED, PA 16731
(814)225-4241
Mckean
393415
393894
393420
393923
393975
EMPORIUM HEALTH CENTER
288 SIZERVILLE ROAD
EMPORIUM, PA 15834
(814)486-0810
Cameron
393918
83 HILLCREST DRIVE, SUITE 200
PUNXSUTAWNEY, PA 15767
(814)938-3550
Jefferson
393410
FAMILY HEALTH CARE CENTER OF
PUNXSUTAWNEY INC
FAMILY HEALTH CARE MEYERSDALE RHC
7160 MASON DIXON HIGHWAY
MEYERSDALE, PA 15552
(814)634-5935
Somerset
393409
FAMILY HEALTH CARE SALISBURY RHC
231 ORD STREET
SALISBURY, PA 15558
(814)662-2755
Somerset
393413
FAMILY HEALTH CLINIC OF BARNES KASSON
HOSPITAL
FAMILY HEALTH CLINIC OF BARNES-KASSON
137 DELAWARE STREET
NEW MILFORD, PA 18834
(570)465-7330
Susquehanna
2872 TURNPIKE STREET
SUSQUEHANNA, PA 18847
(717)999-9999
Susquehanna
FAMILY HEALTH CLINIC OF BARNES-KASSON
HOSPITAL
GALETON HEALTH CENTER
401 BROAD AVENUE
SUSQUEHANNA, PA 18847
(717)853-3995
Susquehanna
30 RIVER STREET
GALETON, PA 16922
(814)435-2942
Potter
393419
393407
393994
Run Date: 10/08/2015
Job # 41303463
Last Update: 10/07/2015
Page 2 of 3
CASPER Report 0006D
Name and Address Listing
For Rural Health Clinic
Based on Current Survey
Pennsylvania
CCN
Provider Name
Address
City, State and ZIP
Telephone # County Name
393429
HAVEN CENTER FOR WOMEN'S HEALTH
24 CREE DRIVE THIRD FLOOR
LOCK HAVEN, PA 17745
(570)893-5043
Clinton
393423
HAVEN MEDICAL CENTER
208 E CHURCH STREET
LOCK HAVEN, PA 17745
(717)999-9999
Clinton
393871
HIGHLAND PHYSICIANS INC
1839 FAIR AVENUE
HONESDALE, PA 18431
(570)251-6500
Wayne
393902
4324 GLADES PIKE
SOMERSET, PA 15501
(814)445-4585
Somerset
393893
HIGHLANDS FAMILY MEDICINE RURAL HEALTH
CLINIC
HUNTINGDON HEALTHCARE INC
814 WASHINGTON STREET
HUNTINGDON, PA 16652
(814)643-4415
Huntingdon
393873
JOHN E BALMER D O CANADOHTA
35255 BROWN HILL ROAD
UNION CITY, PA 16438
(814)694-2339
Erie
393884
JUNIATA VALLEY MEDICAL CENTER INC
PO BOX 355 846 MEDICAL CENTER
ALEXANDRIA, PA 16611
(814)669-4444
Huntingdon
393911
MEADVILLE COMMUNITY HEALTH CENTER
747 TERRACE STREET
MEADVILLE, PA 16335
(814)373-2976
Crawford
393821
MEDICAL ASSOCIATES OF BOSWELL
136 PINE STREET BOX 340
STOYSTOWN, PA 15563
(814)893-5568
Somerset
393820
MEDICAL ASSOCIATES OF BOSWELL
430 STONYCREEK STREET
BOSWELL, PA 15531
(814)629-5612
Somerset
393986
MERCER FAMILY MEDICINE CENTER
551 GREENVILLE ROAD
MERCER, PA 16137
(412)662-4155
Mercer
393857
MILLER DONMOYER FAMILY HEALTH CENTER
255 WEST SPRUCE STREET
SHAMOKIN, PA 17872
(717)644-5050
Northumberland
393886
MOUNT UNION AREA MEDICAL CENTE
100 SOUTH PARK STREET
MT UNION, PA 17066
(814)542-8627
Huntingdon
393426
NATHAN THOMAS PRACTICE
312 INDUSTRIAL PARK ROAD
MEYERSDALE, PA 15552
(814)634-5954
Somerset
393901
NEW PARIS RURAL HEALTH CLINIC
4186 CORTLAND AVENUE
NEW PARIS, PA 15554
(814)839-4108
Bedford
393983
NORTHERN POTTER HEALTH CENTER
511 ACADEMY STREET
ULYSSES, PA 16948
(814)848-7555
Potter
393906
PEDIATRIC PRACTICES OF NEPA
27-B WOODLAND DRIVE
WAYMART, PA 18472
(570)488-9550
Wayne
393887
PEDIATRIC PRACTICES OF NORTHEASTERN
PENNSYLVANIA
PEDIATRIC PRACTICES OF NORTHEASTERN
PENNSYLVANIA
PENN HIGHLANDS BROOKVILLE FAMILY
PRACTICE NEW BETH
PENN HIGHLANDS BROOKVILLE MARIENVILLE
FAMILY PRACT
PINNACLE HEALTH PARTNERS INC
1837 FAIR AVENUE
HONESDALE, PA 18431
(570)253-5838
Wayne
62 INDUSTRIAL PARK ROAD
LAKE ARIEL, PA 18436
(570)689-7565
Wayne
1323 BROOKVILLE STREET
FAIRMOUNT CITY, PA 16224
(814)275-3320
Clarion
125 CHESTNUT STREET PO BOX 463
MARIENVILLE, PA 16239
(814)927-5609
Forest
132 MANLY ROAD
TAFTON, PA 18464
(570)226-2151
Pike
393888
393424
393412
393895
393988
PORT ALLEGANY HEALTH CENTER
45 PINE STREET
PORT ALLEGANY, PA 16743
(814)642-7205
Mckean
393909
PORTAGE HEALTH CENTER RHC
3670 PORTAGE STREET SUITE 105
PORTAGE, PA 15946
(814)736-9614
Cambria
393876
RIMERSBURG MEDICAL CENTER
57 EAST BROAD STREET
RIMERSBURG, PA 16248
(814)473-3191
Clarion
393907
SAINT BENEDICT RURAL HEALTH CENTER
564 THEATRE ROAD
CARROLLTOWN, PA 15722
(814)344-8480
Cambria
393889
SAINT VINCENT MEDICAL GROUP
315 YORK STREET
CORRY, PA 16407
(814)664-8686
Erie
393984
SHINGLEHOUSE HEALTH CENTER
129 NORTH PURITAN STREET
SHINGLEHOUSE, PA 16748
(814)260-9352
Potter
393877
SHORE FAMILY HEALTH CARE RURAL
82 TOWN RUN ROAD
FAIRMOUNT CITY, PA 16224
(814)275-1600
Clarion
393824
SOUTHERN HUNTINGDON COUNTY MED
PO BOX 40
ORBISONIA, PA 17243
(814)447-5556
Huntingdon
393851
SPARTANSBURG MEDICAL CENTER
132 MECHANIC ST SPARTENSBURG MEDICAL CT
SPARTANSBURG, PA 16434
(814)654-7334
Crawford
393417
ST LUKE'S MINER'S HEALTH CENTER - MCADOO 14 N KENNEDY DRIVE
MCADOO, PA 18237
(570)645-1880
Schuylkill
393408
ST LUKE'S MINERS HEALTH CENTER
NESQUEHONING, PA 18240
(570)669-9787
Carbon
108 WEST CATAWISSA STREET
Run Date: 10/08/2015
Job # 41303463
Last Update: 10/07/2015
Page 3 of 3
CASPER Report 0006D
Name and Address Listing
For Rural Health Clinic
Based on Current Survey
Pennsylvania
CCN
Provider Name
Address
City, State and ZIP
Telephone # County Name
393411
253 CLAREMONT AVENUE
HOMETOWN, PA 18252
(570)668-6111
Schuylkill
120 SPRING STREET
HOUTZDALE, PA 16651
(814)497-4297
Clearfield
393425
ST LUKE'S MINERS HEALTH CENTER HOMETOWN
TYRONE HOSPITAL RURAL HEALTH CARE HOUTZDALE
TYRONE HOSPITAL RURAL HEALTH CLINIC
221 HOSPITAL DRIVE
TYRONE, PA 16686
(814)684-2501
Blair
393849
UPPER ALLEGHENY MEDICAL CENTER
1 WILLOW STREET
PORT ALLEGANY, PA 16743
(814)642-9531
Mckean
393897
WASHINGTON PHYSICIAN SERVICES
343 EAST ROY FURMAN HIGHWAY SUITE 105
WAYNESBURG, PA 15370
(724)627-8080
Greene
393982
WESTFIELD HEALTH CENTER
222 CHURCH STREET
WESTFIELD, PA 16950
(814)367-5971
Tioga
393427
Total Providers for this State = 70
Run Date: 10/08/2015
Job # 41303463
Last Update: 10/07/2015
Page 1 of 2
CASPER Report 0006D
Name and Address Listing
For Rural Health Clinic
Based on Current Survey
Virginia
CCN
Provider Name
Address
City, State and ZIP
Telephone # County Name
493840
ABINGDON FAMILY HEALTH CARE
445 PORTERFIELD HIGHWAY SUITE A
ABINGDON, VA 24210
(540)628-3144
Washington
493412
BATH COMMUNITY MEDICAL PRACTICE
106 PARK DRIVE, SUITE C
HOT SPRINGS, VA 24445
(540)839-7197
Bath
498915
BLUEFIELD FAMILY MEDICINE
106 HUFFARD DRIVE
BLUEFIELD, VA 24605
(276)322-5732
Tazewell
498914
BLUEFIELD INTERNAL MEDICINE
2111 COLLEGE AVENUE
BLUEFIELD, VA 24605
(276)322-4661
Tazewell
498911
CENTRA HEALTH MEDICAL CENTER-GRETNA
291 MCBRIDE LANE
GRETNA, VA 24557
(434)656-1274
Pittsylvania
498916
1280 A MAIN STREET
ALTAVISTA, VA 24517
(434)309-1165
Campbell
498906
CENTRA HEALTH PROFESSIONAL SERVICES,
LLC
CHASE CITY PRIMARY CARE CLINIC
200 EAST FIFTH STREET
CHASE CITY, VA 23924
(434)372-0900
Mecklenburg
493820
CLINCH VALLEY PHYSICIANS
1 CLINIC DRIVE, CLAYPOOL HILL
RICHLANDS, VA 24641
(540)964-1267
Tazewell
493857
COMMUNITY HEALTH CLINIC P C
686 MAIN STREET, BOX 1020
HONAKER, VA 24260
(540)873-6300
Russell
493835
DR VARANDANI AND ASSOCIATES
1119 LAKE AVENUE PO BOX 187
PENNINGTON GAP, VA 24277
(276)546-1182
Lee
493807
FAIRFIELD MED ASSOC
PO BOX 405 ROUTE 710
FAIRFIELD, VA 24435
(703)377-2156
Rockbridge
493836
FAMILY HEALTH CARE CENTER - GRETNA
107 HENRY STREET
GRETNA, VA 24557
(804)656-2224
Pittsylvania
498918
FRIES COMMUNITY HEALTH CARE INC
109 CARROLL DRIVE
FRIES, VA 24330
(276)744-3660
Grayson
493843
GREEVER RURAL HEALTH CLINIC
403 CHILHOWIE STREET PO BOX 346
CHILHOWIE, VA 24319
(276)646-3241
Smyth
493869
KENBRIDGE FAMILY MEDICINE INC
306 EAST SIXTH AVENUE
KENBRIDGE, VA 23944
(434)676-8021
Lunenburg
493416
LURAY FAMILY MEDICINE
250 MEMORIAL DRIVE, SUITE C
LURAY, VA 22835
(540)843-4624
Page
498917
MARTINSVILLE PEDIATRICS
1109 BROOKDALE STREET, SUITE C
MARTINSVILLE, VA 24112
(276)666-7545
Martinsville City
493866
CORNER OF ROUTE 460 AND 624
OAKWOOD, VA 24631
(276)498-3135
Buchanan
6719 GOVERNOR GC PEERY HWY SUITE 3100
RICHLANDS, VA 24641
(276)964-9102
Tazewell
493981
MERIT MEDICAL RURAL HEALTH CLINIC OAKWOOD
MERIT MEDICAL RURAL HEALTH CLINIC RICHLANDS
MSMG FP GLDE
636 SOUTH MONTE VISTA DRIVE
GLADE SPRING, VA 24340
(276)429-5163
Washington
493978
MSMG FP ST PA
16431 WISE STREET
SAINT PAUL, VA 24283
(703)762-2300
Wise
493825
OLDE TOWNE MEDICAL CENTER
5249 OLDE TOWNE ROAD
WILLIAMSBURG, VA 23188
(757)259-3258
James City Co.
493977
PAGE HEALTHCARE ASSOCIATES
125 MEMORIAL DRIVE
LURAY, VA 22835
(540)743-2887
Page
493987
PAGE RURAL HEALTH CENTER
235 MEDICAL DRIVE
STANLEY, VA 22851
(703)778-4259
Page
493411
PAGE SHENANDOAH HEALTH CENTER
505 WILLIAMS AVENUE
SHENANDOAH, VA 22849
(540)652-9100
Page
493863
PATRICK A MOLONY RHC
127 HEALTHCARE WAY
PENNINGTON GAP, VA 24277
(703)546-5212
Lee
493864
PATRICK A MOLONY RHC
HIGHWAY 58
JONESVILLE, VA 24263
(540)346-1137
Lee
493830
PATRICK CO FAMILY PRACTICE - STUART
WOODLAND DRIVE PO BOX 1019
STUART, VA 24171
(540)694-4466
Patrick
493415
PIONEER FAMILY MEDICAL
835 WOODLAND DRIVE
STUART, VA 24171
(276)694-6677
Patrick
498901
REGIONAL HEALTH RESOURCES INC
373 CECIL D QUILLEN DRIVE, SUITE 101
DUFFIELD, VA 24244
(276)431-1638
Scott
493810
RIDGEWOOD HEALTH CARE CLINIC
143 WEST MAIN STREET
LEBANON, VA 24266
(276)889-2394
Russell
493833
SOUTH HILL FAMILY MEDICINE INC
416 BRACEY LANE
SOUTH HILL, VA 23970
(804)447-6969
Mecklenburg
498913
THE FAMILY MEDICAL CLINIC
101 HARRIS DRIVE, BUILDING 6
KILMARNOCK, VA 22482
(804)435-0023
Lancaster
493829
TRI-STATE CLINIC INC
1520 SLATE CREEK ROAD
GRUNDY, VA 24614
(276)935-6055
Buchanan
493844
Run Date: 10/08/2015
Job # 41303463
Last Update: 10/07/2015
Page 2 of 2
CASPER Report 0006D
Name and Address Listing
For Rural Health Clinic
Based on Current Survey
Virginia
CCN
Provider Name
Address
City, State and ZIP
Telephone # County Name
493417
VALLEY INTERNAL MEDICINE
250 MEMORIAL DRIVE SUITE D
LURAY, VA 22835
(540)743-6558
Page
493834
VIRGINIA PRIMARY CARE ASSOCIAT
121 COURTHOUSE LANE
BOWLING GREEN, VA 22427
(804)633-5840
Caroline
Total Providers for this State = 36
Run Date: 10/08/2015
Job # 41303463
Last Update: 10/07/2015
Page 1 of 2
CASPER Report 0006D
Name and Address Listing
For Rural Health Clinic
Based on Current Survey
West Virginia
CCN
Provider Name
Address
City, State and ZIP
Telephone # County Name
513995
ATHENS MEDICAL CENTER
401 VERMILLION STREET
ATHENS, WV 24712
(304)487-7451
Mercer
513917
BLUEWELL FAMILY CLINIC
3720 COAL HERITAGE ROAD
BLUEFIELD, WV 24701
(304)589-4377
Mercer
513992
173 STATE STREET
MADISON, WV 25130
(304)369-1230
Boone
660A SOUTH MAIN STREET
MADISON, WV 25130
(304)369-4250
Boone
513889
BOONE MEMORIAL HOSPITAL, INC - RURAL
HEALTH CLINIC
BOONE MEMORIAL HOSPITAL, INC RURAL
HEALTH CLINIC
BRADSHAW MEDICAL RHC
BOX 240 MAIN STREET
BRADSHAW, WV 24817
(304)967-5034
Mcdowell
513400
BRAXTON COMM. HEALTH CTR. RHC
100 HOYLMAN DRIVE
GASSAWAY, WV 26624
(304)364-1093
Braxton
513884
BRAXTON PRIMARY HEALTH CARE
110 MUNICIPAL STREET
BURNSVILLE, WV 26335
(304)853-2278
Braxton
513981
ELK GARDEN CLINIC
48 OAK STREET
ELK GARDEN, WV 26717
(304)788-3141
Mineral
513843
FAMILY CARE CLINIC
P. O. BOX 179
HINTON, WV 25951
(304)466-2501
Summers
513848
FAMILY HEALTH CARE ASSOCIATES
MAIN STREET: P. O. BOX 1650
PINEVILLE, WV 24874
(304)732-6611
Wyoming
513900
FAMILY HEALTHCARE ASSOCIATES
114 MAIN STREET
MAN, WV 25635
(304)583-0020
Logan
513905
FAMILY HEALTHCARE ASSOCIATES
113 3RD AVENUE
GILBERT, WV 25621
(304)732-6735
Mingo
513850
FAMILY HEALTHCARE ASSOCIATES
205 HOWARD AVENUE
MULLENS, WV 25882
(304)294-4880
Wyoming
513849
FAMILY HEALTHCARE ASSOCIATES
COOK PARKWAY: P. O. BOX 1710
OCEANA, WV 24870
(304)682-8238
Wyoming
513918
FAMILY HEALTHCARE ASSOCIATES - WELCH
19771 COAL HERITAGE ROAD
WELCH, WV 24801
(304)436-6650
Mcdowell
513988
HAMPSHIRE RURAL HEALTH CLINIC
329 SUNRISE BLVD
ROMNEY, WV 26757
(304)822-5817
Hampshire
513859
HARDY COUNTY MEDICAL SERVICES
422 SOUTH MAIN STREET
MOOREFIELD, WV 26836
(304)538-2331
Hardy
513897
HARPERS FERRY FAMILY MEDICINE CENTER
171 TAYLOR STREET
HARPERS FERRY, WV 25425
(304)535-6343
Jefferson
513891
JANA PETERS DO
365 COURTHOUSE ROAD
PRINCETON, WV 24740
(304)425-3922
Mercer
513804
LOVE MEMORIAL CLINIC
112 KUYKENDALL LANE
MOOREFIELD, WV 26836
(304)530-7755
Hardy
513865
MANCHIN CLINIC
MAIN STREET
FARMINGTON, WV 26571
(304)825-6554
Marion
513902
800 EAST MAIN STREET
MANNINGTON, WV 26582
(304)986-2996
Marion
513997
MANNINGTON PRIMARY CARE OF MON
GENERAL HOSPITAL
MIDDLE ISLAND HEALTH CLINIC
200 FAIR STREET
MIDDLEBOURNE, WV 26149
(304)758-5100
Tyler
513914
MILLER FAMILY PRACTICE
3921 SENECA TRAIL SOUTH
PETERSTOWN, WV 24963
(304)753-9100
Monroe
513998
MINNIE HAMILTON HLTH. CARE CTR
186 HOSPITAL DRIVE
GRANTSVILLE, WV 26147
(304)354-9244
Calhoun
513410
MORAD/HUGHES HEALTH CLINIC
122 PINNELL STREET
RIPLEY, WV 25271
(304)372-2731
Jackson
513912
MOUNTAINEER HEALTHCARE PLLC
1500 TERRACE STREET
HINTON, WV 25951
(304)466-2933
Summers
513987
NEW MARTINSVILLE HEALTH CENTER
150 PADUCAH DRIVE
NEW MARTINSVILLE, WV 26155
(304)455-8190
Wetzel
513879
NORTH MARION MEDICAL ASSOCIATES, PLLC
118 MARKET STREET
MANNINGTON, WV 26582
(304)986-1750
Marion
513989
PINE GROVE HEALTH CARE RHC
P. O. BOX 418
PINE GROVE, WV 26419
(304)889-3344
Wetzel
513415
RR2 BOX 52W
BUCKEYE, WV 24924
(304)799-7400
Pocahontas
513414
POCAHONTAS MEMORIAL HOSPITAL RURAL
HEALTH CLINIC
RIVERSIDE CLINIC
122 ASHFIELD STREET
PIEDMONT, WV 26750
(304)355-2323
Mineral
513408
ROANE GENERAL MEDICAL ASSOCIATES
300 HOSPITAL DRIVE
SPENCER, WV 25276
(304)927-6203
Roane
513411
Run Date: 10/08/2015
Job # 41303463
Last Update: 10/07/2015
Page 2 of 2
CASPER Report 0006D
Name and Address Listing
For Rural Health Clinic
Based on Current Survey
West Virginia
CCN
Provider Name
Address
City, State and ZIP
Telephone # County Name
513990
ROANE GENERAL MEDICAL CENTER
200 HOSPITAL DRIVE
SPENCER, WV 25276
(304)927-6822
Roane
513852
ROMNEY MEDICAL ASSOCIATES
255 WEST MAIN STREET, ROUTE 50 EAST
ROMNEY, WV 26757
(304)822-3838
Hampshire
513901
RUPERT PRIMARY CARE
1109 GREENBRIER STREET
RUPERT, WV 25984
(304)392-5381
Greenbrier
513911
S K SHAMMAA MD INC
623 TEMPLE STREET
HINTON, WV 25951
(304)466-1243
Summers
513412
SISTERSVILLE GENERAL HOSPITAL RURAL
HEALTH CLINIC
SISTERSVILLE GENERAL MEDICAL CENTER
305 CLAY ST
SISTERSVILLE, WV 26175
(304)447-2030
Tyler
314 SOUTH WELLS STREET
SISTERSVILLE, WV 26175
(304)447-2038
Tyler
513413
513409
SOUTHERN ROANE MEDICAL CLINIC
ONE LIBRARY LANE SUITE 2
LEFT HAND, WV 25251
(304)565-3151
Roane
513991
SUMMERS COUNTY ARH CLINIC
TERRACE STREET: P. O. BOX 940
HINTON, WV 25951
(304)466-2905
Summers
513893
SUMMERSVILLE PEDIATRIC, INC
400 FAIRVIEW HEIGHTS ROAD
SUMMERSVILLE, WV 26651
(304)872-7063
Nicholas
513416
74 AVENUE B
RICHWOOD, WV 26261
(304)846-4980
Nicholas
513402
SUMMERSVILLE REGIONAL MEDICAL CENTERRICHWOOD FAMI
SUMMERSVILLE RURAL HEALTH CLINIC
400 FAIRVIEW HEIGHTS ROAD
SUMMERSVILLE, WV 26651
(304)872-5124
Nicholas
513873
THE MYERS CLINIC
#3 HEALTH CARE DRIVE
PHILIPPI, WV 26416
(304)457-2800
Barbour
513978
TYGART VALLEY TOTAL CARE CENTER
500 MARKET STREET
GRAFTON, WV 26354
(304)265-6416
Taylor
513405
TYGART VALLEY TOTAL CARE FLEMINGTON
EMS BUILDING ROUTE 76
FLEMINGTON, WV 26347
(304)739-4867
Taylor
513417
WALTON MEDICAL CLINIC
94 SCHOOL DRIVE
WALTON, WV 25286
(304)577-6815
Roane
513880
WARDENSVILLE MEDICAL SERVICES
ROUTE 259, 55 MAIN STREET
WARDENSVILLE, WV 26851
(304)874-4012
Hardy
513407
WEBSTER COUNTY MEMORIAL HOSPITAL RHC
324 MILLER MOUNTAIN DRIVE
WEBSTER SPRINGS, WV 26288
(304)847-5682
Webster
513979
WELCH COMMUNITY HOSPITAL RHC
454 MCDOWELL STREET
WELCH, WV 24801
(304)436-8461
Mcdowell
513907
YUKON MEDICAL CLINIC
HC 32 BOX 78-A
WAR, WV 24892
(304)875-2302
Mcdowell
Total Providers for this State = 52
Run Date: 10/08/2015
Job # 41303463
Last Update: 10/07/2015
Page 1 of 3
CASPER Report 0006D
Name and Address Listing
For Rural Health Clinic
Based on Current Survey
Alabama
CCN
Provider Name
Address
City, State and ZIP
Telephone # County Name
013444
ACH FAMILY PHYSICIANS
611 LAUREL STREET
ATMORE, AL 36502
(251)368-8001
Escambia
013446
ACH MED PLUS
406 MEDICAL PARK DRIVE
ATMORE, AL 36502
(251)368-6384
Escambia
013445
ACH PRIMARY CARE
402 MEDICAL PARK DRIVE
ATMORE, AL 36502
(251)368-6334
Escambia
013947
ARAB FAMILY HEALTHCARE LLC
121 GOLFVIEW DRIVE N E
ARAB, AL 35016
(256)931-3531
Marshall
013888
BAPTIST HEALTH CENTER BLOUNT & ETOWAH
180 MEDICAL ST
SNEAD, AL 35952
(205)466-7114
Etowah
013848
BAPTIST HEALTH CENTER TALLADEG
320 EAST COOSA STREET
TALLADEGA, AL 35160
(256)362-3636
Talladega
018911
BHC - WALKER PRIMARY CARE
JASPER, AL 35501
(205)385-0630
Walker
013873
BHC BLOUNT AND ETOWAH
3400 HIGHWAY 78 EAST, MEDICAL ARTS
TOWER,SUITE 321
203 SHIRLEY ST
ONEONTA, AL 35121
(205)274-8198
Blount
018918
BHC JEMISON
25420 US HIGHWAY 31 NORTH
JEMISON, AL 35085
(205)668-1616
Chilton
013855
BHC LINCOLN
47344 U S HIGHWAY 78
LINCOLN, AL 35096
(205)763-7848
Talladega
013811
BHC MUNFORD HEALTH CLINIC
48 NORTH CEDARS ROAD
MUNFORD, AL 36268
(256)358-4553
Talladega
013961
BHC TALLADEGA FAMILY MEDICINE
101 STEPHEN J WHITE MEMORIAL BLVD
TALLADEGA, AL 35160
(256)362-4000
Talladega
013943
BHC TALLADEGA PEDIATRICS
722 STONE AVENUE
TALLADEGA, AL 35160
(256)362-1725
Talladega
018912
BHC-TALLADEGA OB/GYN
724 STONE AVENUE
TALLADEGA, AL 35160
(256)362-1410
Talladega
013976
BIBB MEDICAL ASSOCIATES
405 BELCHER STREET
CENTREVILLE, AL 35042
(205)926-4694
Bibb
013457
BUTLER PRIMARY CARE
138 JONES STREET
GEORGIANA, AL 36033
(334)376-0078
Butler
013454
CARROLLTON PRIMARY CARE
289 WILLIAM E HILL DRIVE
CARROLLTON, AL 35447
(205)375-6251
Pickens
013958
CENTRAL PEDIATRICS, INC
101 FITNESS WAY, SUITE 1100
ATHENS, AL 35611
(256)233-0712
Limestone
013923
CHATOM PRIMARY CARE, PC
653 ST STEPHENS AVENUE
CHATOM, AL 36518
(251)847-6262
Washington
013886
CHEROKEE CLINIC
395 NORTHWOOD DRIVE
CENTRE, AL 35960
(256)927-4900
Cherokee
013422
CHOCTAW URGENT CARE CENTER
1404 E PUSHMATAHA STREET
BUTLER, AL 36904
(205)459-4488
Choctaw
013429
COFFEEVILLE MEDICAL CLINIC
101 PARK CIRCLE
COFFEEVILLE, AL 36524
(334)275-3191
Clarke
013458
COMPLETE FAMILY CARE
94 MEDICAL CIRCLE
MOULTON, AL 35650
(256)974-9216
Lawrence
018919
COVINGTON HEALTHCARE, LLC
1608A GILMER AVE
TALLASSEE, AL 36078
(334)283-2291
Elmore
013884
614 WEST BYPASS
ANDALUSIA, AL 36420
(334)222-0119
Covington
013967
COVINGTON PEDIATRICS RURAL HEALTH
CLINIC
CRENSHAW FAMILY CARE CENTER
58 ROY BEALL DRIVE
LUVERNE, AL 36049
(334)335-1212
Crenshaw
013846
CULLMAN INTERNAL MEDICINE PC
1890 ALABAMA HIGHWAY 157 SUITE 300
CULLMAN, AL 35058
(256)734-9370
Cullman
013856
DEKALB CLINIC
415 MEDICAL CENTER DRIVE SW
FORT PAYNE, AL 35968
(256)997-2820
De Kalb
013971
EPEDIATRICS AND FAMILY CARE CLINIC
299 PRAIRIE STREET NORTH
UNION SPRINGS, AL 36089
(334)738-7337
Bullock
013450
EVERGREEN PRIMARY CARE
98 CRESTVIEW AVENUE
EVERGREEN, AL 36401
(251)578-0278
Conecuh
018905
FALKVILLE MEDICAL CLINIC
434 EAST PIKE ROAD
FALKVILLE, AL 35622
(256)784-2200
Morgan
013456
FAMILY CARE CLINIC
826 WEST WASHINGTON STREET
EUFAULA, AL 36027
(334)688-7410
Barbour
018914
FAMILY CARE FIRST, INC
1023 HWY 13
HALEYVILLE, AL 35565
(205)486-5050
Winston
018913
FAMILY CARE FIRST, INC
11809 AL HWY 157 SUITE E
MOULTON, AL 35650
(256)905-0340
Lawrence
Run Date: 10/08/2015
Job # 41303463
Last Update: 10/07/2015
Page 2 of 3
CASPER Report 0006D
Name and Address Listing
For Rural Health Clinic
Based on Current Survey
Alabama
CCN
Provider Name
Address
City, State and ZIP
Telephone # County Name
013959
FAMILY HEALTH CLINIC OF UNION SPRINGS
309 N PRAIRIE NORTH
UNION SPRINGS, AL 36089
(334)738-2146
Bullock
013440
FLOMATON MEDICAL CENTER
174 HIGHWAY 113
FLOMATON, AL 36441
(251)296-2456
Escambia
013962
FORT MITCHELL CLINIC PC
2 GILMORE RD
FORT MITCHELL, AL 36856
(334)664-1960
Russell
018917
FORT PAYNE PEDIATRICS - WATERWORKS
1359 OLD WATERWORKS ROAD SW
FORT PAYNE, AL 35968
(256)997-5900
De Kalb
018910
FORT PAYNE PEDIATRICS LLC
1906 GLENN BLVD SW SUITE 100A
FORT PAYNE, AL 35968
(256)997-5900
De Kalb
013954
FULTON FAMILY MEDICAL
218 MAIN STREET
FULTON, AL 36446
(334)636-4823
Clarke
013911
GRANT FAMILY PRACTICE CLINIC
5447 MAIN STREET
GRANT, AL 35747
(256)498-5770
Marshall
013449
607 WILSON AVE
EUTAW, AL 35462
(205)372-1260
Greene
013905
GREENE COUNTY HOSPITAL PHYSICIANS'
CLINIC
GREENVILLE PEDIATRICS
84 LV STABLER DRIVE
GREENVILLE, AL 36037
(334)382-9760
Butler
013438
GROVE HILL HEALTH CARE
295-B SOUTH JACKSON STREET
GROVE HILL, AL 36451
(251)275-3173
Clarke
013894
GUNTERSVILLE FAMILY PRACTICE CLINIC
1241 BLOUNT AVENUE
GUNTERSVILLE, AL 35976
(205)582-6377
Marshall
013447
HALE COUNTY HOSPITAL CLINIC
508 GREENE STREET
GREENSBORO, AL 36744
(334)624-4442
Hale
013430
HILL HOSPITAL PHYSICIANS CLINIC
724 DERBY DRIVE
YORK, AL 36925
(205)392-5263
Sumter
013878
HMC RURAL HEALTH CLINIC
2201 NORTH AIRPORT ROAD
JASPER, AL 35502
(205)221-9351
Walker
018902
HORIZON HEALTHCARE, LLC
126 COMMERCE AVENUE
VALLEY HEAD, AL 35989
(256)635-6600
De Kalb
013926
IMC FAMILY MEDICAL OF JACKSON PC
226 HOSPITAL DRIVE
JACKSON, AL 36545
(251)246-4446
Clarke
013424
IVY CREEK CLINIC
125 CHURCH STREET
GEORGIANA, AL 36033
(334)376-2291
Butler
013461
3945 BROAD STREET
PINE HILL, AL 36769
(334)963-2113
Wilcox
319 MCWILLIAMS AVE
CAMDEN, AL 36726
(334)682-4224
Wilcox
018915
J PAUL JONES HOSPITAL PINE HILL RURAL
HEALTH CLINI
J PAUL JONES HOSPITAL RURAL HEALTH
CLINIC
KEVIN G KELLY, MD
13150 HWY 43, SUITE 10
RUSSELLVILLE, AL 35653
(256)332-5901
Franklin
013420
LAKE MARTIN FAMILY MEDICINE
301 MARIARDEN RD SUITE D
DADEVILLE, AL 36853
(205)825-7871
Tallapoosa
013955
LAKESHORE PEDIATRICS OF RUSSELLVILLE
603 GANDY STREET NE
RUSSELLVILLE, AL 35653
(256)331-5055
Franklin
013994
10939 ALABAMA HIGHWAY 157
MOULTON, AL 35650
(205)974-3390
Lawrence
350 TENNESSEE STREET P O BOX 320
COURTLAND, AL 35618
(205)637-8033
Lawrence
013939
LAWRENCE RHC, MOULTON/LAWRENCE
URGENT CARE CENTER
LAWRENCE RURAL HEALTH CLINICCOURTLAND
LOWER ALABAMA PEDIATRICS
1205 BELLEVILLE AVENUE
BREWTON, AL 36426
(251)867-3608
Escambia
013917
MAINSTREET MEDICAL CLINIC
1508 COSWELL AVENUE
PELL CITY, AL 35125
(205)814-1598
Saint Clair
013982
MARION CLINIC
1768 SO WASHINGTON STREET, HWY 45 SOUTH
MARION, AL 36756
(334)683-9085
Perry
013448
MCB FAMILY CLINIC
31 RAILROAD STREET
LOUISVILLE, AL 36048
(334)266-5110
Barbour
013908
MED - ASSIST
3442 US HWY 431
ALBERTVILLE, AL 35950
(256)593-1234
Marshall
013455
MED EXPRESS
14490 COUNTY LINE ROAD, SUITE A
MUSCLE SHOALS, AL 35661
(256)661-2078
Colbert
013459
MED EXPRESS LITTLEVILLE
1369A GEORGE WALLACE AVE HWY
RUSSELLVILLE, AL 35654
(256)331-9700
Franklin
013460
MED EXPRESS RED BAY, LLC
221 HOSPITAL ROAD
RED BAY, AL 35582
(256)356-8907
Franklin
013965
MEDICAL EAST OF DECATUR
2941 POINT MALLARD PARKWAY
DECATUR, AL 35603
(256)432-2822
Morgan
013452
013401
Run Date: 10/08/2015
Job # 41303463
Last Update: 10/07/2015
Page 3 of 3
CASPER Report 0006D
Name and Address Listing
For Rural Health Clinic
Based on Current Survey
Alabama
CCN
Provider Name
Address
City, State and ZIP
Telephone # County Name
013928
MERIT HEALTHCARE OF GOODWATER
21342 ALABAMA HWY 9
GOODWATER, AL 35072
(256)839-5900
Coosa
018901
MIDWAY MEDICAL CLINIC, LLC
111 BROOKLYN ROAD
HOLLY POND, AL 35083
(256)796-3084
Cullman
013936
MILLPORT FAMILY PRACTICE CLINIC, LLC
13530 HIGHWAY 96
MILLPORT, AL 35576
(205)662-5784
Lamar
013963
MILLRY PEDIATRIC CLINIC, LLC
75 FIFTH AVENUE
MILLRY, AL 36558
(251)846-3233
Washington
013851
MORROW CLINICS INC
34867 US HIGHWAY 43
HACKLEBURG, AL 35564
(205)935-3744
Marion
013415
MOUNTAIN VIEW FAMILY MEDICINE
5995 HIGHWAY 72 EAST
GURLEY, AL 35748
(256)776-2094
Madison
013938
NABERS FAMILY MEDICAL CLINIC
219 HOSPITAL ROAD
RED BAY, AL 35582
(256)356-9537
Franklin
013969
NC HEALTH CARE CLINIC, LLC
68 MARCO DRIVE
DECATUR, AL 35603
(256)274-4524
Morgan
013462
1256 MILITARY STREET SOUTH
HAMILTON, AL 35570
(205)921-6200
Marion
200 EAST BATTLE STREET, SUITE B
TALLADEGA, AL 35160
(256)368-9800
Talladega
013433
NORTH MISS MEDICAL CTR HAMILTON'S
PRIMARY CARE CTR
PEDIATRIC CARE CENTER OF NORTHEAST
ALABAMA TALLADE
PERFECT KIDS AND FAMILY CARE
111 WEST CONECUH STREET
UNION SPRINGS, AL 36089
(334)738-1500
Bullock
013904
PHIL CAMPBELL MEDICAL CLINIC
2930 HIGHWAY 237
PHIL CAMPBELL, AL 35581
(205)993-5642
Franklin
013973
PHYSICIANS CARE OF SWEET WATER, LLC
31431 ALABAMA HIGHWAY 10
SWEET WATER, AL 36782
(334)994-6300
Marengo
013864
PISGAH MEDICAL CLINIC
6110 COUNTY ROAD 88
PISGAH, AL 35765
(205)451-1250
Jackson
013902
PREFERRED FAMILY HEALTHCARE, LLC
312 SAND MOUNTAIN DRIVE, SE
ALBERTVILLE, AL 35950
(256)878-1053
Marshall
013957
PREMIER FAMILY CARE, LLC
2017 OBRIG AVENUE
GUNTERSVILLE, AL 35976
(256)582-2324
Marshall
018906
PREMIER MEDICAL CLINIC, LLC
506 HARLEY STREET
SCOTTSBORO, AL 35768
(256)259-0685
Jackson
013434
RIVER REGION FAMILY MEDICINE
41 CAMBRIDGE COURT
WETUMPKA, AL 36093
(334)567-3309
Elmore
013964
ROANOKE RURAL HEALTH CLINIC
1950 MAIN STREET
ROANOKE, AL 36274
(334)863-2311
Randolph
018916
RURAL PRIMARY CARE SOUTH, INC
143 WHITE OAK TRAIL, SUITE 2
WARRIOR, AL 35180
(205)543-6668
Jefferson
013989
RUSH MEDICAL GROUP - LIVINGSTON
1221 WASHINGTON STREET
LIVINGSTON, AL 35470
(205)652-9575
Sumter
013966
SOUTH ALABAMA MEDICAL CLINIC, LLC
10075 GRAND BAY WILMER ROAD
GRAND BAY, AL 36541
(251)865-1852
Mobile
013854
SOUTH DEKALB FAMILY MEDICAL CENTER
15239 AL HIGHWAY 68 W
CROSSVILLE, AL 35962
(256)528-7173
De Kalb
013915
SOUTHERN FAMILY HEALTH, LLC
201 OLD HWY 25 EAST
COLUMBIANA, AL 35051
(205)669-4884
Shelby
018907
SOUTHVIEW MEDICAL CLINIC, LLC
222 ARKADELPHIA ROAD, NE
HANCEVILLE, AL 35077
(256)352-4767
Cullman
013970
SULLIGENT MEDICAL CLINIC
478 ELM STREET
SULLIGENT, AL 35586
(205)698-7111
Lamar
013847
SYLACAUGA PEDIATRIC CLINIC LLC
115 WEST CLAY STREET
SYLACAUGA, AL 35150
(256)245-3267
Talladega
018908
TANNER MEDICAL CLINIC
20104 SWANNER BLVD, SUITE C
TANNER, AL 35671
(256)686-3334
Limestone
018904
TANNER PRIMARY CARE OF WEDOWEE, INC
1030 MAIN STREET SOUTH
WEDOWEE, AL 36278
(256)357-2188
Randolph
013876
THREE NOTCH RURAL HEALTH INC
835 THREE NOTCH STREET
ANDALUSIA, AL 36420
(334)222-8421
Covington
013956
VALLEY HEAD CLINIC, LLC
2605 GAULT AVENUE N, SUITE 200
FORT PAYNE, AL 35967
(256)635-6600
De Kalb
013960
WETUMPKA FAMILY RURAL HEALTH CLINIC
815 JACKSON TRACE ROAD
WETUMPKA, AL 36092
(334)567-2882
Elmore
013924
WINSTON COUNTY MEDICAL CLINIC
15341 HIGHWAY 278
DOUBLE SPRINGS, AL 35553
(205)489-3322
Winston
013953
WOODLAND FAMILY HEALTHCARE
76 COUNTY RD 64, SUITE 3
WOODLAND, AL 36280
(256)449-2001
Randolph
018903
Run Date: 10/08/2015
Job # 41303463
CCN
Provider Name
Total Providers for this State = 101
Last Update: 10/07/2015
Page 4 of 4
CASPER Report 0006D
Name and Address Listing
For Rural Health Clinic
Based on Current Survey
Alabama
Address
City, State and ZIP
Telephone # County Name
Run Date: 10/08/2015
Job # 41303463
Last Update: 10/07/2015
Page 1 of 5
CASPER Report 0006D
Name and Address Listing
For Rural Health Clinic
Based on Current Survey
Florida
CCN
Provider Name
Address
City, State and ZIP
Telephone # County Name
683800
A WOMAN'S PLACE INC
1415 NW 23RD AVENUE
CHIEFLAND, FL 32626
(352)493-9393
Levy
103911
ACORN CLINIC
23320 NORTH STATE ROAD 235
BROOKER, FL 32622
(904)485-1133
Bradford
108997
ACUTE CARE PEDIATRICS OF PALM COAST PA
397 SW PALM COAST PKWY
PALM COAST, FL 32137
(386)447-7337
Flagler
108985
ACUTE CARE PEDIATRICS, PA
1301 REID ST
PALATKA, FL 32177
(386)328-5437
Putnam
103918
AHMAD TARIQ ISMAIL
110 EAST BYRD STREET
BONIFAY, FL 32425
(904)547-4799
Holmes
683802
ARCHER FAMILY HEATH CARE
16939 SW 134TH AVE
ARCHER, FL 32618
(352)495-2550
Alachua
103905
AVON MEDICAL CENTER
2398 HARTFORD DR
AVON PARK, FL 33825
(813)453-2500
Highlands
103814
AVON PARK PEDIATRICS INC
1571 US HWY 27 N
AVON PARK, FL 33825
(863)453-7337
Highlands
103453
BAKER RURAL HEALTH CLINIC
159 NORTH 3RD STREET
MACCLENNY, FL 32063
(904)259-3279
Baker
103944
BELLAM MEDICAL CLINIC
20021 SW 111TH PL
DUNNELLON, FL 34432
(352)465-1199
Marion
103941
BEVERLY HILLS MEDICAL CLINIC
3737 N LECANTO HWY
BEVERLY HILLS, FL 34465
(352)746-1515
Citrus
108922
BIRTH & BEYOND
1326 SR 100
GRANDIN, FL 32138
(904)659-2104
Putnam
103920
BUSHNELL FAMILY PRACTICE
117 W BELT AVE
BUSHNELL, FL 33513
(904)568-1988
Sumter
103451
CALHOUN LIBERTY PRIMARY CARE CLINIC
20370 NE BURNS AVE
BLOUNTSTOWN, FL 32424
(850)237-3000
Calhoun
103446
5429 COLLEGE DR
GRACEVILLE, FL 32440
(850)263-9350
Jackson
103864
CAMPBELLTON-GRACEVILLE HOSPITAL
PHYSICIANS OFFICE
CENTURY MEDICAL CENTER
8401 N CENTURY BLVD.
CENTURY, FL 32535
(904)256-5314
Escambia
103954
CHARLES S LI MD
7647 W GULF TO LAKE HWY
CRYSTAL RIVER, FL 34429
(352)795-1718
Citrus
103932
CHIEFLAND MEDICAL CENTER LLC
1113 NW 23RD AVE
CHIEFLAND, FL 32644
(904)463-2348
Levy
103840
CHILDREN'S MEDICAL CENTER
798 W DUVAL ST
LAKE CITY, FL 32055
(904)364-8050
Columbia
108940
CHILDREN'S MEDICAL CENTER
6704 E MT VERNON STREET
GLEN SAINT MARY, FL 32040
(904)299-7420
Baker
108932
CHILDREN'S MEDICAL CENTER
1419 S 6TH ST
MACCLENNY, FL 32063
(904)755-2588
Baker
108960
CHILDREN'S MEDICAL CENTER - ALACHUA
14861 NW HWY 441
ALACHUA, FL 32615
(386)462-1911
Alachua
103868
CHILDREN'S MEDICAL CENTER LIVE OAK
1002 11TH ST SW
LIVE OAK, FL 32064
(386)364-8050
Suwannee
103902
CHILDRENS CLINIC
1100 N MAIN ST
BELLE GLADE, FL 33430
(407)996-8505
Palm Beach
108943
CHIPLEY MEDICAL GROUP
1376 BRICKYARD RD
CHIPLEY, FL 32428
(904)638-7910
Washington
103966
CITRA FAMILY HEALTH
17805 US HWY 301 N
CITRA, FL 32113
(352)595-7777
Marion
103957
CITRUS SPRINGS RURAL HEALTH CLINIC
10489 N FLORIDA AVE
CITRUS SPRINGS, FL 34434
(352)489-2486
Citrus
108972
CLARK CLINIC INC
212 S FLORIDA ST
BUSHNELL, FL 33513
(352)793-2441
Sumter
108973
CLARK CLINIC, INC
107 W CENTRAL AVE
HOWEY IN THE HILLS, FL 34737
(352)324-0504
Lake
103897
810 COMMED BLVD
ORANGE CITY, FL 32763
(386)774-1155
Volusia
1190 N STONE ST
DELAND, FL 32724
(904)738-1792
Volusia
683814
COMMUNITY MEDICAL CENTER OF WEST
VOLUSIA PA
COMMUNITY MEDICAL CENTER OF WEST
VOLUSIA PA
COMPREHENSIVE PRIMARY CARE
4363 S SUNCOAST BLVD
HOMOSASSA, FL 34446
(352)503-2011
Citrus
103819
COPELAND CLINIC
10820 MARVIN E JONES BLVD
LIVE OAK, FL 32060
(904)658-5300
Suwannee
103869
Run Date: 10/08/2015
Job # 41303463
Last Update: 10/07/2015
Page 2 of 5
CASPER Report 0006D
Name and Address Listing
For Rural Health Clinic
Based on Current Survey
Florida
CCN
Provider Name
Address
City, State and ZIP
Telephone # County Name
103417
DESOTO MEMORIAL CENTER FOR FAMILY
HEALTH
DEVEN MEDICAL CENTER
888 N ROBERT AVE
ARCADIA, FL 34266
(941)494-8401
De Soto
11707 N WILLIAMS ST STE 2
DUNNELLON, FL 34432
(352)465-1199
Marion
103922
108987
DFS WALK-IN CLINIC
9 W ORANGE AVE
DEFUNIAK SPRINGS, FL 32435
(850)951-1800
Walton
108941
21 W MAIN AVE
DEFUNIAK SPRINGS, FL 32435
(850)892-2888
Walton
103440
DOCTORS MEDICAL CENTER OF WALTON
COUNTY PA
DOCTORS MEMORIAL FAMILY MEDICINE
117 SW VIRGINIA CIRCLE
MAYO, FL 32066
(904)294-2475
Lafayette
103441
DOCTORS MEMORIAL FAMILY PRACTICE
555 N BYRON BUTLER PARKWAY
PERRY, FL 32347
(850)838-2141
Taylor
103422
DR JAMES D FORBES FAMILY CARE
500 W SAGAMORE AVE
CLEWISTON, FL 33440
(941)983-3434
Hendry
683809
DYNAMIC HEALTH CENTERS INC
155 SE 6TH PL
LAKE BUTLER, FL 32054
(352)505-5346
Union
103964
DYNAMIC HEALTH CENTERS INC
2806 W HWY 90
LAKE CITY, FL 32055
(386)438-8391
Columbia
103853
ERNEST GONZALEZ MD
800 ZEAGLER DR
PALATKA, FL 32177
(386)328-9484
Putnam
108981
EXCEL PEDIATRICS
265 CITRUS TOWER BLVD, SUITE 102
CLERMONT, FL 34711
(352)394-3929
Lake
103951
EXPRESS CARE OF BELLEVIEW
10762 S US HWY 441
BELLEVIEW, FL 34420
(352)245-1087
Marion
108991
EXPRESS CARE OF LEESBURG
2500 CITRUS BLVD
LEESBURG, FL 34748
(352)347-5225
Lake
103879
FAMILY MEDICAL GROUP PA
225 US 27 S
LAKE PLACID, FL 33852
(813)699-9977
Highlands
103884
FAMILY MEDICAL GROUP PA
3420 US 27 N
SEBRING, FL 33870
(813)385-7077
Highlands
103857
FAMILY MEDICAL GROUP PA
105 TOMOKA BLVD. SOUTH
LAKE PLACID, FL 33852
(813)465-7010
Highlands
683815
FIRST COAST OBSTETRICS & GYNECOLOGY PA 6100 ST JOHNS AVE
PALATKA, FL 32177
(386)325-5699
Putnam
103449
1006 W PLEASANT ST
AVON PARK, FL 33825
(863)453-3121
Highlands
515 CARLTON ST
WAUCHULA, FL 33873
(813)773-6606
Hardee
103921
FL HOSP HEARTLAND MED CTR FAMILY
PRACTICE CENTER
FLORIDA HOSPITAL WAUCHULA PIONEER
MEDICAL CENTER
FOREST FAMILY HEALTH
15932 E HWY 40
SILVER SPRINGS, FL 34488
(904)694-4445
Marion
108975
GARCIA MEDICAL CLINIC LLC
411 E NELSON AVE
DEFUNIAK SPRINGS, FL 32433
(850)892-4791
Walton
103999
GATEWAY MEDICAL CLINIC - CRESTVIEW
127 E REDSTONE AVE
CRESTVIEW, FL 32539
(615)377-4522
Okaloosa
103411
GATEWAY MEDICAL CLINIC DFS
1045 US HWY 331 S
DEFUNIAK SPRINGS, FL 32435
(904)892-2366
Walton
103448
103903
GRACE HEALTHCARE SOLUTIONS INC
7368 STATE RD 15, US 441
PAHOKEE, FL 33476
(561)958-3484
Palm Beach
683810
GRACE PEDIATRICS PL
4196 W US HWY 90
LAKE CITY, FL 32055
(386)243-8474
Columbia
103980
HEALTHMARK OF WALTON RURAL HEALTH
CLINIC INC
HEARTLAND PEDIATRIC ASSOCIATES
4413 US HWY 331 S
DEFUNIAK SPRINGS, FL 32435
(904)892-1019
Walton
103856
103851
7215 US HIGHWAY 27 N
SEBRING, FL 33870
(813)452-1818
Highlands
120 HEARTLAND WAY
WAUCHULA, FL 33873
(813)767-1414
Hardee
344 E ROYAL PALM ST
LAKE PLACID, FL 33852
(941)699-1414
Highlands
108907
HEARTLAND PEDIATRIC ASSOCIATION OF
WAUCHULA
HEARTLAND PEDIATRICS OF LAKE P
103968
HEARTLAND PEDIATRICS OF LAKE WALES LLC
1354 STATE ROAD 60 E
LAKE WALES, FL 33853
(941)679-8888
Polk
103445
HENDRY REGIONAL CONVENIENT CARE
CENTER
HERNANDO MEDICAL CENTER
450 S MAIN ST
LABELLE, FL 33935
(863)675-2356
Hendry
2669 N FLORIDA AVE
HERNANDO, FL 34442
(352)637-2550
Citrus
103969
Run Date: 10/08/2015
Job # 41303463
Last Update: 10/07/2015
Page 3 of 5
CASPER Report 0006D
Name and Address Listing
For Rural Health Clinic
Based on Current Survey
Florida
CCN
Provider Name
Address
City, State and ZIP
Telephone # County Name
103889
HIGH SPRINGS PEDIATRICS LLC
210 NW 1ST AVE
HIGH SPRINGS, FL 32643
(386)454-1156
Alachua
103896
HORIZON PEDIATRICS LLC
112 IRVIN AVE SW
LIVE OAK, FL 32064
(386)362-5437
Suwannee
103866
MARIANNA, FL 32446
(904)526-5300
Jackson
103848
INTERNAL MEDICINE ASSOCIATES OF JACKSON 4318 FIFTH AVENUE
HOSPITAL
IRA FIALKO DO, PA
6171 W GULF TO LAKE HWY
CRYSTAL RIVER, FL 34429
(352)429-2679
Citrus
103846
JACK M MATHENY II MD
205 ZEAGLER DRIVE
PALATKA, FL 32177
(904)328-6746
Putnam
103858
JAY MEDICAL CENTER
14088 ALABAMA STREET
JAY, FL 32565
(904)675-4546
Santa Rosa
103908
KIDS CARE PEDIATRICS PA
6910 OLD WOLF BAY RD
PALATKA, FL 32177
(904)328-7337
Putnam
103933
KIDS HEALTH ALLIANCE PA
2650 NW 2ND ST
OCALA, FL 34475
(352)237-5400
Marion
103424
LAKE BUTLER FAMILY & PEDIATRIC CLINIC
575 SE 3RD AVE
LAKE BUTLER, FL 32054
(904)496-2323
Union
108915
LAKE PEDIATRICS P A
4880 N HWY 19A
MOUNT DORA, FL 32757
(352)383-8111
Alachua
103808
LITTLE PINE PEDIATRICS PLLC
1702 S JEFFERSON ST
PERRY, FL 32348
(850)973-4195
Taylor
103901
LOUIS J RADNOTHY DO PA
390 S CENTRAL AVE
UMATILLA, FL 32784
(904)669-3175
Lake
103934
MEENA NATHAN MEDICAL CLINIC
840 S BEA AVE
INVERNESS, FL 34453
(352)637-6300
Citrus
103916
MILLA PEDIATRICS RURAL HEALTH CLINIC
426 SW COMMERCE DR
LAKE CITY, FL 32025
(904)755-2240
Columbia
103882
MOHAMMAD YUNGUS MD RURAL HEALTH CARE 404 EAST HIGHWAY 90
BONIFAY, FL 32425
(904)547-4284
Holmes
103942
NATURE COAST FAMILY HEALTH CLINIC
3400 N LECANTO HWY
BEVERLY HILLS, FL 34465
(352)746-2227
Citrus
103421
NATURE COAST FAMILY HEALTH SERVICES
125 SW 7TH STREET
WILLISTON, FL 32696
(352)529-0300
Levy
108905
NATURE COAST FAMILY MEDICAL CENTER
405 N CENTRAL AVE
INVERNESS, FL 34453
(352)341-2400
Citrus
683803
NATURE COAST MEDICAL GROUP PA
130 SW 7TH ST
WILLISTON, FL 32696
(618)664-9818
Levy
108906
NORTH FLORIDA PEDIATRICS
1117 US HWY 41 NW
JASPER, FL 32052
(904)758-0003
Hamilton
103931
NORTH FLORIDA PEDIATRICS PA
1859 SW NEWLAND WAY
LAKE CITY, FL 32025
(904)758-0003
Columbia
103875
NORTH FLORIDA PEDIATRICS RHC
4316 5TH AVE
MARIANNA, FL 32446
(904)526-5437
Jackson
108925
OAK HILL MEDICAL
185 A US #1, NORTH
OAK HILL, FL 32759
(904)345-0003
Volusia
683805
OB & GYN OF NE FL, PA
700 ZEIGLER DR
PALATKA, FL 32177
(386)530-2380
Putnam
683811
LAKE CITY, FL 32025
(386)719-9227
Columbia
103972
ORIGINS FAMILY MEDICAL & WEIGHT LOSS
194 SW WALL TERRACE
CLINIC INC
PALM GLADES RURAL HEALTH ASSOCIATES INC 217 W AVE A
BELLE GLADE, FL 33430
(561)753-5563
Palm Beach
683801
PANHANDLE FAMILY MEDICINE LLC
310 EAST BYRD AVE STE B
BONIFAY, FL 32425
(314)968-0076
Holmes
108984
PANHANDLE FAMILY MEDICINE PA
877 3RD ST
CHIPLEY, FL 32428
(850)638-4555
Washington
103863
1990 N PROSPECT AVE
LECANTO, FL 34461
(352)527-6888
Citrus
108964
PEDIATRIC AND INTERNAL MEDICINE
SPECIALISTS PA
PEDIATRIC ASSOCIATES OF LAKELAND
2140 E EDGEWOOD DR
LAKELAND, FL 33803
(863)669-1212
Polk
108966
PEDIATRIC PARTNERS OF WINTER HAVEN
550 POPE AVE NW
WINTER HAVEN, FL 33880
(863)293-2144
Polk
108969
PEDIATRICS IN BREVARD
134 S WOODS DR
ROCKLEDGE, FL 32955
(321)636-3066
Brevard
108968
PEDIATRICS IN BREVARD MELBOURNE
1755 W HIBISCUS BLVD
MELBOURNE, FL 32901
(321)724-5437
Brevard
108970
PEDIATRICS IN BREVARD PA
699 W COCOA BEACH CSWY
COCOA BEACH, FL 32931
(321)784-5437
Brevard
Run Date: 10/08/2015
Job # 41303463
Last Update: 10/07/2015
Page 4 of 5
CASPER Report 0006D
Name and Address Listing
For Rural Health Clinic
Based on Current Survey
Florida
CCN
Provider Name
Address
City, State and ZIP
Telephone # County Name
108944
PHILIP COLAIZZO MD PA
170 S BARFIELD HWY
PAHOKEE, FL 33476
(561)924-5155
Palm Beach
103818
POSITIVE HEALTHCARE MOBILE CLINIC
4300 BAYOU BLVD
PENSACOLA, FL 32503
(850)470-8071
Escambia
103801
PREMIER MEDICAL PEDIATRICS CLINIC INC
315 E ASH ST
PERRY, FL 32347
(850)838-2121
Taylor
683812
PREMIER PEDIATRICS
11223 N WILLIAMS
DUNNELLON, FL 34432
(352)671-6741
Marion
103881
PREMIER PEDIATRICS, LLC
7960 SW 60TH AVE
OCALA, FL 34476
(352)671-6741
Marion
103904
PRIMARY CARE CENTER OF LIVE OAK
1500 OHIO AVE N
LIVE OAK, FL 32064
(386)330-0100
Suwannee
103924
PROFESSIONAL PEDIATRICS
1050 US HWY 27 N
CLERMONT, FL 34714
(352)404-8944
Lake
108949
PUTNAM OBSTETRICS AND GYNECOLOGY
6061 ST JOHNS AVE
PALATKA, FL 32177
(386)325-0826
Putnam
103429
QUINCY MEDICAL GROUP
178 LASALLE LEFALL DR
QUINCY, FL 32351
(904)875-3600
Gadsden
103854
RAYPAR, INC DBA TRINITY MEDICAL CENTER
1064 N BROADWAY AVE
BARTOW, FL 33830
(863)519-9797
Polk
103804
RIDGE MANOR MEDICAL CLINIC
34498 CORTEZ BLVD
RIDGE MANOR, FL 33523
(352)583-4520
Hernando
103883
ROMULO J CAMOGLIANO MD PA
1400 US HWY 441 N
THE VILLAGES, FL 32159
(352)259-3435
Lake
103452
SACRED HEART MEDICAL GROUP ON THE GULF 55 AVENUE E
APALACHICOLA, FL 32320
(850)370-1000
Franklin
103914
SEBRING PEDIATRICS LLC
3201 MEDICAL WAY, SUITE #101
SEBRING, FL 33870
(941)382-0770
Highlands
103435
SHANDS LIVE OAK MEDICAL GROUP
1426 CANYON AVE NE
LIVE OAK, FL 32064
(904)362-1809
Suwannee
103998
SHANDS MEDICAL GROUP OF STARKE
1550 S WATER ST
STARKE, FL 32091
(904)368-2480
Bradford
103887
SHORELINE MEDICAL GROUP
419 BALTZELL AVENUE
PORT SAINT JOE, FL 32456
(904)670-8585
Gulf
103952
SONNIS PEDIATRICS INC
1125 S 6TH AVE
WACHULA, FL 33873
(863)767-1616
Hardee
108947
SOUTHERN FAMILY HEALTHCARE PA
877 3RD ST
CHIPLEY, FL 32428
(850)638-4383
Washington
683804
SOUTHERN HEALTH CLINIC
2910 HOSPITAL DRIVE
BONIFAY, FL 32425
(850)547-8158
Holmes
108971
ST FRANCIS PRIMARY CARE CLINIC
720 N BAY ST
EUSTIS, FL 32726
(352)357-3129
Lake
108909
ST VINCENTS PRIMARY CARE
3772 W 3RD ST
HILLIARD, FL 32046
(904)845-3574
Nassau
103430
STEINHATCHEE FAMILY CENTER
1209 1ST AVE S
STEINHATCHEE, FL 32359
(352)498-5888
Taylor
683806
SUMTER MEDICAL CENTER
411 N WEST ST
BUSHNELL, FL 33513
(352)508-1125
Sumter
108950
SUN N LAKE MEDICAL GROUP - SEBRING
4958 SUN N LAKE BLVD
SEBRING, FL 33872
(863)386-4711
Highlands
108999
SUN N LAKE MEDICAL GROUP PA
511 W INTERLAKE BLVD
LAKE PLACID, FL 33852
(863)699-1220
Highlands
108954
SUNCOAST PRIMARY CARE SPECIALISTS
3733 E GULF TO LAKE HWY
INVERNESS, FL 34450
(352)746-1588
Citrus
103855
SUNCOAST PRIMARY CARE SPECIALISTS
7991 S SUNCOAST BLVD
HOMOSASSA, FL 34446
(352)489-2486
Citrus
108961
SUNRISE PRIMARY CARE
811 N SUMMIT ST
CRESCENT CITY, FL 32112
(386)698-2279
Putnam
108995
SUNRISE PRIMARY CARE INC
219 N PALM AVENUE
PALATKA, FL 32177
(386)325-8002
Putnam
103973
SUNSHINE PEDIATRICS OF OCALA PA
1900 SW 20TH PL
OCALA, FL 34471
(352)840-5437
Marion
103409
1549 S JEFFERSON ST
MONTICELLO, FL 32344
(904)997-0707
Jefferson
103928
TALLAHASSEE MEMORIAL FAMILY MEDICINE
MONTICELLO
TAVARES PEDIATRICS, INC.
2523 DORA AVENUE
TAVARES, FL 32778
(352)394-3929
Lake
103847
THE HEALTH CLINIC LLC
1351 SOUTH BLVD
CHIPLEY, FL 32428
(904)638-1230
Washington
Run Date: 10/08/2015
Job # 41303463
Last Update: 10/07/2015
Page 5 of 5
CASPER Report 0006D
Name and Address Listing
For Rural Health Clinic
Based on Current Survey
Florida
CCN
Provider Name
Address
City, State and ZIP
Telephone # County Name
108963
THE MEDICAL CENTER AT BLOUNTSTOWN
20454 NE FINLEY AVE
BLOUNTSTOWN, FL 32424
(850)674-2221
Calhoun
108978
THREE RIVERS MEDICAL INC
208 NW SUWANNEE AVE
BRANFORD, FL 32008
(386)935-1607
Suwannee
103997
TMH PHYSICIAN PARTNERS BLOUNTSTOWN
17808 NE CHARLEY JOHNS ST
BLOUNTSTOWN, FL 32424
(904)674-8450
Calhoun
103428
TMH PHYSICIAN PARTNERS WAKULLA
15 COUNCIL MOORE RD
CRAWFORDVILLE, FL 32327
(850)926-7105
Wakulla
108998
TRI COUNTY PRIMARY CARE INC
306 NE HWY 351
CROSS CITY, FL 32628
(352)498-3372
Dixie
103949
URGENT AND CONVENIENT CARE CENTER
700 SOUTH MAIN ST
LA BELLE, FL 33935
(239)325-1310
Hendry
103450
VERNON CLINIC
3250 MAIN ST
VERNON, FL 32462
(850)638-1610
Washington
108989
VERNON FAMILY HEALTH CENTER
3027 MAIN ST
VERNON, FL 32462
(850)535-0703
Washington
103815
41 FELI WAY
CRAWFORDVILLE, FL 32327
(850)926-3140
Wakulla
108934
WAKULLA URGENT CARE AND DIAGNOSTIC
CENTER PLC
WEIRSDALE FAMILY HEALTH CENTER
16400 SOUTH HIGHWAY 25
WEIRSDALE, FL 32195
(352)821-9797
Marion
103834
WEST FLORIDA MEDICAL ASSOCIATES PA
213 S PINE AVE
INVERNESS, FL 34452
(352)344-5511
Citrus
108923
WEST FLORIDA MEDICAL ASSOCIATES PA
41 N INGLIS AVE
INGLIS, FL 34449
(352)447-3031
Levy
103893
WEST FLORIDA MEDICAL ASSOCIATES, PA
3775 N LECANTO HWY
BEVERLY HILLS, FL 34465
(352)746-0600
Citrus
108939
WILLISTON PEDIATRICS PA
223 N MAIN ST
WILLISTON, FL 32696
(352)529-0477
Levy
103974
300 NW 1ST AVE
WILLISTON, FL 32696
(352)528-3561
Levy
103923
WILLISTON RURAL HEALTH AND WELLNESS
CLINIC
WIMAUMA FAMILY HEALTH CENTER
5121 STATE RD 674
WIMAUMA, FL 33598
(813)633-8489
Hillsborough
683813
WOMEN'S CENTER OF FLORIDA
1546 S WATER ST
STARKE, FL 32091
(904)964-4777
Bradford
Total Providers for this State = 150
Run Date: 10/08/2015
Job # 41303463
Last Update: 10/07/2015
Page 1 of 3
CASPER Report 0006D
Name and Address Listing
For Rural Health Clinic
Based on Current Survey
Georgia
CCN
Provider Name
Address
City, State and ZIP
Telephone # County Name
118905
ANGELITE FAMILY CLINIC
1009 3RD AVENUE
WEST POINT, GA 31833
(706)645-1046
Harris
118518
APPLE MEDICAL CENTER
822 INDUSTRIAL BOULEVARD
ELLIJAY, GA 30540
(706)635-5177
Gilmer
118520
APPLING MEDICAL GROUP
755 SOUTH MAIN STREET
BAXLEY, GA 31513
(912)367-9841
Appling
113400
ARABI HEALTH CARE CLINIC
4110 BEDGOOD AVE
ARABI, GA 31712
(229)273-0116
Crisp
118544
ARCHBOLD PELHAM PRIMARY CARE CLINIC
250 BLANTON STREET NE
PELHAM, GA 31779
(229)294-2437
Mitchell
113872
B. LAMAR MURRAY, M.D. (RHCS)
311 FOURTH STREET
WAYNESBORO, GA 30830
(706)554-5908
Burke
113408
BACON COUNTY COMMUNITY CARE CENTER
204 EAST 15TH STREET
ALMA, GA 31510
(912)632-2952
Bacon
118516
BLUE MOUNTAIN FAMILY PRACTICE
178 A HOSPITAL ROAD
BLAIRSVILLE, GA 30512
(706)745-4191
Union
118501
BROOKS MEDICAL ASSOCIATES
907 NORTH COURT STREET
QUITMAN, GA 31643
(229)263-4531
Brooks
118549
BUCHANAN MEDICAL CLINIC
30 BUCHANAN BYPASS
BUCHANAN, GA 30113
(770)646-8281
Haralson
113474
CAMILLA PEDIATRIC CENTER
25 PERRY STREET
CAMILLA, GA 31730
(229)336-7472
Mitchell
118538
380 CEDAR STREET
METTER, GA 30439
(912)685-5073
Candler
41 WELLINGTON MILL ROAD
WHITESBURG, GA 30185
(770)836-0504
Carroll
4248 MT. ZION ROAD
MOUNT ZION, GA 30150
(770)836-0103
Carroll
118535
CANDLER COUNTY HOSPITAL FAMILY MEDICAL
CLINIC
CARROLL COUNTY PRIMARY HEALTH CARE
CLINIC
CARROLL COUNTY PRIMARY HEALTH CARE
CLINIC
CLINIC AT WALMART, THE
2630 HIGHWAY 515
BLAIRSVILLE, GA 30512
(706)493-6860
Union
113460
COFFEE REGIONAL FIRST CARE
205 SHIRLEY AVE
DOUGLAS, GA 31533
(912)384-1900
Coffee
113422
6 HOSPITAL PARK
MOULTRIE, GA 31768
(229)985-3320
Colquitt
111 SOUTH WASHINGTON STREET
LINCOLNTON, GA 30817
(706)359-4215
Lincoln
212 HOSPITAL DRIVE
WASHINGTON, GA 30673
(706)678-5982
Wilkes
118534
COLQUITT REG MEDICAL CENTER PRIMARY
CARE CLINIC
COMMUNITY MEDICAL ASSOCIATES OF
LINCOLNTON
COMMUNITY MEDICAL ASSOCIATES OF
WASHINGTON
COOK FAMILY WELLNESS CENTER
103 E JAMES STREET
ADEL, GA 31620
(229)896-3424
Cook
118528
COOK PRIMARY CARE
308 N PARRISH AVE
ADEL, GA 31620
(229)896-8134
Cook
113835
113825
118533
118536
118907
CRISP REGIONAL CONVENIENT CARE
216 HOSPITAL DRIVE
CORDELE, GA 31015
(229)276-2000
Crisp
118529
DAHLONEGA FAMILY PRACTICE
59 TIPTON DRIVE
DAHLONEGA, GA 30533
(706)864-4012
Lumpkin
118910
DAHLONEGA PEDIATRICS
1055 NORTH GROVE STREET
DAHLONEGA, GA 30533
(706)864-6700
Lumpkin
118530
DAWSON FAMILY PHYSICIANS
1078 LUMPKIN CAMPGROUND RD SOUTH STE 100
DAWSONVILLE, GA 30534
(706)265-8439
Dawson
113466
FITZGERALD, GA 31750
(229)424-7263
Ben Hill
118911
DMC INTERNAL MEDICINE AND FAMILY HEALTH 118 NORMAN DORMINY DRIVE
CLINIC
DOERUN FAMILY MEDICINE
128 WEST BROAD AVENUE
DOERUN, GA 31744
(229)782-7589
Colquitt
118541
EFFINGHAM FAMILY MEDICINE
800 TOWNE PARK DRIVE
RINCON, GA 31326
(912)754-6451
Effingham
118542
EFFINGHAM FAMILY MEDICINE AT GOSHEN
100 GOSHEN ROAD
RINCON, GA 31326
(912)754-6451
Effingham
118540
EFFINGHAM FAMILY MEDICINE AT TWENTY ONE 1451 HIGHWAY 21 SOUTH
SPRINGFIELD, GA 31329
(912)754-1035
Effingham
113403
ELLAVILLE PRIMARY MEDICINE CENTER
72 SOUTH BROAD STREET
ELLAVILLE, GA 31806
(229)937-2602
Schley
118546
EMANUEL MEDICAL CENTER
114 S. JEFFERSON STREET
SWAINSBORO, GA 30401
(478)237-7517
Emanuel
Run Date: 10/08/2015
Job # 41303463
Last Update: 10/07/2015
Page 2 of 3
CASPER Report 0006D
Name and Address Listing
For Rural Health Clinic
Based on Current Survey
Georgia
CCN
Provider Name
Address
City, State and ZIP
Telephone # County Name
118554
EMANUEL PEDIATRIC ASSOCIATES
115 S RACETRACK ST
SWAINSBORO, GA 30401
(478)419-1206
Emanuel
118532
EVANS FAMILY CENTERED HEALTHCARE
501 EAST LONG STREET
CLAXTON, GA 30417
(912)739-8001
Evans
113863
FAMILY PRACTICE & SURGERY
120 SPARTA HIGHWAY
EATONTON, GA 31024
(706)444-6521
Putman
113862
FAMILY PRACTICE & SURGERY CENTER
446 SPRING STREET
SPARTA, GA 31087
(706)444-6521
Hancock
118525
FAMILY PRACTICE CLINIC
2383 NORTH THIRD STREET
FOLKSTON, GA 31537
(912)496-4839
Charlton
113954
FIROZ PATKA, MD
809 PEACHTREE STREET
LOUISVILLE, GA 30434
(478)625-3743
Jefferson
113431
FLINT RIVER RURAL HEALTH CLINIC
502 SUMTER STREET
MONTEZUMA, GA 31063
(478)472-8178
Dooly
113404
FLINT RIVER- RHC
509 SUMTER ST
MONTEZUMA, GA 31063
(478)472-3100
Dooly
113851
FRANKLIN PRIMARY HEALTH CARE CLINIC
1236 FRANKLIN PARKWAY
FRANKLIN, GA 30217
(706)675-8669
Heard
118902
HABIGAILE CRIBE, MD LLC
911 PLAZA AVE STE B
EASTMAN, GA 31023
(478)374-5582
Dodge
113952
HIAWASSEE FAMILY PRACTICE, PC
56 HOSPITAL STREET
HIAWASSEE, GA 30546
(706)896-2289
Towns
113965
HINESVILLE FAMILY CARE CENTER
502 EAST GENERAL STEWART WAYS
HINESVILLE, GA 31313
(912)368-4169
Liberty
113968
KIRK CLINIC, THE
8 LAUREL COURT
MOULTRIE, GA 31768
(229)891-9016
Colquitt
118537
280 WILLOW CREEK LANE
MC RAE, GA 31055
(229)868-4122
Telfair
118908
LOWER OCONEE RURAL HEALTH CLINIC AT
MCRAE
MADISON MEDICAL ASSOCIATES, PC
1075 SOUTH MAIN STREET SUITE 100
MADISON, GA 30650
(706)752-0322
Morgan
113808
MEDICAL ACCESS CLINIC
808 PROFESSIONAL BLVD.
DALTON, GA 30720
(706)226-5446
Whitfield
113886
MEDICAL ASSOCIATES
305 JONES AVENUE
WAYNESBORO, GA 30830
(706)554-5147
Burke
113958
MEDICAL CENTER OF ELBERTON, LLP, THE
109 COLLEGE AVENUE
ELBERTON, GA 30635
(706)283-3315
Elbert
118519
MEDICAL GROUP OF MITCHELL COUNTY
259 US HIGHWAY 19 NORTH
CAMILLA, GA 31730
(229)336-1949
Mitchell
118545
222 PERRY HIGHWAY BUILDING A SUITE 101
HAWKINSVILLE, GA 31036
(478)783-4080
Pulaski
113997
MIDDLE GEORGIA PEDIATRICS AT
HAWKINSVILLE
MILLER COUNTY MEDICAL CENTER
208 N. CUTHBERT STREET
COLQUITT, GA 39837
(229)758-3304
Miller
113869
MOUNTAIN VALLEY MEDICAL CENTER
92 BETTY'S CREEK ROAD
DILLARD, GA 30537
(706)746-6571
Rabun
118912
NORMAN PARK FAMILY MEDICINE CLINIC
139 E BROAD
NORMAN PARK, GA 31771
(229)769-3500
Colquitt
118527
NORTH GEORGIA FAMILY PRACTICE
60 OLD HIGHWAY 5 SOUTH
ELLIJAY, GA 30540
(706)698-4362
Gilmer
113882
NORTH JEFFERSON MEDICAL CENTER
406 E. BROAD STREET
WRENS, GA 30833
(706)547-7008
Jefferson
118548
OPTIM PRIMARY CARE - DARIEN
1101 NORTH WAY
DARIEN, GA 31305
(423)243-6185
Mcintosh
118512
OPTIM PRIMARY CARE- COBBTOWN
36671 HIGHWAY 23
COBBTOWN, GA 30420
(912)684-3692
Tattnall
118511
OPTIM PRIMARY CARE- GLENNVILLE
1000B NORTH VETERANS BLVD
GLENNVILLE, GA 30427
(912)654-1080
Long
118513
OPTIM PRIMARY CARE- MILLEN
961 E WINTHROPE AVENUE
MILLEN, GA 30442
(478)982-9081
Jenkins
118508
OPTIM PRIMARY CARE- REIDSVILLE
125 MEMORIAL DRIVE
REIDSVILLE, GA 30453
(912)557-1000
Tattnall
118547
OPTIM PRIMARY CARE- SYLVANIA
213 MIMS ROAD
SYLVANIA, GA 30467
(912)564-7426
Screven
113972
PHOEBE FAMILY MED CENTER- PELHAM
410 CURRY STREET
PELHAM, GA 31779
(229)294-9233
Mitchell
113936
PHOEBE FAMILY MEDICAL CENTER- CAMILLA
48 U.S. 19 SOUTH
CAMILLA, GA 31730
(229)336-5208
Mitchell
113477
PHOEBE WORTH FAMILY MEDICINE
1014 WEST FRANKLIN ST
SYLVESTER, GA 31791
(229)776-2965
Worth
STE A
Run Date: 10/08/2015
Job # 41303463
Last Update: 10/07/2015
Page 3 of 3
CASPER Report 0006D
Name and Address Listing
For Rural Health Clinic
Based on Current Survey
Georgia
CCN
Provider Name
Address
City, State and ZIP
Telephone # County Name
113420
PHYSICIANS' HEALTH GROUP
1067 PEACHTREE STREET
LOUISVILLE, GA 30434
(478)625-8471
Jefferson
113453
PHYSICIANS' HEALTH GROUP- WADLEY
162 NORTH MAIN STREET
WADLEY, GA 30477
(478)252-8900
Jefferson
118543
PIONEER FAMILY CARE
11168 COLUMBIA STREET
BLAKELY, GA 39823
(000)123-6544
Early
118509
BLAKELY, GA 39823
(229)723-4313
Early
118552
PIONEER FAMILY MEDICAL OF EARLY COUNTY, 11045 COLUMBIA STREET
LLC
PORTER FAMILY MEDICAL CLINIC
124 VICTORY DRIVE
SWAINSBORO, GA 30401
(478)237-5506
Emanuel
118904
R T STANLEY HEALTH CENTER
LYONS, GA 30436
(912)526-9355
Toombs
110 R.T. STANLEY, SR. PLACE
113429
RANDOLPH MEDICAL ASSOCIATES
125 MCDONALD AVE
CUTHBERT, GA 39840
(229)732-2181
Randolph
118510
RANDOLPH MEDICAL ASSOCIATES
107 PARK STREET
SHELLMAN, GA 39886
(229)679-5579
Randolph
118526
RAY MEDICAL CLINIC
401 WEST MAIN STREET
SWAINSBORO, GA 30401
(478)289-1150
Emanuel
113885
REDDY MEDICAL GROUP- FRANKLIN SPRINGS
STREET
REDDY MEDICAL GROUP- GENERAL DANIEL
AVENUE
REDDY URGENT CARE- HARTWELL, LLC
132 FRANKLIN SPRINGS STREET
ROYSTON, GA 30662
(706)245-7371
Franklin
280 GENERAL DANIEL AVENUE
DANIELSVILLE, GA 30633
(706)795-2211
Madison
138 GIBSON STREET
HARTWELL, GA 30643
(706)247-5450
Hart
113856
118909
113858
RIVERSTONE MD, PC
101 RIVERSTONE VISTA SUITE 205
BLUE RIDGE, GA 30513
(706)632-4400
Fannin
113497
ROBERT E. JENNINGS MEDICAL CLINIC
103 R.E. JENNINGS AVENUE,
ARLINGTON, GA 39813
(229)725-4251
Calhoun
118550
SCREVEN COUNTY FAMILY HEALTH CENTER
105 ROCKY FORD RD
SYLVANIA, GA 30467
(912)564-7133
Screven
118906
SJC MEDICAL GROUP INC
10 DOCTORS STREET
METTER, GA 30439
(912)685-5715
Candler
118522
SOUTH GEORGIA MEDICAL ASSOCIATES
105 EAST TOLLISON STREET, STE B
BAXLEY, GA 31515
(912)367-9841
Appling
113948
SOUTHCARE MEDICAL CENTER
2514 C TOBACCO ROAD
HEPHZIBAH, GA 30815
(706)790-0311
Richmond
113841
ST. JOSEPH'S/CANDLER MEDICAL GROUP
159 WEST RAILROAD ST
PEMBROKE, GA 31321
(912)653-2897
Bryan
118551
SWAINSBORO INTERNAL MED CLINIC
119 VICTORY DR SUITE A
SWAINSBORO, GA 30401
(478)237-8342
Emanuel
118504
TALLAPOOSA FAMILY HEALTHCARE
25 WEST LYONS STREET
TALLAPOOSA, GA 30176
(770)824-2800
Haralson
118900
TANNER FAMILY HEALTHCARE OF FRANKLIN
2906 FRANKLIN PARKWAY
FRANKLIN, GA 30217
(706)675-6949
Heard
113960
THOMSON PEDIATRICS & INTERNAL MEDICINE
306 MOUNT PLEASANT ROAD
THOMSON, GA 30824
(706)595-0090
Mcduffie
118505
TMC HARALSON FAMILY HEALTHCARE CENTER 204 ALLEN MEMORIAL DR, STE 201
BREMEN, GA 30110
(770)537-6500
Haralson
118553
TWIN CITY FAMILY MEDICAL CLINIC
115 GILLIKIN ST
TWIN CITY, GA 30471
(478)763-3036
Emanuel
118539
VALLEY MEDICAL CENTER
701 BLUE BIRD BLVD
FORT VALLEY, GA 31030
(478)825-7000
Crawford
113998
WARWICK HEALTH CARE CLINIC
135 DOGWOOD STREET
WARWICK, GA 31796
(229)535-4170
Worth
113890
WEST CARROLL FAMILY HEALTH CARE CTR
1125 EAST HIGHWAY 166
BOWDON, GA 30108
(770)836-9388
Carroll
113498
WRENS PHYSICIANS' HEALTH GROUP
400 CANTERBURY DRIVE
WRENS, GA 30833
(478)625-7000
Jefferson
Total Providers for this State = 95
Run Date: 10/08/2015
Job # 41303463
Last Update: 10/07/2015
Page 1 of 6
CASPER Report 0006D
Name and Address Listing
For Rural Health Clinic
Based on Current Survey
Kentucky
CCN
Provider Name
Address
City, State and ZIP
Telephone # County Name
183821
AARON K JONAN MEMORIAL CLINIC
832 HIGHWAY 15 NORTH
JACKSON, KY 41339
(606)666-5142
Breathitt
183972
ACCESS FAMILY HEALTH CENTER
315 HOSPITAL DRIVE, SUITE 2
BARBOURVILLE, KY 40906
(606)546-4060
Knox
183941
ALBAREE HEALTH SERVICES, LLC
906 E MOUNTAIN PARKWAY, ROUTE 114
SALYERSVILLE, KY 41465
(606)349-8100
Magoffin
183955
ANNVILLE MEDICAL CLINIC
78 STATE ROAD 3444
ANNVILLE, KY 40402
(606)364-5162
Jackson
183893
APPALACHIA HEALTH SERVICES
3080 US HIGHWAY 25W, NORTH
WILLIAMSBURG, KY 40769
(606)549-9107
Whitley
183932
APPALACHIAN CLINIC-WOOTON
21154 HWY 421, SUITE A
HYDEN, KY 41749
(606)672-1144
Leslie
183924
APPALACHIAN PHYSICIANS, PSC
48 DANIEL BOONE PLAZA
HAZARD, KY 41701
(606)487-9999
Perry
183886
ARH DANIEL BOONE CLINIC - HARLAN
37 BALL PARK ROAD
HARLAN, KY 40831
(606)573-4520
Harlan
183452
ARH MCDOWELL CLINIC
9879 KY ROUTE 122
MC DOWELL, KY 41647
(606)377-3401
Floyd
183451
ARH MORGAN COUNTY CLINIC
476 LIBERTY ROAD
WEST LIBERTY, KY 41472
(606)743-3198
Morgan
183867
ARH TRI-CITY MEDICAL CENTER
18880 NORTH US HIGHWAY 119
CUMBERLAND, KY 40823
(606)589-0130
Harlan
183888
ARH TUG VALLEY MEDICAL ASSOCIATES
306 HOSPITAL DRIVE
SOUTH WILLIAMSON, KY 41503
(606)237-1757
Pike
183868
ARH WHITESBURG CLINIC
214 HOSPITAL ROAD
WHITESBURG, KY 41858
(606)633-3632
Letcher
183877
ASSOCIATES IN PHYSICIAN SERVICES
1573 HIGHWAY 259 NORTH
BROWNSVILLE, KY 42210
(270)597-2168
Edmonson
183933
ATIENZA-ACOB MEDICAL CLINIC
110 ROY KIDD AVENUE
CORBIN, KY 40701
(606)528-7400
Knox
188929
AUBURN COMMUNITY HEALTH CLINIC
128 SUGAR MAPLE DRIVE
AUBURN, KY 42206
(270)542-5500
Logan
183447
B F TAYLOR MEDICAL ARTS CLINIC
299-A GLASGOW ROAD
BURKESVILLE, KY 42717
(270)864-2555
Cumberland
183950
BAPTIST HEALTH MEDICAL ASSOCIATES
1010 MEDICAL CENTER DRIVE
POWDERLY, KY 42367
(270)377-1600
Muhlenberg
188935
BAPTIST PRIMARY CARE OF BARBOURVILLE
602 KNOX STREET
BARBOURVILLE, KY 40906
(606)546-6027
Knox
188940
BAPTIST PRIMARY CARE OF WILLIAMSBURG
403 SYCAMORE STREET
WILLIAMSBURG, KY 40769
(606)549-8244
Whitley
183916
BARBOURVILLE FAMILY HEALTH CENTER
215 NORTH ALLISON AVENUE
BARBOURVILLE, KY 40906
(606)546-9287
Knox
183945
BATES, MILLER, AND SIMS, PLLC
100 JAY STREET
STANFORD, KY 40484
(606)365-1547
Lincoln
188938
BATH FAMILY HEALTH SERVICES
44 WATER STREET
OWINGSVILLE, KY 40360
(606)674-9776
Bath
183480
BEATTYVILLE FAMILY MEDICAL CLINIC
1027 HIGHWAY 11 NORTH
BEATTYVILLE, KY 41311
(606)464-0061
Lee
183485
BEDFORD FAMILY PRACTICE
470 HIGHWAY 421 NORTH
BEDFORD, KY 40006
(502)225-7732
Trimble
183470
BEECH FORK ARH CLINIC
805 MIDDLE FORK ROAD
ASHER, KY 40803
(606)374-3393
Leslie
183859
BELL CLINIC, PLLC
105 ELK FORK ROAD
ELKTON, KY 42220
(270)265-2574
Todd
183421
BETSY LAYNE CLINIC
9350 US HIGHWAY 23 S, SUITE 3
STANVILLE, KY 41659
(606)478-3636
Floyd
183471
BIG CREEK ARH CLINIC
17644 SOUTH HIGHWAY 421
BIG CREEK, KY 40914
(606)598-6196
Clay
188931
BLOUNT RURAL HEALTH CENTER
810 SOUTH MAIN STREET
ELKTON, KY 42220
(270)265-6504
Todd
183956
BLUEGRASS CLINIC LIBERTY, PLLC
19 ABES PLAZA
LIBERTY, KY 42539
(606)787-0014
Casey
183939
BLUEGRASS CLINIC STANFORD, PLLC
107 METKER TRAIL, SUITE A
STANFORD, KY 40484
(606)365-8338
Lincoln
188946
BRYANT FAMILY MEDICINE
2932 N HIGHWAY 25W
WILLIAMSBURG, KY 40769
(606)549-8088
Whitley
183831
BURKHART RURAL HEALTH CLINIC
117 E. MAIN ST BOX 6
SALEM, KY 42078
(270)988-3839
Livingston
183967
BURNING SPRINGS MEDICAL CLINIC
11901 NORTH HIGHWAY 421
MANCHESTER, KY 40962
(606)598-2706
Clay
Run Date: 10/08/2015
Job # 41303463
Last Update: 10/07/2015
Page 2 of 6
CASPER Report 0006D
Name and Address Listing
For Rural Health Clinic
Based on Current Survey
Kentucky
CCN
Provider Name
Address
City, State and ZIP
Telephone # County Name
183489
BUTLER COUNTY FAMILY CARE
210 NORTH MAIN STREET
MORGANTOWN, KY 42261
(270)526-3137
Butler
183482
CAMPTON RURAL HEALTH CLINIC
49 KY 15 NORTH
CAMPTON, KY 41301
(606)668-9481
Wolfe
183922
CARLISLE CLINIC
107 SOUTH BROADWAY STREET
CARLISLE, KY 40311
(859)289-4124
Nicholas
183985
CARROLL COUNTY RURAL HEALTH CLINIC
309 11TH STREET
CARROLLTON, KY 41008
(502)732-3272
Carroll
188912
CASA SAN PIO
638 E COLLEGE AVENUE, SUITE B
STANTON, KY 40380
(606)318-3500
Powell
183466
CASEY COUNTY FAMILY PRACTICE
112 LIBERTY SQUARE SHOPPING CENTER
LIBERTY, KY 42539
(606)787-5044
Casey
183428
187 WOLFORD AVENUE
LIBERTY, KY 42539
(606)787-8348
Casey
1495 SOUTH DIXIE STREET
HORSE CAVE, KY 42749
(270)786-2372
Hart
183478
CASEY COUNTY PRIMARY CARE RURAL
HEALTH CLINIC
CAVERNA MEMORIAL HOSPITAL PHYSICIANS
OFFICE
CENTRAL CITY CLINIC
101 LEGION DRIVE
CENTRAL CITY, KY 42330
(270)754-5400
Muhlenberg
183827
CHILDREN'S CLINIC
223 RIVER DRIVE
IRVINE, KY 40336
(606)723-5142
Estill
183849
CHILDREN'S CLINIC ANNEX
62 MERCY COURT
IRVINE, KY 40336
(606)723-5142
Estill
183919
CLARK CLINIC PRIMARY CARE
225 HOSPITAL DRIVE
WINCHESTER, KY 40391
(859)744-5757
Clark
183931
CLARK FAMILY CARE
29 CANARY LANE
WINCHESTER, KY 40391
(859)745-4469
Clark
188927
CLAY CITY PEDIATRICS AND PRIMARY CARE
98 RIVER STREET
CLAY CITY, KY 40312
(606)663-7788
Powell
183823
CLOVER FORK OUTPATIENT MEDICAL PROJECT 101 CHAD ST
EVARTS, KY 40828
(606)837-2108
Harlan
183412
CLOVERPORT HEALTH CLINIC
209 ELM STREET
CLOVERPORT, KY 40111
(270)778-3000
Breckinridge
183465
CMH MUNFORDVILLE PHYSICIANS OFFICE
1134 MAIN STREET
MUNFORDVILLE, KY 42765
(270)524-3641
Hart
188928
COMMUNITY FAMILY CLINIC, PLLC
17 MILLER DRIVE
OWINGSVILLE, KY 40360
(606)674-3033
Bath
183949
COMMUNITY FAMILY CLINIC, PLLC
784 HIGHWAY 36
FRENCHBURG, KY 40322
(606)768-9190
Menifee
183917
CORBIN FAMILY HEALTH CENTER
140 BRYAN BOULEVARD
CORBIN, KY 40701
(606)523-2005
Knox
183929
CORBIN PEDIATRIC ASSOCIATES, PSC
60 BRYAN BOULEVARD, SUITE 200
CORBIN, KY 40701
(606)528-9700
Knox
183965
CORBIN RURAL HEALTH CENTER, PLLC
1013 MASTER STREET
CORBIN, KY 40701
(606)280-7772
Knox
188925
CRAB ORCHARD PRIMARY CARE
207 MAIN STREET
CRAB ORCHARD, KY 40419
(606)355-7800
Garrard
188930
CUMBERLAND FAMILY CLINIC, PLLC
57 HOGUE ROAD
PINE KNOT, KY 42635
(606)354-9444
Mccreary
183957
DANIEL BOONE FAMILY HEALTHCARE, PLLC
215 TREUHAFT BOULEVARD, SUITE 3B
BARBOURVILLE, KY 40906
(606)545-0400
Knox
188944
EAST KENTUCKY HEALTHCARE SERVICES
CENTER, INC
EASTERN KY TENDER CARE PEDIATRICS
566 HWY 899
HINDMAN, KY 41822
(606)785-5327
Knott
4851 KY ROUTE 321
PRESTONSBURG, KY 41653
(606)886-1173
Floyd
31 MARK SHOPVILLE ROAD
SOMERSET, KY 42503
(606)485-4553
Pulaski
183481
EASTERN PULASKI RURAL HEALTH CLINIC,
PLLC
EDDYVILLE FAMILY MEDICAL
209 W MAIN STREET
EDDYVILLE, KY 42038
(270)388-0620
Lyon
183994
EDMONTON PRIMARY CARE CENTER
112 SARTIN DRIVE, LOT 1
EDMONTON, KY 42129
(270)432-5782
Metcalfe
188908
ELKTON CLINIC, PSC
713 WEST MAIN STREET
ELKTON, KY 42220
(270)265-5353
Todd
188910
EPHRAIM MCDOWELL GARRARD CLINIC
405 DANVILLE STREET
LANCASTER, KY 40444
(859)792-2124
Garrard
183905
EPHRAIM MCDOWELL SPRINGFIELD FAMILY
MEDICAL CENTER
280 LINCOLN DRIVE
SPRINGFIELD, KY 40069
(859)336-9801
Washington
183464
183914
188939
Run Date: 10/08/2015
Job # 41303463
Last Update: 10/07/2015
Page 3 of 6
CASPER Report 0006D
Name and Address Listing
For Rural Health Clinic
Based on Current Survey
Kentucky
CCN
Provider Name
Address
City, State and ZIP
Telephone # County Name
183892
ERTEL MEDICINE & PEDIATRICS
1520 BOONESBORO ROAD
WINCHESTER, KY 40391
(859)744-0067
Clark
183952
ERTEL MEDICINE & PEDIATRICS - POWELL, PSC 68 EAST ELKINS STREET
STANTON, KY 40380
(606)663-2511
Powell
188903
ESTILL MEDICAL CLINIC
275 N COURT STREET
IRVINE, KY 40336
(606)723-2167
Estill
183826
325 WALNUT STREET, SUITE 600
LEBANON, KY 40033
(270)699-9500
Marion
183902
FAMILY & INTERNAL MEDICINE ASSOCIATES
PLLC
FAMILY CARE CLINIC MT STERLING
644 N MAYSVILLE ROAD, SUITE 8
MOUNT STERLING, KY 40353
(859)498-6006
Montgomery
188926
FAMILY FIRST HEALTH CARE, PLLC
363 OFFICE PARK DRIVE
COLUMBIA, KY 42728
(270)384-3939
Adair
183899
FAMILY HEALTH CARE ASSOCIATES
1927 S HWY 25 E
BARBOURVILLE, KY 40906
(606)546-7777
Knox
183936
FAMILY HEALTH CARE CLINIC
312 JASON DRIVE, SUITE 9
RICHMOND, KY 40475
(859)626-9696
Madison
183884
FAMILY MEDICAL CENTER
1463 CAMPBELLSVILLE ROAD
COLUMBIA, KY 42728
(270)384-9934
Adair
183897
FAMILY MEDICAL CENTER OF HART COUNTY
117 WEST SOUTH STREET
MUNFORDVILLE, KY 42765
(270)524-7231
Hart
183488
FAMILY PRACTICE ASSOCIATES
124 DOWELL ROAD
RUSSELL SPRINGS, KY 42642
(270)866-2440
Russell
183898
FAMILY PRACTICE CLINIC OF BOONEVILLE
200 MULBERRY STREET, SUITE A
BOONEVILLE, KY 41314
(606)593-6023
Owsley
183963
FAMILY PRACTICE CLINIC, PSC
518 WEST GUM STREET
MARION, KY 42064
(270)965-5238
Crittenden
188922
FIRST YOU MEDICAL CENTER, PLLC
18 ALEXANDER AVENUE, UNIT 1
BEDFORD, KY 40006
(502)255-0222
Trimble
188923
FIRST YOU MEDICAL CENTER, PLLC
151 EAST BROADWAY
EMINENCE, KY 40019
(502)845-6288
Henry
183896
FLAT LICK MEDICAL CLINIC
34 MARY ALICE LANE
FLAT LICK, KY 40935
(606)542-5900
Knox
183974
FLOWERS RURAL HEALTH CARE
333 KEEN STREET
BURKESVILLE, KY 42717
(270)864-3371
Cumberland
188917
FOOTHILLS HEALTH AND WELLNESS CENTER
108 12TH STREET
CLAY CITY, KY 40312
(606)663-9011
Powell
183408
FORDSVILLE AREA MEDICAL CLINIC
44 W MAIN STREET
FORDSVILLE, KY 42343
(270)276-9953
Ohio
183432
FOUNTAIN RUN RURAL HEALTH CLINIC
47 AKERSVILLE ROAD
FOUNTAIN RUN, KY 42133
(270)434-4857
Monroe
183940
FREDERICK MEDICAL CLINIC
430 LIBERTY ROAD
WEST LIBERTY, KY 41472
(606)743-3114
Morgan
183964
FREEMAN FAMILY PRACTICE
10755 NORTH US HIGHWAY 25 E
GRAY, KY 40734
(606)258-8050
Knox
183958
GEORGE HAYDEN CAUDILL, PSC
1893 RED FOX ROAD
REDFOX, KY 41847
(606)642-3250
Knott
183448
GRAND LAKES CLINIC
1860 J H O'BRYAN AVENUE
GRAND RIVERS, KY 42045
(270)362-8246
Livingston
183455
GREEN COUNTY PRIMARY CARE
310 INDUSTRIAL PARK ROAD
GREENSBURG, KY 42743
(270)299-2247
Green
188904
GREENSBURG HEALTH CARE
2680 CAMPBELLSVILLE ROAD
GREENSBURG, KY 42743
(270)299-2222
Green
183477
HAROLD PRIMARY CARE
24 LEFT PENHOOK ROAD
HAROLD, KY 41635
(606)478-8787
Floyd
183906
HARRODSBURG FAMILY MEDICAL CENTER
1509 LOUISVILLE ROAD
HARRODSBURG, KY 40330
(859)734-5770
Mercer
183449
HICKMAN-FULTON CO MED CLINIC
2003 S 7TH STREET
HICKMAN, KY 42050
(270)236-3202
Fulton
183490
HIGHLANDS PRIMARY CARE
100 BRIANNA BOULEVARD, SUITE 100
SALYERSVILLE, KY 41465
(606)349-6500
Magoffin
183943
HILLTOP PRIMARY CARE, INC
7617 UPPER JOHNS CREEK RD
PHELPS, KY 41553
(606)835-9333
Pike
183928
HO PHYSICIANS SERVICES CORPORATION
841 US HWY 25W SOUTH, SUITE 5
WILLIAMSBURG, KY 40769
(606)549-0123
Whitley
183930
HOMETOWN CLINIC
96 HIGHWAY 80
HYDEN, KY 41749
(606)672-4878
Leslie
183909
HOSKINS MEDICAL CENTER
1120 REUBEN STREET
LONDON, KY 40743
(606)862-7000
Laurel
Run Date: 10/08/2015
Job # 41303463
Last Update: 10/07/2015
Page 4 of 6
CASPER Report 0006D
Name and Address Listing
For Rural Health Clinic
Based on Current Survey
Kentucky
CCN
Provider Name
Address
City, State and ZIP
Telephone # County Name
183472
HYDEN ARH CLINIC
130 KATE IRELAND DRIVE
HYDEN, KY 41749
(606)672-2901
Leslie
183838
534 HILLCREST DRIVE
BRANDENBURG, KY 40108
(270)422-5000
Meade
417 RIVER DRIVE
IRVINE, KY 40336
(606)723-0399
Estill
3470 HIGHWAY 80W
EMMALENA, KY 41740
(606)785-9377
Knott
183901
JEWISH HOSPITAL HEALTH CENTER-MEADE
COUNTY
KENTUCKYONE HEALTH PRIMARY CARE
ASSOCIATES
KNOTT COUNTY CENTER FOR FAMILY HEALTH,
LLC
KNOTT COUNTY FAMILY HEALTHCARE
70 HOLLY HILLS MALL ROAD
HINDMAN, KY 41822
(606)785-9440
Knott
183405
LAKE CUMBERLAND MEDICAL ASSOCIATES
350 HOSPITAL WAY, SUITE 100
SOMERSET, KY 42501
(606)451-2619
Pulaski
183430
LIBERTY FAMILY MEDICAL CENTER
511 MIDDLEBURG STREET
LIBERTY, KY 42539
(606)787-5963
Casey
188913
LIVING WELL HEALTHCARE, LLC
200 NORTH CRAWFORD STREET, SUITE 3
TOMPKINSVILLE, KY 42167
(270)407-5052
Monroe
183891
188934
183959
LON E LAFFERTY, MD, PSC
2160 BLACKLOG ROAD, SUITE 120
INEZ, KY 41224
(606)298-7405
Martin
183435
21 MIDDLE GROUND WAY
LONDON, KY 40744
(606)877-3990
Laurel
183926
LONDON PEDIATRIC AND ADOLESCENT
MEDICINE
LONDON WOMEN'S CARE, PLLC
803 MEYERS-BAKER ROAD, SUITE 200
LONDON, KY 40741
(606)878-3240
Laurel
183935
MADISON FAMILY CLINIC
2161 LEXINGTON ROAD, 1ST FLOOR, SUITE 5
RICHMOND, KY 40475
(859)626-7794
Madison
188914
MADISON PRIMARY CARE, LLC
210 ST GEORGE STREET, SUITE 110
RICHMOND, KY 40475
(859)626-9766
Madison
183960
MARION PHYSICIANS CLINIC
308 S MAIN STREET
MARION, KY 42064
(270)965-4377
Crittenden
183442
MARTIN CLINIC
12579 MAIN STREET, SUITE 101
MARTIN, KY 41649
(606)285-0681
Floyd
188911
MARTIN COUNTY AFTER HOURS CLINIC
1238 MIDDLE FORK ROAD
INEZ, KY 41224
(606)298-4000
Martin
188941
MARTIN COUNTY RURAL HEALTH CLINIC, PLLC
428 EAST MAIN STREET
INEZ, KY 41224
(606)886-1173
Martin
183438
MARTIN FAMILY HEALTH CENTER
11551 MAIN STREET, PO BOX 910
MARTIN, KY 41649
(606)285-3733
Floyd
188937
MAYFIELD FAMILY MEDICINE
1111 MEDICAL CENTER CIRCLE
MAYFIELD, KY 42066
(270)251-4055
Graves
188924
MCCREARY PRIMARY CARE CENTER, INC
65 CENTER AVENUE
WHITLEY CITY, KY 42653
(606)376-2224
Mccreary
183487
MCDANIELS FAMILY CARE
9798 SOUTH HIGHWAY 259
MCDANIELS, KY 40152
(270)902-4411
Breckinridge
183923
MCKEE MEDICAL CLINIC
25 HWY 290, CAMPBELL DRUG BLDG
MC KEE, KY 40447
(606)287-5162
Jackson
188900
515 MEMORIAL DRIVE, SUITE 3
MANCHESTER, KY 40962
(606)599-0169
Clay
183484
MEDICAL ASSOCIATES OF SOUTHEAST
KENTUCKY
MEMORIAL HOSPITAL RED BIRD CLINIC
53 QUEENDALE CENTER
BEVERLY, KY 40913
(606)598-5135
Bell
183479
MERCY MEDICAL CLINIC OF LEE COUNTY
1025 GRAND AVENUE
BEATTYVILLE, KY 41311
(606)464-8806
Lee
183475
MERCY MEDICAL CLINIC OF POWELL COUNTY
749 IRVINE ROAD
CLAY CITY, KY 40312
(606)663-2153
Powell
183462
MERCY PRIMARY CARE - IRVINE
1100 RICHMOND ROAD
IRVINE, KY 40336
(606)723-7771
Estill
183951
METHODIST FAMILY MEDICINE OF STURGIS
9064 US HIGHWAY 60 WEST
STURGIS, KY 42459
(270)333-4349
Union
183459
METHODIST FAMILY PRACTICE
1284 US HWY 60 W
MORGANFIELD, KY 42437
(270)389-2323
Union
183833
MONTICELLO MEDICAL ASSOCIATES
ONE SOUTH CREEK DRIVE, SUITE 102
MONTICELLO, KY 42633
(606)348-3365
Wayne
183857
MOUNTAIN AFTER-HOURS CLINIC
1908 N MAIN STREET, SUITE 120
HAZARD, KY 41701
(606)439-2662
Perry
188933
MOUNTAIN FAMILY PRACTICE CLINIC OF
MANCHESTER, INC
NEW HORIZONS FAMILY PRACTICE
90 GARRARD SQUARE
GARRARD, KY 40941
(606)658-6333
Clay
120 PROGRESS WAY
OWENTON, KY 40359
(502)484-4656
Owen
183450
Run Date: 10/08/2015
Job # 41303463
Last Update: 10/07/2015
Page 5 of 6
CASPER Report 0006D
Name and Address Listing
For Rural Health Clinic
Based on Current Survey
Kentucky
CCN
Provider Name
Address
City, State and ZIP
Telephone # County Name
183861
NORTH GARRARD CENTER
510 NORTH CAMP DICK ROAD
LANCASTER, KY 40444
(606)548-8000
Garrard
188918
ONE HEALTH OHIO COUNTY
1213 N MAIN STREET
BEAVER DAM, KY 42320
(270)274-4771
Ohio
183907
PEDIATRIC ASSOCIATES OF HAZARD, LLC
HAZARD, KY 41701
(606)487-8300
Perry
183880
PEDIATRIC ASSOCIATES OF PIKEVILLE
474 VILLAGE LN, HAZARD VILLAGE SHOPPING
CENTER
156 ISLAND CREEK ROAD
PIKEVILLE, KY 41502
(606)432-3221
Pike
183468
PHYSICIAN SERVICES OF MEMORIAL HOSPITAL 94 MARIE LANGDON DRIVE, SUITE 4
MANCHESTER, KY 40962
(606)598-7900
Clay
183469
POWELL COUNTY CLINIC
STANTON, KY 40380
(606)663-8000
Powell
68 ELKINS STREET
188936
PREFERRED HEALTHCARE, INC
686 SOUTH HIGHWAY 25W
WILLIAMSBURG, KY 40769
(606)549-5052
Whitley
183942
PRIMARY CARE CENTERS OF EASTERN
KENTUCKY
PRIMARY CARE CENTERS OF EASTERN
KENTUCKY - HYDEN
PRIMARY CARE CENTERS OF EASTERN KY HAZARD
PRIMARY CARE CENTERS OF EASTERN KY HINDMAN
QUANTUM HEALTHCARE
10897 S KY HIGHWAY 15
SCUDDY, KY 41760
(606)476-2274
Perry
21992 MAIN STREET
HYDEN, KY 41749
(606)672-5200
Leslie
145 CITIZENS LANE, SUITE B
HAZARD, KY 41701
(606)439-1300
Perry
58 WEST HIGHWAY 80, SUITE 2
HINDMAN, KY 41822
(606)785-1300
Knott
210 BLACK GOLD BOULEVARD, SUITE 106
HAZARD, KY 41701
(606)436-0711
Perry
103 KINGDOM COME DRIVE
CUMBERLAND, KY 40823
(606)589-5514
Harlan
183953
183918
183947
183871
188920
183934
QUANTUM HEALTHCARE ASSOCIATES OF
CUMBERLAND
RED RIVER PEDIATRICS
321-C EAST COLLEGE AVENUE
STANTON, KY 40380
(606)663-9797
Powell
183476
ROCKCASTLE FAMILY CARE
160 EAST MAIN STREET
MOUNT VERNON, KY 40456
(606)256-7761
Rockcastle
183467
ROCKCASTLE FAMILY WELLNESS
140 NEWCOMB AVENUE
MOUNT VERNON, KY 40456
(606)256-7761
Rockcastle
183483
ROCKCASTLE PEDIATRICS & ADOLESCENTS
140 NEWCOMB AVENUE, SUITE C & D
MOUNT VERNON, KY 40456
(606)256-4148
Rockcastle
188942
ROYAL TREATMENT HEALTHCARE, INC
4671 SOUTH US HIGHWAY 25 EAST
BIMBLE, KY 40915
(606)546-2598
Knox
183473
SAINT JOSEPH BEREA FAMILY MEDICINE
305 ESTILL STREET
BEREA, KY 40403
(859)986-2343
Madison
183961
SALEM MEDICAL CLINIC
141 HOSPITAL DRIVE
SALEM, KY 42078
(270)988-3298
Livingston
183878
SALYERSVILLE MEDICAL CENTER
601 E. MAPLE STREET
SALYERSVILLE, KY 41465
(606)349-5300
Magoffin
188907
SANDY HOOK FAMILY CARE CENTER
1908 NORTH KENTUCKY 7
SANDY HOOK, KY 41171
(606)738-9339
Elliott
183440
SETON FAMILY HEALTH CENTER
11087 MAIN STREET
MARTIN, KY 41649
(606)285-3690
Floyd
183948
SHEPHERDSVILLE FAMILY HEALTH CLINIC, PSC 130 WEST JOE B HALL AVENUE
SHEPHERDSVILLE, KY 40165
(502)921-1231
Bullitt
183962
SMITHLAND MEDICAL CLINIC
SMITHLAND, KY 42081
(270)928-2146
Livingston
205 E ADAIR STREET
183920
SOUTH FORK MEDICAL CLINIC, PLLC
71 MEDICAL LANE
WHITLEY CITY, KY 42653
(606)376-7212
Mccreary
183474
SPRING VIEW CLINIC
79 BOB O LINK DRIVE
SPRINGFIELD, KY 40069
(859)336-0771
Washington
183416
ST CLAIRE REGIONAL FAMILY MEDICINEOWINGSVILLE
ST CLAIRE REGIONAL FAMILY MEDICINEFRENCHBURG
ST CLAIRE REGIONAL FAMILY MEDICINE-OLIVE
HILL
ST CLAIRE REGIONAL FAMILY MEDICINE-SANDY
HOOK
632 SLATE AVENUE
OWINGSVILLE, KY 40360
(606)674-6386
Bath
732 HIGHWAY 36
FRENCHBURG, KY 40322
(606)768-2191
Menifee
155 BRICKLAYER STREET
OLIVE HILL, KY 41164
(606)286-5333
Carter
390 KY HIGHWAY 7 SOUTH
SANDY HOOK, KY 41171
(606)738-5155
Elliott
183418
183417
183415
Run Date: 10/08/2015
Job # 41303463
Last Update: 10/07/2015
Page 6 of 6
CASPER Report 0006D
Name and Address Listing
For Rural Health Clinic
Based on Current Survey
Kentucky
CCN
Provider Name
Address
City, State and ZIP
Telephone # County Name
183904
STANFORD MEDICAL PARK IMMEDIATE CARE
110 METKER TRAIL
STANFORD, KY 40484
(606)365-3360
Lincoln
188945
TALMADGE V HAYS, PSC
121 VIRGINA AVE
PINEVILLE, KY 40977
(606)337-7002
Bell
183829
TAYLOR RURAL HEALTH, LLC
805 BURKESVILLE STREET
COLUMBIA, KY 42728
(270)384-1110
Adair
183458
THE MEDICAL CENTER AT SCOTTSVILLE
466 BURNLEY ROAD
SCOTTSVILLE, KY 42164
(270)618-3700
Allen
188943
THREE RIVERS MEDICAL CLINIC - INEZ
94 BOARD WALK
INEZ, KY 41224
(606)298-2660
Martin
188915
TJ SAMSON TOMPKINSVILLE CLINIC
805 NORTH MAIN STREET
TOMPKINSVILLE, KY 42167
(270)487-0720
Monroe
183406
TRIGG COUNTY PRIMARY CARE CENT
214 MAIN STREET
CADIZ, KY 42211
(270)522-0898
Trigg
183874
UNITED CLINICS OF KENTUCKY
219 MOUNTAIN PARKWAY SPUR
CAMPTON, KY 41301
(606)668-6932
Wolfe
188909
UNITED CLINICS OF KENTUCKY BEATTYVILLE
1060 GRAND AVENUE
BEATTYVILLE, KY 41311
(606)464-0108
Lee
183486
WARSAW FAMILY PRACTICE
202 FRANKLIN STREET
WARSAW, KY 41095
(859)567-2754
Gallatin
183427
166 HOSPITAL STREET
MONTICELLO, KY 42633
(606)348-9343
Wayne
183954
WAYNE COUNTY HOSPITAL RURAL HEALTH
CLINIC
WAYNESBURG CLINIC, PLLC
14098 US HIGHWAY 27 SOUTH
WAYNESBURG, KY 40489
(606)379-6646
Lincoln
183970
WESTLAKE FAMILY PRACTICE
902 WESTLAKE DRIVE, SUITE 101
COLUMBIA, KY 42728
(270)384-0451
Adair
183998
WESTLAKE PRIMARY CARE CENTER
810 JAMESTOWN STREET
COLUMBIA, KY 42728
(270)384-4764
Adair
183446
2465 LAKEWAY DRIVE
RUSSELL SPRINGS, KY 42642
(270)858-3636
Russell
183437
WESTLAKE PRIMARY CARE OF RUSSELL
COUNTY RURAL HEAL
WHEELWRIGHT FAMILY HEALTH CENTER
1403 KY ROUTE 306, SUITE 102
WHEELWRIGHT, KY 41669
(606)452-2300
Floyd
183858
WILLIAM COLLINS MD
109 EAST MAIN STREET
WHITESBURG, KY 41858
(606)633-4488
Letcher
183832
WILLIAMSBURG FAMILY MEDICINE CENTER
475 NORTH HWY 25 W SUITE 100
WILLIAMSBURG, KY 40769
(606)549-2930
Whitley
183903
WINCHESTER FAMILY PRACTICE, PS
4 NORTH HIGHLAND STREET, SUITE A
WINCHESTER, KY 40391
(859)744-1445
Clark
183937
WINCHESTER, PATTON & BURGESS, PSC
19 MEDICAL LOOP
WHITLEY CITY, KY 42653
(606)376-5391
Mccreary
Total Providers for this State = 186
Run Date: 10/08/2015
Job # 41303463
Last Update: 10/07/2015
Page 1 of 6
CASPER Report 0006D
Name and Address Listing
For Rural Health Clinic
Based on Current Survey
Mississippi
CCN
Provider Name
Address
City, State and ZIP
Telephone # County Name
253938
ABERDEEN HEALTH CLINIC
501 CHESTNUT STREET
ABERDEEN, MS 39730
(662)369-6131
Monroe
258587
AIRPARK FAMILY MEDICAL CLINIC
1056 HOLLAND AVENUE
PHILADELPHIA, MS 39350
(601)656-8545
Neshoba
253871
ALL CARE MISSISSIPPI, LLC
301 WEST JACKSON
OXFORD, MS 38655
(662)234-6464
Lafayette
258514
ALLIANCE-LAIRD CLINIC
25155 HWY 15
UNION, MS 39365
(601)774-1513
Neshoba
253821
ANAZIA MEDICAL II, INC
456 RIVER ROAD
FAYETTE, MS 39069
(601)789-0390
Jefferson
258584
ANDERSON CHILDREN'S MEDICAL CLINIC
1400 20TH AVENUE, SUITE D
MERIDIAN, MS 39301
(601)703-8370
Lauderdale
258995
ANDREW GEORGE, MD
25 SOUTH 4TH STREET
ROLLING FORK, MS 39159
(662)873-0477
Sharkey
258598
ARRINGTON MEDICAL CLINIC
14415 MAIN STREET
COFFEEVILLE, MS 38922
(662)473-5901
Yalobusha
258509
ARTHUR E WOOD MEDICAL CLINIC
920 MATTHEW DRIVE
WAYNESBORO, MS 39367
(601)735-7101
Wayne
258536
110 PARK STREET
WALNUT GROVE, MS 39189
(601)253-0173
Leake
258508
BAPTIST LEAKE MEDICAL CLINIC-WALNUT
GROVE
BAPTIST LEAKE PRIMARY CARE CENTER
1100 HIGHWAY 16 EAST
CARTHAGE, MS 39051
(601)267-1470
Leake
258589
BAPTIST LEAKE WOMEN'S HEALTH CLINIC
303 WEST FRANKLIN STREET
CARTHAGE, MS 39051
(601)267-9658
Leake
253885
BAY SPRNGS AFTER HRS & FAM HLT
31 EAST 5TH AVENUE
BAY SPRINGS, MS 39422
(601)764-2143
Jasper
253891
BOLTON FAMILY CLINIC
115 WEST MADISON STREET, P O BOX 217
BOLTON, MS 39041
(601)866-7723
Hinds
258541
BROOKSVILLE PRIMARY CARE CLINIC
139 NORTH OLIVER STREET/ P O BOX 348
BROOKSVILLE, MS 39739
(662)738-4424
Noxubee
253896
CAMPBELL FAMILY CLINIC
580 FRIAR'S POINT
CLARKSDALE, MS 38614
(662)624-4316
Coahoma
258936
CANTON PRIMARY CARE CLINIC
1883 HIGHWAY 43 SOUTH, STE D / P O BOX 819
CANTON, MS 39046
(601)667-3492
Madison
253986
CENTRAL MS FAMILY HEALTH CLINIC
905-C SOUTH FRONTAGE ROAD
MERIDIAN, MS 39301
(601)486-4210
Lauderdale
253421
CHARLESTON CLINIC
401 CHURCH ST / PO BOX 27
CHARLESTON, MS 38921
(662)647-5816
Tallahatchie
258975
CHESTNUT MEDICAL CLINIC
502 JACKSON STREET, SUITE 6
ABERDEEN, MS 39730
(662)369-9525
Monroe
258925
CHILDREN'S CLINIC OXFORD
2888 SOUTH LAMAR
OXFORD, MS 38655
(662)234-8286
Lafayette
258599
CHOCTAW MEDICAL CLINIC OF WEIR
780 MAIN STREET
WEIR, MS 39772
(662)547-9407
Choctaw
258577
CLARK MEDICAL CLINIC
321 HIGHWAY 13 SOUTH
MORTON, MS 39117
(601)732-8612
Scott
258578
COFFEEVILLE MEDICAL CLINIC
14430 MAIN STREET
COFFEEVILLE, MS 38922
(662)675-2500
Yalobusha
253948
COLLINS FAMILY PRACTICE CLINIC
704 FIFTH STREET
COLLINS, MS 39428
(601)765-4414
Covington
258504
COMMUNITY HEALTH CLINIC
1123 HWY 35 SOUTH
FOREST, MS 39074
(601)469-4771
Scott
253988
COMMUNITY MEDICAL CENTER
92 WEST RATLIFF STREET
LUCEDALE, MS 39452
(601)947-8181
George
253917
CONVENIENT CARE CLINIC, PLLC
555 HIGHWAY 6 EAST
BATESVILLE, MS 38606
(662)578-2030
Panola
258973
COTTON PLANT FAMILY CLINIC
1755 CR81
BLUE MOUNTAIN, MS 38610
(662)538-4111
Tippah
253807
CRAWFORD HEALTH CLINIC, LLC
365-C MAIN STREET
CRAWFORD, MS 39743
(662)272-5500
Lowndes
258505
DECATUR FAMILY MEDICAL
14884 HIGWAY 15
DECATUR, MS 39327
(601)635-2258
Newton
258586
DELTA PRIMARY CARE RURAL HEALTH CLINIC
110 BAKER STREET, SUITE B
INDIANOLA, MS 38751
(662)887-7339
Sunflower
253461
DELTA REGIONAL HEALTH CLINIC
344 ARNOLD AVENUE
GREENVILLE, MS 38701
(662)344-9100
Washington
253452
DOCTORS CLINIC
210 BAY AVENUE WEST
RICHTON, MS 39476
(601)788-9222
Perry
Run Date: 10/08/2015
Job # 41303463
Last Update: 10/07/2015
Page 2 of 6
CASPER Report 0006D
Name and Address Listing
For Rural Health Clinic
Based on Current Survey
Mississippi
CCN
Provider Name
Address
City, State and ZIP
Telephone # County Name
258543
EAST CENTRAL MEDICAL CENTER-RHC
7001 HIGHWAY 614/ MAIL - P.O. BOX 850
HURLEY, MS 39555
(228)588-6622
Jackson
253808
EAST MISSISSIPPI MEDICAL CLINIC
9425 EASTSIDE DRIVE, EXTENSION, SUITE A
NEWTON, MS 39345
(601)635-3333
Newton
253841
EAST MISSISSIPPI MEDICAL CLINIC-RHC
4711 POPLAR SPRINGS DRIVE
MERIDIAN, MS 39305
(601)485-7777
Lauderdale
258600
ECRU MEDICAL CLINIC
202 MAIN STREET
ECRU, MS 38841
(662)488-7670
Pontotoc
253901
EMS CLINIC
1509 STRONG AVENUE
GREENWOOD, MS 38930
(662)455-4411
Leflore
258588
ENTERPRISE FAMILY MEDICAL CENTER
83-A OLD MILL CREEK ROAD
ENTERPRISE, MS 39330
(601)704-1020
Clarke
258596
EUPORA FAMILY MEDICAL CLINIC
1301 VETERAN'S MEMORIAL BLVD
EUROPA, MS 39744
(662)258-7200
Webster
258580
EUPORA PEDIATRIC CLINIC
15 MEDICAL PLAZA
EUROPA, MS 39744
(662)258-4701
Webster
258605
EUPORA PRIMARY CARE CLINIC
70 MEDICAL PLAZA
EUPORA, MS 39744
(662)258-6221
Webster
253845
EVERGREEN FAMILY MEDICAL CLINIC
4929 HIGHWAY 371 SOUTH
NETTLETON, MS 38858
(662)963-9154
Itawamba
258531
1122 EAST MAIN STREET, SUITE 4
PHILADELPHIA, MS 39350
(601)656-1001
Neshoba
258562
FAIRCHILD-CLEARMAN MEDICAL ASSOCIATES
RHC
FAMILY CARE EXPRESS
3275 HIGHWAY 49 SUITE E
COLLINS, MS 39428
(601)765-6292
Covington
258996
FAMILY CARE MEDICAL CLINIC
109 PARKGATE EXT
TUPELO, MS 38801
(662)840-4175
Lee
258561
FAMILY CARE OF SEMINARY
104 W MAIN STREET, SUITE 20
SEMINARY, MS 39479
(601)722-3610
Covington
258954
FAMILY CLINIC OF NEW ALBANY
474 WEST BANKHEAD STREET
NEW ALBANY, MS 38652
(662)534-7777
Union
253426
FAMILY CLINIC OF RIENZI,THE
82 MAIN STREET BOX 194
RIENZI, MS 38865
(662)462-8600
Alcorn
258994
FAMILY MEDICAL 101, INC
101 MIMOSA STREET
BOONEVILLE, MS 38829
(662)720-4919
Prentiss
253497
FAMILY MEDICAL ASSOCIATES
701 HOLLY AVENUE
COLLINS, MS 39428
(601)765-3180
Covington
258575
FAMILY MEDICAL CLINIC
1500 HIGHWAY 19 N
MERIDIAN, MS 39307
(601)703-1480
Lauderdale
253422
FAMILY MEDICAL CLINIC OF HOUST
105 HILLCREST DRIVE
HOUSTON, MS 38851
(662)456-5008
Chickasaw
258542
FAMILY MEDICAL CLINIC OF OKOLONA
521 WEST DRIVE
OKOLONA, MS 38860
(662)447-1405
Chickasaw
253417
FAMILY MEDICAL CLINIC OF VARDA
310 WEST SWEET POTATO STREET
VARDAMAN, MS 38878
(662)682-7555
Calhoun
253995
FAMILY MEDICAL GROUP OF MEADVILLE
PO BOX 636
MEADVILLE, MS 39653
(601)384-3199
Franklin
253495
FAMILY MEDICAL GROUP OF UNION
24345 HIGHWAY 15
UNION, MS 39365
(601)774-8211
Neshoba
253435
FAMILY PRACTICE CLINIC MCCOMB
1506 HARRISON AVENUE
MCCOMB, MS 39648
(601)249-4757
Pike
258953
FLORENCE FAMILY CLINIC
218 EAST MAIN STREET
FLORENCE, MS 39073
(601)845-6602
Rankin
258501
FMCH CATCHINGS CLINIC
451 BANK STREET
WOODVILLE, MS 39669
(601)888-3421
Wilkinson
258502
FMCH FIELD CLINIC
260 WEST MAIN STREET
CENTREVILLE, MS 39631
(601)645-5361
Wilkinson
258503
FMCH GLOSTER CLINIC
178 MS HIGHWAY 24
CENTREVILLE, MS 39631
(601)225-4711
Wilkinson
253923
FOREST FAMILY PRACTICE CLINIC
#1 MEDICAL LANE
FOREST, MS 39074
(601)469-4861
Scott
253904
G S V CARE MEDICAL CLINC
400 THIRD AVENUE, HWY 32 WEST
HOULKA, MS 38850
(662)568-2013
Chickasaw
253946
GLENDORA CLINIC
CORNER OF GIPSON AVE AND WESTBROOK ST
GLENDORA, MS 38928
(662)375-8878
Tallahatchie
258552
GLH-MAGNOLIA MEDICAL CLINIC
1413 STRONG AVENUE
GREENWOOD, MS 38930
(662)459-1207
Leflore
253824
GOLDEN AGE CLINIC
2901 HIGHWAY 82 EAST
GREENWOOD, MS 38930
(662)374-2185
Leflore
Run Date: 10/08/2015
Job # 41303463
Last Update: 10/07/2015
Page 3 of 6
CASPER Report 0006D
Name and Address Listing
For Rural Health Clinic
Based on Current Survey
Mississippi
CCN
Provider Name
Address
City, State and ZIP
Telephone # County Name
258981
1237 HIGHWAY 182 EAST CLAYTON VILLAGE
STARKVILLE, MS 39759
(662)320-7001
Oktibbeha
153 HIGHWAY 45 N
COLUMBUS, MS 39705
(662)328-9623
Lowndes
500 RUSSELL STREET, SUITE 3
STARKVILLE, MS 39759
(662)324-2244
Oktibbeha
710 HIGHWAY 45 N
WEST POINT, MS 39773
(662)524-4120
Clay
253800
GOLDEN TRIANGLE RURAL FAMILY HEALTH
CENTER
GOLDEN TRIANGLE URGENT CARE LLCCOLUMBUS
GOLDEN TRIANGLE URGENT CARE LLCSTARKVILLE
GOLDEN TRIANGLE URGENT CARE LLC-WEST
POINT
GORTON RURAL HEALTH CLINIC, LLC
107 CHURCH STREET
BELZONI, MS 39038
(662)247-2105
Humphreys
253911
GREEN TREE FAMILY MEDICAL CENT
603 MAIN STREET
MOUNT OLIVE, MS 39119
(601)797-3405
Covington
258544
GREENE COUNTY FAMILY MEDICAL CLINIC
1017 JACKSON AVENUE
LEAKESVILLE, MS 39451
(601)394-2820
Greene
253894
GREENVILLE PRIMARY CARE CLINIC
2363 HIGHWAY 1 SOUTH
GREENVILLE, MS 38701
(662)334-1253
Washington
258555
1601 STRONG AVENUE
GREENWOOD, MS 38930
(662)451-7565
Leflore
258566
GREENWOOD LEFLORE HOSPITAL AFTER
HOURS CLINIC
GREENWOOD LEFLORE WALK IN CLINIC
(662)459-2181
Leflore
258500
HANCOCK MEDICAL SERVICES
706 HIGHWAY 82 W, SUITE B / PO BOX 1410 38935- GREENWOOD, MS 38930
1410
3068 PORT AND HARBOUR DRIVE
BAY SAINT LOUIS, MS 39520
(228)533-9000
Hancock
258535
HARRISVILLE MEDICAL CLINIC
1652 SIMPSON HIGHWAY 469 / P.O. BOX 279
HARRISVILLE, MS 39082
(601)847-7784
Simpson
258987
HEALTH 1ST FAMILY MEDICAL CLINIC
131 HIGHWAY 309 SOUTH
BYHALIA, MS 38611
(662)838-5565
Marshall
253849
HEALTH CARE CLINIC OF MISSISSIPPI, LLC
4213 HIGHWAY 49
DREW, MS 38737
(662)745-0305
Sunflower
253810
HICKORY FLAT FAMILY CLINIC
250 OAK AVENUE
HICKORY FLAT, MS 38633
(662)333-6387
Benton
253940
HOLLANDALE FAMILY CARE PC
1257 HIGHWAY 61 SOUTH
HOLLANDALE, MS 38748
(662)827-2214
Washington
253812
HOLMES COUNTY MEDICAL CLINIC-WEST
18295 EMORY ROAD
WEST, MS 39192
(662)967-2462
Holmes
253813
HOLMES FAMILY MEDICAL CLINIC
239 BOWLING GREEN ROAD
LEXINGTON, MS 39095
(662)834-5339
Holmes
258547
IMMEDIATE CARE FAMILY CLINIC
1710 14TH STREET
MERIDIAN, MS 39301
(601)482-9211
Lauderdale
258525
INDIANOLA FAMILY MEDICAL GROUP
122 EAST BAKER STREET
INDIANOLA, MS 38751
(662)887-2212
Sunflower
258902
INTERNAL MEDICINE CLINIC OF CO
914 SUMRALL ROAD
COLUMBIA, MS 39429
(601)731-1470
Marion
253958
INTERNAL MEDICINE RHC OF NEW A
300 OXFORD ROAD
NEW ALBANY, MS 38652
(662)534-8166
Union
253418
ITTA BENA CLINIC
103 BASKET STREET
ITTA BENA, MS 38941
(662)254-7717
Leflore
253949
JACKSON CLINIC
29 SOUTH FOURTH STREET
ROLLING FORK, MS 39159
(662)873-4361
Sharkey
258523
JEFFERSON DAVIS RURAL HEALTH CLINIC
1014 ROSE STREET, SUITE A
PRENTISS, MS 39474
(601)792-2200
Jefferson Davis
258591
K D H PRIMARY CARE CLINIC
823 GRAND AVENUE
YAZOO CITY, MS 39194
(662)751-8188
Yazoo
253814
L C TENNIN, JR, MD, PA
1883 HIGHWAY 43 SOUTH, STE D
CANTON, MS 39046
(601)859-8992
Madison
258510
LAUREL PEDIATRIC & ADOLESCENT
234 SOUTH 12TH AVENUE
LAUREL, MS 39440
(601)649-3520
Jones
258526
LAWRENCE COUNTY FAMILY PRACTICE
1135 EAST BROAD STREET
MONTICELLO, MS 39654
(601)249-2701
Lawrence
258962
LELAND MEDICAL CLINIC
201 BAKER BLVD
LELAND, MS 38756
(662)686-4121
Washington
253490
LEXINGTON PRIMARY CARE CLINIC
110 TCHULA STREET
LEXINGTON, MS 39095
(662)834-1855
Holmes
253889
LIFECORE HEALTH GROUP
499 GLOSTER CREEK VILLAGE, SUITE A-3
TUPELO, MS 38801
(662)844-1717
Lee
258904
LOUISVILLE MEDICAL ASSOCIATES
564 EAST MAIN STREET
LOUISVILLE, MS 39339
(662)773-7500
Winston
253905
253906
253909
Run Date: 10/08/2015
Job # 41303463
Last Update: 10/07/2015
Page 4 of 6
CASPER Report 0006D
Name and Address Listing
For Rural Health Clinic
Based on Current Survey
Mississippi
CCN
Provider Name
Address
City, State and ZIP
Telephone # County Name
258602
LOUISVILLE MEDICAL CLINIC
320 HIGHWAY 15 NORTH
LOUISVILLE, MS 39339
(662)773-7500
Winston
258978
LOWER CROSSING MEDICAL CLINIC
670 HIGHWAY 178- SUITES 2&3
SHERMAN, MS 38869
(662)844-7999
Pontotoc
253481
LUCEDALE OB/GYN CENTER
92 WEST RATLIFF STREET SUITE B
LUCEDALE, MS 39452
(601)947-6000
George
253487
MACON PRIMARY CLINIC
606 NORTH JEFFERSON STREET
MACON, MS 39341
(662)726-4231
Noxubee
258999
MADISON CANTON MEDICAL CLINIC
1171 HART ST
CANTON, MS 39046
(601)859-9888
Madison
258970
MAGEE AFTER HOURS CLINIC
376-A SIMPSON HWY 49
MAGEE, MS 39111
(601)849-5321
Simpson
258570
MAIN STREET MEDICAL CLINIC OF MORTON
347 SOUTH 4TH STREET
MORTON, MS 39117
(601)732-1524
Scott
258569
17509 HIGHWAY 21
SEBASTOPOL, MS 39359
(601)625-9818
Scott
258565
MAIN STREET MEDICAL CLINIC OF
SEBASTOPOL
MARION PRIMARY CARE CENTER
5334 DALE DRIVE
MARION, MS 39342
(601)703-0130
Lauderdale
253403
MEDI STAT CLINIC
703 ALCORN DRIVE, SUITE 109
CORINTH, MS 38834
(662)286-1499
Alcorn
258540
MEDICAL GROUP OF QUITMAN,THE
603 SOUTH ARCHUSA AVENUE
QUITMAN, MS 39355
(601)776-2123
Clarke
253903
MINOR MEDICAL CARE RAYMOND
120 WEST MAIN ST/P O BOX 1223
RAYMOND, MS 39154
(601)857-2341
Hinds
253897
NATCHEZ RHC INC
500 MARTIN LUTHER KING STREET
NATCHEZ, MS 39120
(601)446-7332
Adams
258559
NESHOBA INTERNAL MEDICINE ASSOCIATES
921 WEST BEACON STREET
CHOCTAW, MS 39350
(601)656-6116
Neshoba
258560
NESHOBA URGENT CARE CLINIC
1120 EAST MAIN STREET, SUITE 1
PHILADELPHIA, MS 39350
(601)663-1360
Neshoba
258592
NESHOBA URGENT CARE HOSPITAL
1003 HOLLAND AVE SUITE 103
PHILADELPHIA, MS 39350
(601)781-2390
Neshoba
258603
NEW ALBANY MEDICAL CLINIC
400 DOCTORS DRIVE
NEW ALBANY, MS 38652
(662)534-5036
Union
253488
NEWTON FAMILY AND SPECIALTY CLINIC
9421 EASTSIDE DRIVE EXTENSION
NEWTON, MS 39345
(601)683-6041
Newton
253474
NEWTON FAMILY MEDICAL ASSOCIATES
252 NORTHSIDE DRIVE
NEWTON, MS 39345
(601)683-3117
Newton
258537
NINA JURNEY'S FAMILY MEDICAL PRACTICE
502 JACKSON STREET, SUITE 4
ABERDEEN, MS 39730
(662)369-9945
Monroe
253471
NORTH HILLS FAMILY MEDICAL CLINIC
4331 HIGHWAY 39 NORTH
MERIDIAN, MS 39305
(601)484-6180
Lauderdale
258972
NURSE MED INC
1031 NORTHRIDGE ROAD
BALDWYN, MS 38824
(662)365-9305
Lee
253865
NURSE MED INC
716 SOUTH MAIN STREET
RIPLEY, MS 38663
(662)837-1534
Tippah
258538
ODOM RURAL HEALTH CLINIC
604 SOUTH MAIN STREET
WATER VALLEY, MS 38965
(662)473-1311
Yalobusha
258556
PEARL RIVER FAMILY CLINIC
302 HIGHWAY 11 SOUTH
POPLARVILLE, MS 39470
(601)403-8284
Pearl River
258948
PEDIATRIC AND ADOLESCENT CLINI
308 HIGHLAND BOULEVARD
NATCHEZ, MS 39120
(601)442-7676
Adams
253970
PICAYUNE HEALTH SERVICES
2274 HIGHWAY 43 SOUTH
PICAYUNE, MS 39466
(601)798-3964
Pearl River
258968
PINNACLE MEDICAL CLINIC
7900 MS HWY 570 WEST
SUMMIT, MS 39666
(601)684-7771
Pike
258515
PIONEER FAMILY MEDICAL
502 JACKSON STREET, SUITE 4
ABERDEEN, MS 39730
(662)369-9500
Monroe
258550
PIONEER FAMILY MEDICAL OF AMORY
1506 HWY 278 EAST, SUITE A
AMORY, MS 38821
(662)304-4027
Monroe
258549
PIONEER FAMILY MEDICAL OF CALEDONIA
771 MAIN STREET
CALEDONIA, MS 39740
(662)356-4621
Monroe
258521
PIONEER FAMILY MEDICAL OF HAMILTON
40128 HAMILTON ROAD
HAMILTON, MS 39746
(662)343-5129
Monroe
258604
PONTOTOC MEDICAL CLINIC
345 HIGHWAY 15 NORTH
PONTOTOC, MS 38863
(662)488-7670
Pontotoc
258530
POPLARVILLE FAMILY MEDICAL CLINIC
1222 SOUTH MAIN STREET
POPLARVILLE, MS 39470
(601)795-9320
Pearl River
Run Date: 10/08/2015
Job # 41303463
Last Update: 10/07/2015
Page 5 of 6
CASPER Report 0006D
Name and Address Listing
For Rural Health Clinic
Based on Current Survey
Mississippi
CCN
Provider Name
Address
City, State and ZIP
Telephone # County Name
258567
PREMIER MEDICAL CLINIC
300 RAWLS DRIVE, SUITE 600
MC COMB, MS 39648
(601)249-4415
Pike
253965
PRENTISS FAMILY PRACTICE CLINI
1014 ROSE STREET, STE D
PRENTISS, MS 39474
(601)792-2072
Jefferson Davis
258574
PRIMARY HEALTH CARE
1080 HIGHWAY 35 SOUTH
FOREST, MS 39074
(601)469-3555
Scott
258606
PUCKETT MEDICAL CLINIC
6455 HIGWAY 18
BRANDON, MS 39042
(601)824-9490
Rankin
253908
PURVIS FAMILY PRACTICE CLINIC
102 SHELBY SPEIGHTS DRIVE
PURVIS, MS 39475
(601)794-8065
Lamar
253861
RANKIN RURAL MEDICAL CLINIC
120 SCARBROUGH STREET, SUITE A
RICHLAND, MS 39218
(769)233-7141
Rankin
253850
REGION I I I PRIMARY CARE
2434 SOUTH EASON BLVD
TUPELO, MS 38804
(662)844-1717
Lee
253816
RIVER REGION RURAL HEALTH- MOB1
2100 HIGHWAY 61 NORTH
VICKSBURG, MS 39183
(601)883-5000
Warren
253817
RIVER REGION RURAL HEALTH- SC
2200 HIGHWAY 61 NORTH (EFF 5-18-15)
VICKSBURG, MS 39180
(601)883-5000
Warren
258922
RUNNELSTOWN CLINIC
5034 HWY 29
PETAL, MS 39465
(601)583-1553
Forrest
258576
RUSH FAMILY PRACTICE-LAKE
24489 HIGHWAY 80
LAKE, MS 39092
(601)775-3264
Scott
258564
RUSH MEDICAL CLINC-DEKALB
14365 HIGHWAY 16 WEST
DE KALB, MS 39328
(601)743-4626
Kemper
258579
RUSH MEDICAL CLINIC PHILADELPHIA
1106 CENTRAL DRIVE
PHILADELPHIA, MS 39350
(601)656-6921
Neshoba
258554
RUSH MEDICAL CLINIC- COLLINSVILLE
9097 COLLINSVILLE ROAD
COLLINSVILLE, MS 39325
(601)626-8374
Lauderdale
253801
SARDIS FAMILY MEDICAL CLINIC, INC
124 SOUTH MAIN STREET
SARDIS, MS 38666
(662)487-1064
Panola
258906
SHANNON FAMILY MEDICAL CLINIC LLC
219 BROAD STREET
SHANNON, MS 38868
(662)767-8840
Lee
253437
SOUTH CENTRAL ELLISVILLE MED C
1205 AVENUE B
ELLISVILLE, MS 39437
(601)477-8553
Jones
258581
SOUTH CENTRAL URGENT CARE
1430 JEFFERSON STREET
LAUREL, MS 39441
(601)425-2273
Jones
253479
SOUTHWEST FAMILY MEDICINE
421 MARION AVENUE
MCCOMB, MS 39648
(601)684-6891
Pike
258519
STONE COUNTY FAMILY MEDICAL CENTER
144 EAST CENTRAL AVENUE
WIGGINS, MS 39577
(601)928-6700
Stone
253408
SUMNER CLINIC
100 N COURT SQUARE
SUMNER, MS 38957
(662)375-9989
Tallahatchie
253400
SUNFLOWER RURAL HEALTH CLINIC
840 NORTH OAK AVENUE
RULEVILLE, MS 38771
(662)756-2711
Sunflower
258977
THE WOMAN'S CLINIC
2000 NORTH STATE STREET
CLARKSDALE, MS 38614
(662)627-7361
Coahoma
253820
TOCCOPOLA FAMILY MEDICAL CLINIC
7908 HWY 334 P O BOX 389
TOCCOPOLA, MS 38874
(662)488-0270
Lafayette
258595
TOTAL CARE CLINIC
526 DEERFIELD LANE SUITE C
FOREST, MS 39074
(601)469-0291
Scott
258518
TRACE FAMILY HEALTH & INTERNAL MEDICINE 1002 EAST MADISON
HOUSTON, MS 38851
(662)456-2800
Chickasaw
258516
TRI LAKES PEDIATRIC CLINIC
BATESVILLE, MS 38606
(662)563-7873
Panola
435 HWY 6 EAST
258517
TRI LAKES WOMEN'S CLINIC
225 MEDICAL CENTER DRIVE, SUITE B
BATESVILLE, MS 38606
(662)578-8272
Panola
253964
TRI STATE RURAL HEALTH CLINIC
502 ALCORN DRIVE
CORINTH, MS 38835
(662)287-5216
Alcorn
253847
TRINITY HEALTH CLINIC
321 SOUTH SHARPE AVENUE
CLEVELAND, MS 38732
(662)284-3870
Bolivar
253924
TUTWILER CLINIC
205 ALMA STREET
TUTWILER, MS 38963
(662)345-8334
Tallahatchie
258568
TYLERTOWN FAMILY CLINIC
200 HOSPITAL DR
TYLERTOWN, MS 39667
(601)876-5303
Walthall
258590
UMMC-GRENADA PRIMARY CARE CLINIC
965 AVENT DRIVE, SUITE 107
GRENADA, MS 38901
(662)227-7575
Grenada
258546
WAYNESBORO FAMILY MEDICINE AND
OBSTERTRICS
950 MATTHEW DRIVE, SUITE A
WAYNESBORO, MS 39367
(601)735-2401
Wayne
Run Date: 10/08/2015
Job # 41303463
Last Update: 10/07/2015
Page 6 of 6
CASPER Report 0006D
Name and Address Listing
For Rural Health Clinic
Based on Current Survey
Mississippi
CCN
Provider Name
Address
City, State and ZIP
Telephone # County Name
253851
WIGGINS CLINIC
303 SOUTH FIRST STREET
WIGGINS, MS 39577
(601)928-4412
Stone
258527
WIGGINS PRIMARY CARE
975 HALL STREET
WIGGINS, MS 39577
(601)528-9119
Stone
258528
WILLIAMS MEDICAL CLINIC
1938 CRESCENT MEADOW DRIVE
HOLLY SPRINGS, MS 38634
(662)252-1599
Marshall
258529
WILLIAMS MEDICAL CLINIC OF POT
39 CENTER ST BOX 40
POTTS CAMP, MS 38659
(662)333-6933
Marshall
258593
WINSTON MEDICAL CLINIC
923 CHURCH STREET
LOUISVILLE, MS 39339
(662)773-3503
Winston
258594
WINSTON MEDICAL CLINIC ( NOXAPATER)
90 EAST MAIN STREET
NOXAPATER, MS 39346
(662)733-3503
Winston
258976
WOLFE FAMILY MEDICAL CLINIC
204 EAST WALNUT STREET
CHARLESTON, MS 38921
(662)647-0900
Tallahatchie
253884
WOMEN'S HEALTH CLINIC OF GRENA
1401 OAK STREET
GRENADA, MS 38901
(662)226-4010
Grenada
253945
WOMEN'S PAVILION
551 EAGLE DAY AVENUE
COLUMBIA, MS 39429
(601)736-6137
Marion
253878
WOMEN'S PAVILION OF SOUTH MS, PLLC
1242 HIGHWAY 29 NORTH
ELLISVILLE, MS 39437
(601)719-0003
Jones
258937
WOODLAND CLINIC
120 MARKET STREET PO BOX 186
WOODLAND, MS 39776
(662)456-0111
Chickasaw
253855
YAZOO FAMILY CLINIC
1435 GRAND AVENUE
YAZOO CITY, MS 39194
(662)746-3555
Yazoo
258969
YAZOO FAMILY HEALTHCARE PLLC
307 EAST 15TH STREET
YAZOO CITY, MS 39194
(662)746-2113
Yazoo
Total Providers for this State = 182
Run Date: 10/08/2015
Job # 41303463
Last Update: 10/07/2015
Page 1 of 3
CASPER Report 0006D
Name and Address Listing
For Rural Health Clinic
Based on Current Survey
North Carolina
CCN
Provider Name
Address
City, State and ZIP
Telephone # County Name
343411
ANGEL URGENT CARE CENTER
195 FRANKLIN PLAZA
FRANKLIN, NC 28744
(828)369-4427
Macon
343931
BENSON AREA MEDICAL CENTER INC
3333 NC HWY 242N PO BOX 399
BENSON, NC 27504
(919)894-2011
Johnston
343905
BLACK RIVER FAMILY PRACTICE
301 SOUTH CAMPBELL STREET
BURGAW, NC 28425
(910)259-5721
Pender
343867
BLACK RIVER HEALTH SERVICES
109 W CHURCH STREET
ATKINSON, NC 28421
(910)283-5011
Pender
343426
BLUE RIDGE MEDICAL CENTER - MAYLAND
CAMPUS
BLUE RIDGE MEDICAL CENTER - SPRUCE PINE
CAMPUS
BLUE RIDGE MEDICAL CENTER - YANCEY
CAMPUS
CAPE FEAR VALLEY BLADEN MEDICAL ASSOC
EXPRESSCARE
CAPE FEAR VALLEY- BLADEN MEDICAL
ASSOCIATES
CAPE FEAR VALLEY-BLADEN MEDICAL
ASSOCIATES
CAPE FEAR VALLEY-BLADEN MEDICAL
ASSOCIATES
CAPE FEAR VALLEY-BLADEN URGENT CARE
7968 HIGHWAY 19 E
SPRUCE PINE, NC 28777
(828)765-5672
Mitchell
496 ALTAPASS HIGHWAY
SPRUCE PINE, NC 28777
(828)765-0170
Mitchell
800 MEDICAL CAMPUS DRIVE
BURNSVILLE, NC 28714
(828)682-0200
Yancy
107 DUNHAM STREET
ELIZABETHTOWN, NC 28337
(910)862-2122
Bladen
16 3RD STREET
DUBLIN, NC 28332
(910)862-3528
Bladen
1106 W SEABOARD STREET
BLADENBORO, NC 28320
(919)863-3138
Bladen
300A EAST MCKAY STREET
ELIZABETHTOWN, NC 28337
(910)862-6308
Bladen
107 EAST DUNHAM STREET
ELIZABETHTOWN, NC 28337
(910)862-1224
Bladen
343410
343427
343449
343444
343446
343445
343428
343933
CARTERET FAMILY PRACTICE
2 MEDICAL PARK (PENNY LANE)
MOREHEAD CITY, NC 28557
(919)247-5177
Carteret
343918
CHADBOURN FAMILY PRACTICE P A
104 SEVENTH AVENUE
CHADBOURN, NC 28431
(910)654-3143
Columbus
343970
CLECO MEDICAL CENTER OF SHELBY
808 SCHENCK STREET
SHELBY, NC 28150
(704)480-9344
Cleveland
348906
COLUMBUS CO COMMUNITY HEALTH CENTER
15 HILL PLAZA, SUITE A
WHITEVILLE, NC 28472
(910)641-0202
Columbus
343443
COMMUNITY MEDICINE OLD FORT
32 E MAIN STREET
OLD FORT, NC 28762
(828)659-5741
Mcdowell
343453
DOSHER MEDCIAL BOLIVIA
3875 BUSINESS 17 E
BOLIVIA, NC 28422
(910)253-7990
Brunswick
343454
DOSHER MEDICAL HOLDEN BEACH
2930 HOLDEN BEACH ROAD SW
SUPPLY, NC 28462
(910)842-5991
Brunswick
343450
DOSHER MEDICAL LONG BEACH ROAD
4222 LONG BEACH ROAD SE
SOUTHPORT, NC 28461
(910)454-1197
Brunswick
343451
DOSHER MEDICAL-905 N HOWE STREET
905 N HOWE STREET
SOUTHPORT, NC 28461
(910)457-5657
Brunswick
343452
DOSHER MEDICAL-SMITHVILLE CROSSING
1513 N HOWE STREET
SOUTHPORT, NC 28461
(910)457-9127
Brunswick
343448
DOSHER MEDICAL/OAK ISLAND
4700 EAST OAK ISLAND
OAK ISLAND, NC 28465
(910)278-6414
Brunswick
348959
DR ARTHUR J ROBINSON MEDICAL C
800 MARTIN LUTHER KING DRIVE
LUMBERTON, NC 28359
(910)739-4204
Robeson
348939
105 COMMERCE STREET
POWELLSVILLE, NC 27967
(252)332-6484
Bertie
348957
EASTERN CAROLINA GERIATRIC ASSOC & FAM
CARE CTR PL
FAIRMONT MEDICAL CLINIC
101 N WALNUT STREET
FAIRMONT, NC 28340
(910)628-0655
Robeson
348932
FAMILY CARE CENTER
1668 NC HWY 16 SOUTH
TAYLORSVILLE, NC 28681
(828)632-9736
Alexander
343440
FAMILY MEDICINE-GLENWOOD
5623 US 221 SOUTH
MARION, NC 28752
(828)659-9000
Mcdowell
343441
FAMILY MEDICINE-NEBO
339 NEBO SCHOOL ROAD
NEBO, NC 28761
(828)652-6326
Mcdowell
343431
FIRSTHEALTH MONTGOMERY MEMORIAL
HOSPITAL-FAMILY CA
GRANVILLE FAMILY MEDICINE PA
522 ALLEN STREET
TROY, NC 27371
(910)571-5510
Montgomery
103 PROFESSIONAL PARK A
OXFORD, NC 27565
(919)693-7108
Granville
343950
Run Date: 10/08/2015
Job # 41303463
Last Update: 10/07/2015
Page 2 of 3
CASPER Report 0006D
Name and Address Listing
For Rural Health Clinic
Based on Current Survey
North Carolina
CCN
Provider Name
City, State and ZIP
Telephone # County Name
343437
GRANVILLE INTERNAL MEDICINE & GERIATRICS 1032 COLLEGE STREET
OXFORD, NC 27565
(919)693-6541
Granville
343919
HARMONY MEDICAL CARE PA
3210 HARMONY HWY
HARMONY, NC 28634
(704)546-7587
Iredell
343936
HEALTH PLUS BY NURSE PRACTIONERS
835 MERITA STREET
MOUNT AIRY, NC 27030
(919)789-6503
Surry
343414
HEALTH PLUS OF THE MCDOWELL HOSP
472 RANKIN DRIVE
MARION, NC 28752
(828)652-1400
Mcdowell
348944
HIGHLAND MEDICAL ASSOCIATES
165 COOLRIDGE STREET
HENDERSONVILLE, NC 28792
(828)694-3939
Henderson
343422
HOKE FAMILY MEDICAL CENTER
405 S MAIN STREET
RAEFORD, NC 28376
(910)875-5101
Hoke
348962
JOHNSON MEDICAL CLINIC
222 SOUTH MAIN STREET
RED SPRINGS, NC 28377
(910)843-4576
Robeson
Address
343413
JOHNSTON FAMILY CARE CENTER
70 CRAPE MYRTLE DR SUITE 104
BENSON, NC 27504
(919)938-0260
Johnston
343963
KINGS MOUNTAIN MEDICAL CENTER
812 W KING STREET
KINGS MOUNTAIN, NC 28086
(704)739-5456
Cleveland
343964
LAUREL HILL MEDICAL CLINIC
18901 IDA MILL ROAD
LAUREL HILL, NC 28351
(910)462-2707
Scotland
343901
LUMBERTON FAMILY MEDICAL CENTER
585 FARRINGDOM ST
LUMBERTON, NC 28358
(910)671-0052
Robeson
343400
MACCLESFIELD HEALTHCARE CENTER
201 W EDGECOMBE STREET
MACCLESFIELD, NC 27852
(252)827-5231
Edgecombe
343904
MAPLE HILL MEDICAL CENTER
4811 NC HWY 53
MAPLE HILL, NC 28454
(910)259-6444
Pender
343987
MAXTON FAMILY PRACTICE CENTER
1001 W DR MARTIN LUTHER KING DR
MAXTON, NC 28364
(910)844-4077
Robeson
343439
1633 SUGAR HILL ROAD
MARION, NC 28752
(828)659-3621
Mcdowell
343438
MCDOWELL OB/GYN MCDOWELL INTERNAL
MEDICINE
MCDOWELL PEDIATRICS
387 US 70 W
MARION, NC 28752
(828)652-6328
Mcdowell
343932
MED CENTER ONE
600 ATLANTIC BEACH CAUSEWAY
ATLANTIC BCH, NC 28512
(252)247-2464
Carteret
348950
MEDICAL CLINIC OF PINETOPS
105-C S W FIRST STREET
PINETOPS, NC 27864
(252)827-1550
Edgecombe
348948
MEDICAL CLINIC OF SHARPSBURG
9201 COUNTY LINE ROAD
ROCKY MOUNT, NC 27803
(252)446-4455
Nash
348951
MID CAROLINA FAMILY MEDICINE, PA
1038 ALBEMARLE ROAD
TROY, NC 27371
(910)572-1785
Montgomery
343455
MISSION WOMEN'S CARE SYLVA
111 CENTRAL STREET
SYLVA, NC 28779
(828)349-6804
Jackson
343425
MOUNTAIN FAMILY CARE CENTER
310 HOSPITAL AVENUE
JEFFERSON, NC 28640
(336)846-6322
Ashe
343847
MOUNTAIN VIEW MEDICAL CTR
5229 ROCK CREEK RD
HAYS, NC 28635
(336)696-2711
Wilkes
348937
MT PLEASANT FAMILY PHYSICIANS
8560 COOK STREET
MOUNT PLEASANT, NC 28124
(704)791-3153
Cabarrus
343858
NEWPORT FAMILY PRACTICE
338 HOWARD BLVD
NEWPORT, NC 28570
(252)223-5054
Carteret
343863
OAKWOOD MEDICAL CENTER
111 S FAIRVIEW RD
ROCKY MOUNT, NC 27801
(919)446-3333
Edgecombe
343893
OCRACOKE HEALTH CENTER INC
PO BOX 543 BACK ROAD
OCRACOKE, NC 27960
(252)928-1511
Hyde
343982
PEMBROKE FAMILY PRACTICE
208 RUTH DIAL ST
PEMBROKE, NC 28372
(910)521-4462
Robeson
343803
PENSLOW HEALTH CLINIC INC
206 NORTH DYSON STREET
HOLLY RIDGE, NC 28445
(910)329-7591
Onslow
343447
PIONEER FAMILY MEDICINE OF DANBURY
1020 HOSPICE DRIVE
DANBURY, NC 27016
(336)593-8281
Stokes
343430
PLYMOUTH PRIMARY CARE
1006 US HIGHWAY 64 EAST
PLYMOUTH, NC 27962
(252)793-7701
Washington
343911
RIEGELWOOD MEDICAL CLINIC
REIGELWOOD SHOPPING CTR HWY 87
RIEGELWOOD, NC 28456
(910)655-0021
Columbus
348938
RIVERQUEST MEDICAL CARE
258 LOWE ROAD
LUMBERTON, NC 28360
(910)735-1234
Robeson
348941
ROANOKE CLINIC
1385 MEDICAL CENTER DRIVE
ROANOKE RAPIDS, NC 27870
(252)537-9176
Halifax
Run Date: 10/08/2015
Job # 41303463
Last Update: 10/07/2015
Page 3 of 3
CASPER Report 0006D
Name and Address Listing
For Rural Health Clinic
Based on Current Survey
North Carolina
CCN
Provider Name
Address
City, State and ZIP
Telephone # County Name
343914
ROSE HILL MEDICAL CENTER
BOX 639, 4008 HWY 117 SOUTH
ROSE HILL, NC 28458
(910)289-3027
Duplin
348960
ROWLAND MEDICAL CLINIC
102 NORTH BOND STREET
ROWLAND, NC 28383
(910)422-3350
Robeson
343818
SALUDA MEDICAL CENTER
86 GREENVILLE STREET
SALUDA, NC 28773
(828)749-4411
Polk
343988
SCOTLAND URGENT CARE CENTER
205 LAUCHWOOD DRIVE
LAURINBURG, NC 28352
(910)277-8300
Scotland
343962
SEAGROVE MEDICAL CLINIC
614 NORTH BROAD STREET
SEAGROVE, NC 27341
(336)873-7248
Randolph
343436
SOUTH GRANVILLE PRIMARY CARE
1614 HWY 56
CREEDMOOR, NC 27522
(919)575-6103
Granville
348961
302 S MAIN STREET
BLADENBORO, NC 28320
(910)863-2400
Bladen
348952
SOUTHEASTERN MEDICAL CLINIC
BLADENBORO
SOUTHEASTERN MEDICAL CLINIC CLARKTON
9928 N W R LATHAN STREET
CLARKTON, NC 28433
(910)647-1503
Bladen
348954
SOUTHEASTERN MEDICAL CLINIC MAXTON
22401 ANDREW JACKSON HIGHWAY
MAXTON, NC 28364
(910)844-2004
Robeson
348964
302 MT TABOR ROAD
RED SPRINGS, NC 28377
(910)843-9991
Hoke
229 S MAIN STREET
RED SPRINGS, NC 28377
(910)843-9991
Robeson
348958
SOUTHEASTERN MEDICAL CLINIC RED
SPRINGS
SOUTHEASTERN RED SPRINGS FAMILY
MEDICINE
ST PAULS MEDICAL CLINIC
128 EAST BROAD STREET
SAINT PAULS, NC 28384
(910)865-5955
Robeson
343972
SWANSBORO MEDICAL CENTER PA
718 CORBETT AVENUE
SWANSBORO, NC 28584
(910)326-5588
Onslow
343923
THE COLUMBIA MEDICAL CENTER
208 NORTH BROAD STREET BOX 189
COLUMBIA, NC 27925
(252)796-0689
Tyrrell
343955
UPPER CLEVELAND MEDICAL CENTER
5009 FALLSTON ROAD
LAWNDALE, NC 28090
(704)538-8532
Cleveland
343951
VANCE FAMILY MEDICINE
381 RUIN CREEK RD
HENDERSON, NC 27536
(252)430-0666
Vance
343423
1403 SOUTH KING STREET
WINDSOR, NC 27983
(252)794-6775
Bertie
343442
VIDANT FAMILY MEDICINE-WINDSOR, A
DEPARTMENT OF VI
WASHINGTON COUNTY MEDICAL CLINIC
9500 NC HIGHWAY 94 N
CRESWELL, NC 27928
(252)793-4135
Washington
348909
WEST COLUMBUS FAMILY PRACTICE PA
110 N BROWN ST
CHADBOURN, NC 28431
(910)654-1701
Columbus
343828
YANCEY COUNTY PRIMARY CARE
202 MEDICAL CAMPUS DRIVE
BURNSVILLE, NC 28714
(828)682-6118
Yancy
348953
Total Providers for this State = 85
Run Date: 10/08/2015
Job # 41303463
Last Update: 10/07/2015
Page 1 of 3
CASPER Report 0006D
Name and Address Listing
For Rural Health Clinic
Based on Current Survey
South Carolina
CCN
Provider Name
Address
City, State and ZIP
Telephone # County Name
423442
ABBEVILLE INTERNAL MEDICINE
901 W GREENWOOD STREET, SUITE 6
ABBEVILLE, SC 29620
(864)366-9938
Abbeville
428956
ADVANCED MEDICAL ASSOCIATES
511 SOUTH MAIN STREET
MULLINS, SC 29574
(843)464-8244
Marion
423970
ANDREWS MEDICAL CENTER
701 SOUTH MORGAN AVENUE
ANDREWS, SC 29510
(843)264-5253
Georgetown
428975
ANGEL OAK FAMILY MEDICINE, LLC
1816 BOHICKET RD, SUITE F
JOHNS ISLAND, SC 29455
(843)559-1938
Charleston
423806
AYNOR FAMILY PRACTICE
1213 ELM STREET
AYNOR, SC 29511
(843)358-5806
Horry
423820
1000 PINE STREET W
VARNVILLE, SC 29944
(803)943-5228
Hampton
428981
BEAUFORT MEMORIAL HARRISON PEEPLES
HEALTHCARE CTR
BEAUFORT PEDIATRICS
964 RIBAUT ROAD
BEAUFORT, SC 29902
(843)524-5437
Beaufort
423438
BLACKVILLE MEDICAL CENTER
914 REYNOLDS ROAD
BARNWELL, SC 29812
(803)259-4041
Barnwell
423449
BLUE GRANITE MEDICAL CENTER
880 WEST MOULTRIE STREET
WINNSBORO, SC 29180
(803)635-0288
Fairfield
428933
BLUE RIDGE PEDIATRICS, LLC
457 B HIGHWAY 123 BYPASS P O BOX 947
SENECA, SC 29678
(864)888-4464
Oconee
428990
BLYTHEWOOD MEDICAL ASSOCIATES
428 - 2 MCNULTY ROAD
BLYTHEWOOD, SC 29016
(803)754-8941
Richland
423801
CAMPUS HEALTH CENTER
237 SGEORGETOWN HWY PO BOX 1008
JOHNSONVILLE, SC 29555
(843)386-2609
Florence
428984
CANNON FAMILY PRACTICE EASTSIDE
111 WEST ROPER ROAD
EASLEY, SC 29640
(864)898-1377
Pickens
423428
CAROLINA MEDICAL ASSOCIATES
1787 ALLENDALE FAIRFAX HWY
FAIRFAX, SC 29827
(803)632-3421
Allendale
428980
CAROLINA PEDIATRIC ASSOCIATES
301 WEST PINE STREET
BLACKSBURG, SC 29702
(864)839-4325
Cherokee
428979
CAROLINA PEDIATRIC ASSOCIATES
1610 B N LIMESTONE STREET
GAFFNEY, SC 29340
(864)839-4325
Cherokee
423885
CAROLINA PEDIATRICS
723 SOUTH DOCTORS DR
CHERAW, SC 29520
(843)537-9360
Chesterfield
423877
801 WEST MAIN STREET
UNION, SC 29379
(864)429-8029
Union
428973
CAROLINAS HEALTH ASSOCIATES - FAMILY
MEDICINE
CHA - UPSTATE PEDIATRICS
407 WEST SOUTH STREET
UNION, SC 29379
(864)429-8846
Union
428992
CHA FAMILY PRACTICE ASSOCIATES
429 E MAIN STREET
UNION, SC 29379
(864)427-9045
Union
428948
CHEROKEE CHILDREN'S CLINIC, PA
1307 N LOGAN STREET
GAFFNEY, SC 29341
(864)488-1333
Cherokee
423890
CLEMSON-SENECA PEDIATRICS
208-1 FRONTAGE ROAD
CLEMSON, SC 29631
(864)654-6034
Pickens
423886
CLEMSON-SENECA PEDIATRICS
207 MAIN STREET
SENECA, SC 29678
(864)888-4222
Oconee
423444
COASTAL CAROLINA MEDICAL ASSOCIATES
1010 MEDICAL CENTER DR SUITE 240
HARDEEVILLE, SC 29927
(843)784-8293
Jasper
423450
COASTAL MEDICAL ASSOCIATES
10911 N JACOB SMART BOULEVARD, D
RIDGELAND, SC 29936
(843)645-1635
Beaufort
423432
COASTAL PLAINS PRIMARY CARE
595 WCAROLINA AVENUE
VARNVILLE, SC 29944
(803)943-1221
Hampton
428940
COLEMAN FAMILY PRACTICE
217 E THIRD AVENUE
PAMPLICO, SC 29583
(843)493-5252
Florence
423865
CONWAY PEDIATRICS
907 BELL STREET
CONWAY, SC 29526
(843)248-2727
Horry
423875
CPG FAMILY MEDICINE
51 11TH AVE
AYNOR, SC 29511
(843)358-3700
Horry
423441
DR J DAULTON DUBOSE MEDICAL CENTER
1056 FELTON STREET
SUMMERTON, SC 29148
(803)435-5270
Clarendon
428905
DUE WEST FAMILY MEDICINE
6 COLLEGE STREET P O BOX 638
DUE WEST, SC 29639
(864)379-2345
Abbeville
423983
EAST CLARENDON MEDICAL CENTER
944 SMITH STREET
TURBEVILLE, SC 29162
(843)659-2114
Clarendon
423968
EASTERN CAROLINA PEDIATRIC ASSOCIATES
105 INDUSTRIAL WAY
DARLINGTON, SC 29532
(843)395-0015
Darlington
428998
EDGEFIELD MEDICAL CLINIC, PA
200 RIDGE MEDICAL PLAZA
EDGEFIELD, SC 29824
(803)637-3146
Edgefield
Run Date: 10/08/2015
Job # 41303463
Last Update: 10/07/2015
Page 2 of 3
CASPER Report 0006D
Name and Address Listing
For Rural Health Clinic
Based on Current Survey
South Carolina
CCN
Provider Name
Address
City, State and ZIP
Telephone # County Name
423883
EDISTO FAMILY PRACTICE
1619 CAROLINA AVE
ORANGEBURG, SC 29115
(803)531-7474
Orangeburg
423838
F MARION DWIGHT MD PA
450 NORTH STREET
BAMBERG, SC 29003
(803)245-5168
Bamberg
423840
FAIRFIELD MEDICAL ASSOCIATES
880 WEST MOULTRIE STEET, SUITE 200
WINNSBORO, SC 29180
(803)635-6461
Fairfield
423872
FAMILY HEALTHCARE NEWBERRY
2605 KINARD STREET SUITE 200
NEWBERRY, SC 29108
(803)405-1900
Newberry
428946
FAMILY HEALTHCARE SAVANNAH LAKES
207 HOLIDAY ROAD
MC CORMICK, SC 29835
(864)391-5011
Mccormick
423451
FAMILY MEDICINE ASSOCIATES
901 W GREENWOOD ST STE 9
ABBEVILLE, SC 29620
(864)366-9681
Abbeville
423888
FAMILY MEDICINE ASSOCIATES, LLC
505 THURGOOD MARSHALL BLVD
KINGSTREE, SC 29556
(843)355-8380
Williamsburg
423821
FAMILY PRACTICE ASSOC OF HOLLY
187 BUNCH FORD RD
HOLLY HILL, SC 29059
(803)496-3312
Orangeburg
423854
FOWLER RURAL MEDICAL
2236 HIGHWAY 76 EAST SUITE B
MARION, SC 29571
(843)423-4044
Marion
428941
GRIFFIN FAMILY PRACTICE
105 NORTH RAILROAD AVENUE PO BOX 1020
LAMAR, SC 29069
(843)326-5777
Darlington
423803
HEALTHWISE FAMILY PRACTICE, LLC
154 WREN STREET
BARNWELL, SC 29812
(803)259-3399
Barnwell
428969
JOHN A MARTIN PRIMARY HEALTH CARE
56 HWY 321 BYPASS NORTH
WINNSBORO, SC 29180
(803)635-6099
Fairfield
423420
103 SOUTH MAIN STREET
BETHUNE, SC 29009
(803)334-6551
Kershaw
423424
KERSHAWHEALTH HEALTHCARE PLACE AT
BETHUNE
LAFFITTE & WARREN MEDICAL CENTER
623 NORTH MEMORIAL AVENUE
ALLENDALE, SC 29810
(803)584-2128
Allendale
428988
LAKE CITY FAMILY MEDICINE, LLC
901 N MATTHEWS ROAD
LAKE CITY, SC 29560
(843)394-8380
Florence
428939
LAKE CITY MEDICAL CLINIC
101 JOHN STREET
LAKE CITY, SC 29560
(803)394-2031
Florence
428995
LANDRUM FAMILY HEALTH CARE LLC
108 W RUTHERFORD STREET
LANDRUM, SC 29356
(864)457-2363
Spartanburg
428920
LAURENS FAMILY PRACTICE GRAY COURT
9100 HWY 14
GRAY COURT, SC 29645
(864)876-4888
Laurens
423866
LAURENS FAMILY PRACTICE RHC
106 PARKVIEW DRIVE
LAURENS, SC 29360
(864)984-0571
Laurens
428945
338 EAST COLUMBIA AVE
BATESBURG-LEESVILLE, SC 29070
(803)604-0066
Lexington
428943
LEXINGTON MEDICAL CENTER BATESBURGLEESVILLE
LEXINGTON MEDICAL CENTER SWANSEA
935 WEST SECOND STREET
SWANSEA, SC 29160
(803)568-2000
Lexington
428960
MACKEY FAMILY PRACTICE
1025 WEST MEETING STREET, SUITE 200
LANCASTER, SC 29720
(803)285-7414
Lancaster
423419
MANNING MEDICINE
50 HOSPITAL ST STE 4
MANNING, SC 29102
(803)435-5250
Clarendon
423852
MARION MEDICAL GROUP, INC
1205 N MAIN STREET
MARION, SC 29571
(843)423-0760
Marion
423874
MARION MEDICAL GROUP-LATTA
108A EAST MAIN ST
LATTA, SC 29565
(843)752-1234
Dillon
423889
MARION PEDIATRICS
2845 E HWY 76 , SUITE 4
MULLINS, SC 29574
(843)431-2720
Marion
423406
MARLBORO PRIMARY CARE ASSOCIATES
1040 MARLBORO WAY SUITE 1
BENNETTSVILLE, SC 29512
(803)479-5890
Marlboro
428989
MCLEOD FAMILY MEDICINE - JOHNSONVILLE
355 SOUTH GEORGETOWN HIGHWAY
JOHNSONVILLE, SC 29555
(843)380-2000
Florence
423416
MCLEOD FAMILY MEDICINE CTR-WILSON
701 CASHUA FERRY ROAD
DARLINGTON, SC 29532
(803)398-8500
Darlington
423857
MCLEOD FAMILY MEDICINE KINGSTREE
512 NELSON BOULEVARD SUITE 200
KINGSTREE, SC 29556
(843)355-5459
Williamsburg
428927
MCLEOD FAMILY MEDICINE-MARION COUNTY
3032 EAST HIGHWAY 76
MULLINS, SC 29574
(803)464-7111
Marion
428962
MCLEOD FAMILY PRACTICE TIMMONSVILLE
755 EAST SMITH STREET
TIMMONSVILLE, SC 29161
(843)346-3900
Florence
428934
MCLEOD PEDIATRICS-DILLON
705 NORTH 8TH AVENUE SUITE 3A
DILLON, SC 29536
(843)774-6091
Dillon
423859
MEDICAL BUILDING PA #2
456 NORTH MAIN STREET
HEMINGWAY, SC 29554
(803)558-9319
Williamsburg
Run Date: 10/08/2015
Job # 41303463
Last Update: 10/07/2015
Page 3 of 3
CASPER Report 0006D
Name and Address Listing
For Rural Health Clinic
Based on Current Survey
South Carolina
CCN
Provider Name
Address
City, State and ZIP
Telephone # County Name
428986
MEDICAL CENTER OF SANTEE
500 BASS DRIVE PO BOX 1190
SANTEE, SC 29142
(803)854-3805
Orangeburg
423808
MONCKS CORNER PEDIATRICS
5000 EPSON PLANTATION DRIVE SUITE B
MONCKS CORNER, SC 29461
(843)761-2000
Berkeley
428919
OCONEE PEDIATRICS
15579 WELLS HIGHWAY
SENECA, SC 29678
(864)882-7800
Oconee
423846
PAGELAND FAMILY MEDICINE
301 N VAN LINGLE MUNGO BLVD
PAGELAND, SC 29728
(843)672-6127
Chesterfield
423878
PALMETTO MEDICAL CARE, LLC
1002 S MAIN STREET
MULLINS, SC 29574
(843)245-0613
Marion
423445
PALMETTO PRIMARY CARE
22 BOZARD STREET PO BOX 137
MANNING, SC 29102
(803)435-8828
Clarendon
423431
PALMETTO PRIMARY CARE
334 MERCY STREET
LAKE CITY, SC 29560
(843)374-9355
Florence
423817
PATE MEDICAL ASSOCIATES
116 HOSPITAL SQUARE
BISHOPVILLE, SC 29010
(803)484-9424
Lee
423443
PEACH TREE MEDICAL CENTER
906 WEST MAIN STREET
RIDGE SPRING, SC 29129
(803)685-7355
Saluda
423436
PEACH TREE MEDICAL CENTER - EDGEFIELD
100 RIDGE MEDICAL PLAZA
EDGEFIELD, SC 29824
(803)637-3630
Edgefield
423429
PEE DEE FAMILY PRACTICE JOHNSONVILLE
625 SOUTH GEORGETOWN HWY PO BOX 180
JOHNSONVILLE, SC 29555
(803)386-3106
Florence
423430
PEE DEE FAMILY PRACTICE LAKE CITY
276 NORTH RON MCNAIR BOULEVARD
LAKE CITY, SC 29560
(843)394-5471
Florence
428928
PEE DEE PEDIATRICS
2845 E HIGHWAY 76, SUITE 5
MULLINS, SC 29574
(803)431-2650
Marion
428976
PIEDMONT PEDIATRICS
996 MEDICAL RIDGE ROAD
CLINTON, SC 29325
(864)833-5654
Laurens
423828
R DALE PADGETT MD PA
526 NORTH STREET
BAMBERG, SC 29003
(803)245-2433
Bamberg
428926
R DALE PADGETT MD RHC
1499 JOHN C CALHOUN DRIVE
ORANGEBURG, SC 29115
(803)533-0007
Orangeburg
423826
RILEY FAMILY PRACTICE ASSOCIATES, PA
595 NEWBERRY HWY
SALUDA, SC 29138
(864)445-2500
Saluda
423868
RMC OBSTETRICS AND GYNECOLOGY
1175 COOK ROAD, SUITE 145
ORANGEBURG, SC 29118
(803)531-2300
Orangeburg
428966
RMC PRIMARY CARE
1750 VILLAGE PARK DRIVE
ORANGEBURG, SC 29118
(803)534-4254
Orangeburg
423818
RMC PRIMARY CARE BAMBERG
498 NORTH STREET
BAMBERG, SC 29003
(803)245-5144
Bamberg
423856
RMC PRIMARY CARE BRANCHVILLE
215 DORANGE ROAD PO BOX 247
BRANCHVILLE, SC 29432
(803)274-8400
Orangeburg
428907
RMC PRIMARY CARE ST MATTHEWS
725 HARRY C RAYSOR DRIVE SOUTH
SAINT MATTHEWS, SC 29135
(803)874-3902
Calhoun
423447
200 EAST HOSPITAL STREET
MANNING, SC 29102
(803)433-0439
Clarendon
428978
ROBERT S EAGERTON JR MD FAMILY
PRACTICE
SALUDA FAMILY MEDICINE, PA
102 R L SAWYER, MD DRIVE
SALUDA, SC 29138
(864)445-2173
Saluda
428964
SINGLETON HEALTH CENTER
1773 VILLAGE PARK DRIVE
ORANGEBURG, SC 29118
(803)535-3600
Orangeburg
423891
ST PAUL'S MEDICAL GROUP, INC
7610 HWY 164
HOLLYWOOD, SC 29449
(843)889-8018
Charleston
423871
SYCAMORE HEALTH CARE LLC
7205 BUFORD'S BRIDGE HIGHWAY
SYCAMORE, SC 29846
(803)632-3900
Allendale
428987
TRI-COUNTY PEDIATRICS, LLC
815 EAST LIBERTY STREET
YORK, SC 29745
(803)628-2728
York
423870
WACCAMAW FAMILY MEDICINE
9699 OCEAN HWY
PAWLEYS IS, SC 29585
(843)237-4296
Georgetown
428958
WACCAMAW MEDICAL CENTER
1075 NORTH FRASER STREET
GEORGETOWN, SC 29440
(843)527-4442
Georgetown
423804
WALTERBORO, SC 29488
(843)549-6331
Colleton
WALTERBORO, SC 29488
(803)549-1558
Colleton
423448
WALTERBORO ADULT & PEDIATRIC MEDICINE, 447 SPRUCE STREET
LLC
WALTERBORO FAMILY PRACTICE ASSOCIATES, 107 CHURCH ST
PA
WILLIAMSBURG REGIONAL HEALTH CENTER
500 THURGOOD MARSHALL HWY
KINGSTREE, SC 29556
(843)933-2494
Williamsburg
423437
WILLISTON FAMILY PRACTICE
WILLISTON, SC 29853
(803)266-3600
Barnwell
428915
45 ROUNDTREE STREET
Run Date: 10/08/2015
Job # 41303463
CCN
Provider Name
Total Providers for this State = 102
Last Update: 10/07/2015
Page 4 of 4
CASPER Report 0006D
Name and Address Listing
For Rural Health Clinic
Based on Current Survey
South Carolina
Address
City, State and ZIP
Telephone # County Name
Run Date: 10/08/2015
Job # 41303463
Last Update: 10/07/2015
Page 1 of 3
CASPER Report 0006D
Name and Address Listing
For Rural Health Clinic
Based on Current Survey
Tennessee
CCN
Provider Name
Address
City, State and ZIP
Telephone # County Name
448903
ALLCARE MEDICAL PLLC
522 MAIN STREET
FRIENDSHIP, TN 38034
(731)677-3000
Crockett
443900
ALLCARE MEDICAL TROY , PLCC
316 HARPER STREET
TROY, TN 38260
(901)536-4624
Obion
443931
APPALACHIA HEALTH SERVICES LLC
292 NORTH MAIN STREET
JELLICO, TN 37762
(423)784-3600
Campbell
448938
ATHENS FAMILY PRACTICE
711 COOK DRIVE SUITE 100
ATHENS, TN 37303
(615)516-3283
Mcminn
448925
ATHENS PEDIATRICS PLLC
111 EPPERSON ST
ATHENS, TN 37303
(423)745-5955
Mcminn
448951
ATHENS WOMENS CLINIC, PC
817 COOK DRIVE
ATHENS, TN 37303
(423)745-3394
Mcminn
443435
BAPTIST HICKMAN MEDICAL CLINIC
150 EAST SWAN STREET
CENTERVILLE, TN 37033
(931)729-3091
Hickman
443937
BEDFORD URGENT CARE
1612 NORTH MAIN STREET, SUITE A
SHELBYVILLE, TN 37160
(615)555-5555
Bedford
448943
CARE RITE, PLLC
106 EAST MAIN STREET
HALLS, TN 38040
(731)836-9700
Lauderdale
448939
CARE RITE, PLLC
124 NORTH JEFFERSON
RIPLEY, TN 38063
(731)635-7000
Lauderdale
448946
CELEBRATION FAMILY CARE PLLC
529 WEST COMMERCE STREET
LEWISBURG, TN 37091
(931)270-9729
Marshall
448901
CENTER FOR FAMILY MEDICINE
1615 MCMINNVILLE HWY, SUITE B
MANCHESTER, TN 37355
(931)728-6205
Coffee
443925
CHARLES H WILKENS MD PC
131 HOSPITAL LANE, PO BOX 447
JELLICO, TN 37762
(423)784-7269
Campbell
448942
CHRISTIAN FAMILY MEDICINE OF BOLIVAR
622 W MARKET STREET
BOLIVAR, TN 38008
(731)635-8189
Hardeman
448936
105 HIGHWAY 431
MARTIN, TN 38237
(731)281-4760
Weakley
443951
CHRISTIAN FAMILY MEDICINE OF WEAKLEY
COUNTY
CHRISTIAN FAMILY MEDICINE, INC
79 HIGHWAY 51 SOUTH
RIPLEY, TN 38063
(731)635-8189
Lauderdale
443956
COMMUNITY MEDICAL CENTER OF MONTEAGLE 926 WEST MAIN STREET, PO BOX 1148
MONTEAGLE, TN 37356
(931)924-6006
Grundy
443916
COOKEVILLE MEDICAL CLINIC RHC
225 NORTH WILLOW AVENUE
COOKEVILLE, TN 38501
(615)528-8089
Putnam
448926
COVENANT PEDIATRICS
421 OLD RICEVILLE ROAD SUITE 2
ATHENS, TN 37303
(423)744-8755
Mcminn
448934
CROCKETT MEDICAL CLINIC
58 SOUTH BELLS STREET
ALAMO, TN 38001
(731)696-5401
Crockett
443957
CUMBERLAND FAMILY CARE OF VANBUREN
817 COLLEGE STREET
SPENCER, TN 38585
(931)946-2113
Van Buren
443448
CUMBERLAND RIVER MEDICAL CLINIC
102 OLD JEFFERSON STREET
CELINA, TN 38551
(931)243-3576
Clay
448914
DOVER MEDICAL CLINIC
133 DR ROBERT H LEE DRIVE
DOVER, TN 37058
(931)232-5141
Stewart
443971
DYERSBURG FAMILY WALK-IN CLINIC, PC
2017 SAINT JOHN AVENUE, SUITE B
DYERSBURG, TN 38024
(731)285-6110
Dyer
443845
EAGLEVILLE MEDICAL GROUP
341 SOUTH MAIN STREET
EAGLEVILLE, TN 37060
(615)274-6207
Rutherford
443918
EAST JACKSON FAMILY MEDICAL CE
655 LEXINGTON AVENUE
JACKSON, TN 38301
(731)425-7900
Madison
443442
136 WHEELERTOWN AVANUE
PIKEVILLE, TN 37367
(423)447-3524
Bledsoe
448941
ERLANGER BLEDSOE - INTERNAL MEDICINE &
PEDIATRICS
FAMILY CARE CLINIC LLC
231 NORTHGATE DR 102
MC MINNVILLE, TN 37110
(931)474-4700
Warren
443955
FAMILY CLINIC OF HENDERSON
236 NORTH AVENUE
HENDERSON, TN 38340
(731)989-5180
Chester
448905
FAMILY FIRST MEDICAL CENTER
899 HIGHWAY 51 SOUTH
COVINGTON, TN 38019
(901)476-8886
Tipton
443930
FAMILY HEALTH CENTER OF ASHLAND CITY
342 FREY STREET
ASHLAND CITY, TN 37015
(615)792-1199
Cheatham
448935
FAMILY HEALTHCARE CLINIC LLC
7065 KNOXVILLE HIGHWAY
OLIVER SPRINGS, TN 37840
(865)435-3918
Morgan
448923
FAMILY HEALTHCARE OF CAMDEN, INC
350 HOSPITAL DRIVE
CAMDEN, TN 38320
(731)584-3330
Benton
448952
FAMILY MEDICINE WEST OF WARTBURG
1236 KNOXVILLE HIGHWAY, SUITE 500
WARTBURG, TN 37887
(423)346-5566
Morgan
Run Date: 10/08/2015
Job # 41303463
Last Update: 10/07/2015
Page 2 of 3
CASPER Report 0006D
Name and Address Listing
For Rural Health Clinic
Based on Current Survey
Tennessee
CCN
Provider Name
Address
City, State and ZIP
Telephone # County Name
448909
FAMILY WALK-IN CLINIC
42 DOOLEY STREET
CROSSVILLE, TN 38555
(931)707-7117
Cumberland
448921
FAMILY WALK-IN CLINIC OF SPARTA
287 W TURNTABLE RD
SPARTA, TN 38583
(931)337-1035
White
448920
GREENFIELD FAMILY CARE
801 S MERIDIAN
GREENFIELD, TN 38230
(731)235-0555
Weakley
443965
HEARTLAND MEDICAL PC
309 N BROAD STREET
NEW TAZEWELL, TN 37825
(423)626-7297
Claiborne
443447
HENDERSON COUNTY MEDICAL GROUP RHC
250 BOSWELL ST
LEXINGTON, TN 38351
(731)968-2006
Henderson
448950
HOHENWALD MEDICAL CENTER
20 S PARK STREET
HOHENWALD, TN 38462
(931)796-7960
Lewis
443913
JENNINGS FAMILY MEDICAL CLINIC
364 TENNESSEE AVENUE SOUTH
PARSONS, TN 38363
(901)847-6396
Decatur
443438
JOHNSON COUNTY MEDICAL GROUP
1901 S SHADY STREET
MOUNTAIN CITY, TN 37683
(423)727-1133
Johnson
448948
JUST 4 KIDS PEDIATRICS, LLC
910 WEST COLLEGE STREET
PULASKI, TN 38478
(931)363-0077
Giles
448945
KIDS ARE SPECIAL
880 COLLOREDO BLVD
SHELBYVILLE, TN 37160
(931)685-8111
Bedford
443973
KIDZCARE PEDIATRICS
119 EPPERSON STREET
ATHENS, TN 37303
(423)745-7500
Mcminn
443961
KINGSTON FAMILY PRACTICE, PC
820 WEST RACE STREET
KINGSTON, TN 37763
(865)376-3406
Roane
448908
LENTZ PEDIATRICS PLC
9486 HIGHWAY 412 W
LEXINGTON, TN 38351
(731)968-5558
Henderson
448924
LEXINGTON FAMILY PRACTICE
524 S BROAD ST
LEXINGTON, TN 38351
(731)651-0300
Henderson
443954
LEXINGTON MEDICAL CLINIC
120 E CHURCH STREET
LEXINGTON, TN 38351
(731)968-0146
Henderson
443974
LIBERTY MEDICAL CLINIC
4944 COLLEGE STREET
BELLS, TN 38006
(731)663-3530
Crockett
443932
LYNETTE M ADAMS, MD
1612 NORTH MAIN, SUITE 13
SHELBYVILLE, TN 37160
(931)685-2022
Bedford
448919
MADISON STREET FAMILY CLINIC
1401 MADISON STREET
SHELBYVILLE, TN 37160
(931)685-2022
Bedford
443441
MANCHESTER RURAL HEALTH CLINIC
482 INTERSTATE DRIVE, SUITE A
MANCHESTER, TN 37355
(931)728-4718
Coffee
448910
MARTIN CHILDREN'S CLINIC LLC
130 COMMONS DR
MARTIN, TN 38237
(731)681-1577
Weakley
448918
MEDSOUTH MEDICAL CENTER, DYERSBURG
1700 WOODLAWN AVE
DYERSBURG, TN 38024
(731)287-4500
Dyer
448932
MICHIE MEDICAL CLINIC INC
6659 MICHIE PEBBLE HILL RD
MICHIE, TN 38357
(731)632-1783
Mcnairy
448907
MONTGOMERY FAMILY HEALTH CENTER INC
727 S MAIN STREET
MIDDLETON, TN 38052
(731)376-2804
Hardeman
443868
MOUNTAIN CITY EXTENDED HOURS H
JOHNSON CO HLTH CTR, 1901 S SHADY ST
MOUNTAIN CITY, TN 37683
(423)727-1150
Johnson
443938
NEW HOPE FAMILY HEALTH CENTER, INC
249 HARDEMAN ROAD
GRAND JUNCTION, TN 38039
(731)764-2200
Hardeman
448931
ONE STOP MEDICAL LLC
325 GERI STREET
LAWRENCEBURG, TN 38464
(931)762-9797
Lawrence
448930
ONE STOP MEDICAL, LLC
912 WEST COLLEGE STREET
PULASKI, TN 38478
(931)424-9797
Giles
443446
PALMER MEDICAL CLINIC
2578 MAIN STREET
PALMER, TN 37365
(931)779-3691
Grundy
443933
PAUL E SCATES FAMILY MEDICINE
12995 HWY 64, PO BOX 399
SOMERVILLE, TN 38068
(901)466-0250
Fayette
448944
PAULA VASSAR INC
1117 S MILES AVENUE SUITE 4
UNION CITY, TN 38261
(731)885-6600
Obion
448900
PEDIATRIC ASSOCIATES P C
1501 BRAYTON AVENUE
DYERSBURG, TN 38024
(555)555-1234
Dyer
448933
PIKEVILLE CLINIC LLC
3062 MAIN STREET
PIKEVILLE, TN 37367
(423)447-2955
Bledsoe
443967
PIONEER PEDIATRICS PLLC
236 E MAIN ST
MC MINNVILLE, TN 37110
(931)815-5457
Warren
443966
PLATEAU PEDIATRICS PLC
3234 MILLER AVENUE
CROSSVILLE, TN 38555
(931)707-8700
Cumberland
443935
R SHANE ROBERTS, MD
398 N MAIN STREET
DECATUR, TN 37322
(423)334-2222
Meigs
Run Date: 10/08/2015
Job # 41303463
Last Update: 10/07/2015
Page 3 of 3
CASPER Report 0006D
Name and Address Listing
For Rural Health Clinic
Based on Current Survey
Tennessee
CCN
Provider Name
Address
City, State and ZIP
Telephone # County Name
448947
RAY MEDICAL
2409 HIGHWAY 70 E
DICKSON, TN 37055
(615)740-7322
Dickson
448913
REELFOOT FAMILY WALK- IN CLINIC
1509 EAST REELFOOT AVENUE
UNION CITY, TN 38261
(731)442-9306
Obion
448940
REELFOOT FAMILY WALK-IN CLINIC
130 E LOCUST STREET
DRESDEN, TN 38225
(731)364-3196
Weakley
448937
REELFOOT FAMILY WALK-IN CLINIC
708 EAST COURT STREET
DYERSBURG, TN 38024
(731)555-5555
Dyer
448922
ROBERSON RIKE CLINIC
768 EVERETT STREET
TIPTONVILLE, TN 38079
(731)253-3760
Lake
443949
RURAL HEALTH CLINICS OF WEST TN, PLLC
326 ASBURY AVENUE, SUITE 101
RIPLEY, TN 38063
(731)635-2755
Lauderdale
443948
RURAL HEALTH CLINICS OF WEST TN, PLLC
1716 PARR AVENUE SUITE A
DYERSBURG, TN 38024
(731)253-3683
Dyer
443950
RURAL HEALTH CLINICS OF WEST TN, PLLC
104 E MAIN STREET
HALLS, TN 38040
(731)836-7700
Lauderdale
448912
21 1ST STREET
MONTEAGLE, TN 37356
(931)924-9000
Grundy
443943
SOUTHERN TENNESSEE PRIMARY CAREMOUNTAIN MEDICAL C
SPRING CITY WALK IN MEDICAL CENTER
126 LAVENDER STREET
SPRING CITY, TN 37381
(423)452-9984
Rhea
443970
SPRINGER MEDICAL ASSOCIATES
16615 HIGHWAY 104 N SUITE B
LEXINGTON, TN 38351
(731)968-0660
Henderson
443445
TENNOVA FAMILY MEDICINE
1 PHYSICIANS DR
SELMER, TN 38375
(731)645-6777
Mcnairy
443997
905 E CENTRAL AVE
LAFOLLETTE, TN 37766
(423)907-1600
Campbell
2145 JACKSBORO PIKE
LA FOLLETTE, TN 37766
(423)907-1700
Campbell
443449
TENNOVA LAFOLLETTE MEDICAL CENTER
CLINIC
TENNOVA LAFOLLETTE MEDICAL CENTER
CLINIC-SOUTH
TENNOVA PRIMARY CARE-HILLVIEW SOUTH
1203 INDUSTRIAL PARK RD
SOUTH FULTON, TN 38257
(731)479-2606
Obion
448916
TERRELL CLINIC LLC
701 EAST REELFOOT AVE SUITE 100
UNION CITY, TN 38261
(731)885-9687
Obion
448906
THE GRAY CLINIC
100 WEST COLLEGE ST
KENTON, TN 38233
(731)749-7444
Gibson
443968
THE GROVE PRIMARY CARE CLINIC
541 WEST PARK PLACE SUITE C
HENDERSON, TN 38340
(731)983-0499
Chester
448929
THE GROVE PRIMARY CARE CLINIC LLC
702 S MAIN STREET
MIDDLETON, TN 38052
(731)376-1311
Hardeman
443960
THE RICKARD CLINIC
557 WEST PARK PLACE
HENDERSON, TN 38340
(731)989-1007
Chester
448928
TRINITY MEDICAL CLINIC, LLC
181 S Y SQ
SELMER, TN 38375
(731)434-0200
Mcnairy
443936
UNIONVILLE FAMILY PRACTICE
3335 HIGHWAY 41A NORTH
UNIONVILLE, TN 37180
(931)685-2022
Bedford
448927
WALK-IN MEDICAL CLINIC OF LINDEN PLLC
847 SQUIRREL HOLLOW DR
LINDEN, TN 37096
(931)589-2600
Perry
443969
WARTRACE FAMILY PRACTICE
507 WEST BLACKMAN BLVD
WARTRACE, TN 37183
(931)389-0600
Bedford
443947
WOMEN'S WELLNESS & MATERNITY CENTER,
INC
3459 HWY 68
MADISONVILLE, TN 37354
(423)442-6624
Monroe
443440
Total Providers for this State = 94
Run Date: 10/08/2015
Job # 41303463
Last Update: 10/07/2015
Page 1 of 7
CASPER Report 0006D
Name and Address Listing
For Rural Health Clinic
Based on Current Survey
Illinois
CCN
Provider Name
Address
City, State and ZIP
Telephone # County Name
148985
AHEARN ASSOCIATES MEDICAL CENTER INC
513 ELLIOTT STREET SUITE 4
KEWANEE, IL 61443
(309)853-2442
Henry
143438
ATWOOD RURAL HEALTH CLINIC
108 S MAIN STREET
ATWOOD, IL 61913
(217)578-3814
Douglas
783821
BENTON COMMUNITY HEALTHCARE
203 BAILEY LANE SUITE 1
BENTON, IL 62812
(618)438-5670
Franklin
143456
BOWEN FAMILY PRACTICE
209 EAST 5TH STREET
BOWEN, IL 62316
(217)842-5211
Hancock
143474
BOYD-FILLAGER CLINIC
712 COLLEGE STREET
GREENFIELD, IL 62044
(217)368-3051
Greene
143917
BRIAN W DOSSETT MD LTD
1029 N 8TH STREET
VANDALIA, IL 62471
(618)283-4469
Fayette
148522
BUSHNELL FAMILY PRACTICE, S C
1150 N COLE ST
BUSHNELL, IL 61422
(309)772-9444
Mcdonough
148921
C C MEDICAL CLINIC
115 E PLEASANT
TAYLORVILLE, IL 62568
(217)287-7477
Christian
148533
CARLE AT TUSCOLA
301 E SOUTHLINE ROAD
TUSCOLA, IL 61953
(217)253-5231
Douglas
148521
CARLE AT WATSEKA
1490 E WALNUT STREET, SUITE C
WATSEKA, IL 60970
(815)432-8200
Iroquois
148531
CARLE DANVILLE ON FAIRCHILD
311 WEST FAIRCHILD STREET
DANVILLE, IL 61832
(217)431-7600
Vermilion
148544
CARLE MATTON ON HURST
2512 HURST DR SUITE 130
MATTOON, IL 61938
(217)258-5900
Coles
148530
CARLINVILLE FAMILY HEALTH CARE
1115 MORGAN STREET #2
CARLINVILLE, IL 62626
(217)854-3881
Macoupin
148926
CARLINVILLE FAMILY PRACTICE
15574 ROUTE 108
CARLINVILLE, IL 62626
(217)854-4319
Macoupin
143937
CARLINVILLE MEDICAL CLINIC
604 N BROAD ST
CARLINVILLE, IL 62626
(217)854-9411
Macoupin
148978
CARLINVILLE MEDICAL CLINIC INC
125 SOUTH 2ND STREET, PO BOX 25
GIRARD, IL 62640
(217)627-3350
Macoupin
148529
CARMI FAMILY CLINIC
110A E MAIN STREET
NORRIS CITY, IL 62869
(618)378-2067
White
143978
CASEY CLINIC
412 NW 3RD, PO BOX 40
CASEY, IL 62420
(217)932-4061
Clark
143458
CCH MEDICAL CLINIC
929 STABY BURK DRIVE, PO BOX 40
FLORA, IL 62839
(618)662-2191
Clay
143880
CENTER FOR FAMILY HEALTH - MALTA
21193 MALTA RD
MALTA, IL 60150
(815)753-9010
De Kalb
143821
CENTER FOR MEDICAL ARTS RURAL HEALTH
2601 W MAIN STREET
CARBONDALE, IL 62901
(618)549-5361
Jackson
148937
CENTRAL ILLINOIS PEDIATRICS
900 WEST TEMPLE SUITE 203
EFFINGHAM, IL 62401
(217)342-5405
Effingham
783803
CENTRALIA FAMILY HEALTH CENTER
1441 WEST BROADWAY
CENTRALIA, IL 62801
(618)532-9050
Marion
783809
CHESTER CLINIC
2319 OLD PLANK ROAD
CHESTER, IL 62233
(618)826-2388
Randolph
143485
CISSNA PARK MEDICAL CLINIC
141 WEST GARFIELD AVENUE
CISSNA PARK, IL 60924
(815)457-2146
Iroquois
143935
CLARK COUNTY FAMILY MEDICINE PC
890 RIDGELAWN ROAD
MARTINSVILLE, IL 62442
(217)382-4191
Clark
148503
CLINTON COUNTY RURAL HEALTH
9401 HOLY CROSS LANE
BREESE, IL 62230
(618)526-7271
Clinton
148502
205 MUNSTER STREET
GERMANTOWN, IL 62245
(618)523-4541
Clinton
143488
CLINTON COUNTY RURAL HEALTH
GERMANTOWN
CMH OBLONG RURAL HEALTH
1366 EAST 1050TH AVENUE
OBLONG, IL 62449
(618)592-3119
Crawford
143486
CMH PALESTINE RURAL HEALTH
209 EAST GRAND PRAIRIE
PALESTINE, IL 62451
(618)586-2153
Crawford
143429
CMH RURAL HEALTH CLINIC
1101 NORTH ALLEN STREET
ROBINSON, IL 62454
(618)544-3699
Crawford
143484
COMMUNITY MEDICAL CLINIC
135 W BROADWAY
ASTORIA, IL 61501
(309)329-2926
Fulton
148508
COMMUNITY MEDICAL CLINIC OF PANA
101 EAST 9TH STREET, SUITE 105
PANA, IL 62557
(217)562-2544
Christian
143948
COMPREHENSIVE HEALTH CENTER
1238 COMMERICAL PARK ROAD
METROPOLIS, IL 62960
(618)524-2284
Massac
Run Date: 10/08/2015
Job # 41303463
Last Update: 10/07/2015
Page 2 of 7
CASPER Report 0006D
Name and Address Listing
For Rural Health Clinic
Based on Current Survey
Illinois
CCN
Provider Name
City, State and ZIP
Telephone # County Name
148527
CONFIDENCE MEDICAL ASSOCIATES VANDALIA 1442 N 8TH SUITE C
VANDALIA, IL 62471
(618)283-0266
Fayette
148545
CONVENIENT CARE
1345 S ROUTE 127
GREENVILLE, IL 62246
(618)665-9390
Bond
143975
CONVENIENT CARE CLINIC
517 N MAIN STREET
ANNA, IL 62906
(618)833-2295
Union
Address
148987
CORK MEDICAL CENTER
408 N 2ND STREET
MARSHALL, IL 62441
(217)826-2361
Clark
143465
COULTERVILLE MEDICAL CLINIC
203 E GRANT
COULTERVILLE, IL 62237
(618)758-2331
Randolph
148993
COWDEN MEDICAL CLINIC LLC
209 EAST ELM STREET, PO BOX 154
COWDEN, IL 62422
(217)783-6565
Shelby
148924
CRAIG W FURRY, MD
20 N WASHINGTON, SUITE 2
DU QUOIN, IL 62832
(618)542-2129
Perry
148524
209 CROSSROADS PLACE, SUITE 120
MOUNT VERNON, IL 62864
(618)242-3465
Jefferson
1209 ROBINSON ST
WAYNE CITY, IL 62895
(618)895-2050
Wayne
143878
CROSSROADS FAMILY MEDICINE OF MT
VERNON
CROSSROADS FAMILY MEDICINE OF WAYNE
CITY
DANVILLE PEDIATRIC CENTER
723 N LOGAN AVE
DANVILLE, IL 61832
(217)446-3259
Vermilion
783801
DIETERICH COMMUNITY MEDICAL CENTER
203 S MAIN STREET PO BOX 182
DIETERICH, IL 62424
(217)925-5730
Effingham
143877
DOCTORS CLINIC, THE
402 S PLUM
CARMI, IL 62821
(618)384-2226
White
143404
DR JOHN WARNER HOSP RURAL HLTH
422 WEST WHITE STREET
CLINTON, IL 61727
(217)935-9571
De Witt
143422
EAST ADAMS COUNTY RURAL HEALTH
102 PRAIRIE MILLS ROAD
GOLDEN, IL 62339
(217)696-4446
Adams
783818
EFFINGHAM OBSTETRICS & GYNECOLOGY
ASSOCIATES LLC
ELDORADO FAMILY MEDICINE CLINIC
912 N HENRIETTA PO BOX 784
EFFINGHAM, IL 62401
(217)342-3337
Effingham
1407 LOCUST STREET
ELDORADO, IL 62930
(618)273-2100
Saline
148523
148507
143473
ELDORADO PRIMARY CARE
1007 U S ROUTE 45
ELDORADO, IL 62930
(618)273-7723
Saline
143483
ELMER HUGH TAYLOR CLINIC
100 W 15TH STREET
BEARDSTOWN, IL 62618
(217)322-4321
Cass
148518
EQUALITY FAMILY PRACTICE
183 WEST LANE STREET
EQUALITY, IL 62934
(618)276-5196
Gallatin
783815
FAMILY CARE ASSOCIATES OF EFFINGHAM, SC 1106 NORTH MERCHANT STREET, PO BOX 665
EFFINGHAM, IL 62401
(217)342-7000
Effingham
143466
FAMILY HEALTH CENTER
207 SOUTH BURNS AVENUE
SPARTA, IL 62286
(618)443-3084
Randolph
143446
FAMILY HEALTHCAR CENTER
200 SOUTH CEDAR STREET
SHELBYVILLE, IL 62565
(217)774-9640
Shelby
148517
FAMILY HEALTHCARE OF FARMER CITY
1230 GEORGE ROCK DRIVE
FARMER CITY, IL 61842
(309)928-9192
De Witt
148516
FAMILY HEALTHCARE OF GIBSON CITY
7 DOCTORS PARK
GIBSON CITY, IL 60936
(217)784-5500
Ford
148515
FAMILY HEALTHCARE OF HOOPESTON
705 S DIXIE HWY
HOOPESTON, IL 60942
(217)728-3553
Vermilion
143412
FAMILY MEDICAL CENTER
203 NORTH WALNUT STREET
PINCKNEYVILLE, IL 62274
(618)357-2131
Perry
143989
FAMILY MEDICAL CENTER
112 WEST MADISON AVENUE
CHRISMAN, IL 61924
(217)269-2394
Edgar
143431
FAMILY MEDICAL CENTER
104 E BUENA VISTA
KANSAS, IL 61933
(217)465-8411
Edgar
143987
FAMILY MEDICAL CENTER
727 E COURT
PARIS, IL 61944
(217)465-8411
Edgar
148992
FAMILY MEDICINE OF MCLEANSBORO
208 S WASHINGTON STREET
MC LEANSBORO, IL 62859
(618)643-2835
Hamilton
148956
FAMILY PRACTICE MEDICAL CENTER
511 W FAIRCHILD STREET
DANVILLE, IL 61832
(217)431-2025
Vermilion
148935
FAMILY PRACTICE MEDICAL CENTER, LTD
508 N MAIN STREET
GEORGETOWN, IL 61846
(217)662-2282
Vermilion
148534
FAMILY RURAL HEALTH OF LAHARPE
501 EAST MAIN STREET
LA HARPE, IL 61450
(217)659-3844
Hancock
148528
FCH RURAL HEALTH ST ELMO
515 N MAIN STREET
SAINT ELMO, IL 62458
(618)829-9200
Fayette
Run Date: 10/08/2015
Job # 41303463
Last Update: 10/07/2015
Page 3 of 7
CASPER Report 0006D
Name and Address Listing
For Rural Health Clinic
Based on Current Survey
Illinois
CCN
Provider Name
Address
City, State and ZIP
Telephone # County Name
148506
FERRELL HOSPITAL FAMILY PRACTICE
1306 MAPLE STREET
ELDORADO, IL 62930
(618)297-9665
Saline
143469
201 BAILEY LANE
BENTON, IL 62812
(618)439-3161
Franklin
148986
FRANKLIN HOSPITAL - FRANKLIN HEALTHCARE
CLINIC
GALLATIN COUNTY WELLNESS CENTER
5150 HIGHWAY 13
JUNCTION, IL 62954
(618)272-7132
Gallatin
148918
GENESIS HEALTH GROUP
530 12TH STREET
ERIE, IL 61250
(309)659-2215
Whiteside
143453
GENESIS HEALTH GROUP, ALEDO
1007 NW 3RD ST
ALEDO, IL 61231
(309)582-5301
Mercer
143882
GIBSON CITY CLINIC SC
222 NORTH SANGAMON AVENUE
GIBSON CITY, IL 60936
(217)784-8148
Ford
143859
GILLESPIE FAMILY PRACTICE
715 W BROADWAY
GILLESPIE, IL 62033
(217)839-4491
Macoupin
143424
GILMAN CLINIC
508 E CRESCENT ST
GILMAN, IL 60938
(815)265-8889
Iroquois
148532
GIRARD FAMILY HEALTH CARE
205 SOUTH THIRD STREET
GIRARD, IL 62640
(217)627-2222
Macoupin
143493
GRAHAM MEDICAL GROUP - LEWISTON
2001 NORTH MAIN ST
LEWISTOWN, IL 61542
(309)547-9700
Fulton
143497
GRAHAM MEDICAL GROUP-CUBA
114 SOUTH 4TH STREET
CUBA, IL 61427
(309)785-5156
Fulton
143494
GRAHAM MEDICAL GROUP-FARMINGTON
601 E FORT ST
FARMINGTON, IL 61531
(309)245-2428
Fulton
143492
GRAHAM SERVICE DBA COLEMAN CLINIC RHC
175 SOUTH MAIN STREET
CANTON, IL 61520
(309)647-0201
Fulton
143403
GREENE COUNTY RURAL HEALTH CLI
116 N MAIN ST
WHITE HALL, IL 62092
(217)374-2188
Greene
143491
GREENVILLE FAMILY WELLNESS CENTER
150 HEALTHCARE DRIVE
GREENVILLE, IL 62246
(618)664-9830
Bond
148513
GREENVILLE MEDICAL ASSOCIATES
101 HEALTHCARE DRIVE
GREENVILLE, IL 62246
(618)664-2531
Bond
143477
HAMILTON MEMORIAL FAMILY CLINIC
611 SOUTH MARSHALL AVENUE, PO BOX 429
MCLEANSBORO, IL 62859
(618)642-2988
Hamilton
148957
HAMILTON-WARSAW CLINIC
1102 N COUNTY RD 700
WARSAW, IL 62379
(217)256-4100
Hancock
143479
HARDIN COUNTY GENERAL HOSPITAL CLINIC
PO BOX 2467, FERRELL ROAD
ROSICLARE, IL 62982
(618)285-2800
Hardin
143457
HAVANA MEDICAL ASSOCIATES
615 PROMENADE ST
HAVANA, IL 62644
(309)543-6600
Mason
148966
HEARTLAND PEDIATRICS
805 WEST DEYOUNG STREET, SUITE B
MARION, IL 62959
(618)993-5274
Williamson
783830
HEARTLAND WOMEN'S HEALTHCARE
3130 VETERNAS MEMORIAL DRIVE
MOUNT VERNON, IL 62864
(314)968-0076
Jefferson
783816
HEARTLAND WOMEN'S HEALTHCARE, LTD
3408 OFFICE PARK DRIVE
MARION, IL 62959
(618)997-5266
Williamson
148999
HEARTLAND WOMEN'S HEALTHCARE, LTD
430 NORTH PLEASANT
CENTRALIA, IL 62801
(618)436-8350
Marion
783827
HENNEPIN MEDICAL CLINIC
220 E HIGH ST SUITE 101
HENNEPIN, IL 61327
(815)925-7032
Putnam
783813
HIGHLAND PRIORITY CARE
30 APEX DRIVE, SUITE 2
HIGHLAND, IL 62249
(618)234-2130
Madison
143448
HOOPESTON MEDICAL CENTER
801 EAST ORANGE STREET
HOOPESTON, IL 60942
(217)283-5644
Vermilion
148500
HORIZON HEALTHCARE RHC
213 NW 10TH STREET, SUITE A
FAIRFIELD, IL 62837
(618)842-4617
Wayne
783831
HSHS MEDICAL GROUP FAMILY MEDICINE
516 S CHESTNUT ST
WENONA, IL 61377
(815)853-4401
Marshall
148917
HSHS MEDICAL GROUP FAMILY MEDICINE
HILLSBORO
HSHS MEDICAL GROUP FAMILY MEDICINETABLE GROVE
HSHS MEDICAL GROUP FAMILY MEDICINERUSHVILLE
HSHS MEDICAL GROUP MEDICINE
400 ROUNTREE ST
HILLSBORO, IL 62049
(217)532-9471
Montgomery
130 N BROADWAY
TABLE GROVE, IL 61482
(309)758-5070
Fulton
108 RODEWALD DRIVE
RUSHVILLE, IL 62681
(217)322-3529
Schuyler
109 E ELM ST
STREATOR, IL 61364
(815)672-4587
La Salle
148972
143905
783832
Run Date: 10/08/2015
Job # 41303463
Last Update: 10/07/2015
Page 4 of 7
CASPER Report 0006D
Name and Address Listing
For Rural Health Clinic
Based on Current Survey
Illinois
CCN
Provider Name
Address
City, State and ZIP
Telephone # County Name
148977
2970 CHARTRES STREET
LA SALLE, IL 61301
(815)223-0196
La Salle
640 W WASHINGTON ST
PITTSFIELD, IL 62363
(217)223-8400
Pike
143425
HYGIENIC INSTITUTE FOR LASALLE, PERU &
OGLESBY
ILLINI COMMUNITY HOSPITAL RURAL HEALTH
CLINIC
IMH MILFORD CLINIC
34 EAST JONES STREET
MILFORD, IL 60953
(815)889-4241
Iroquois
148996
IRVINGTON RURAL HEALTH CENTER
205 HURON ST
IRVINGTON, IL 62848
(618)249-6203
Washington
148536
JCH MEDICAL GROUP CARLINVILLE
103 MCCASLAND AVE
CARLINVILLE, IL 62626
(217)854-2623
Macoupin
143482
148537
JCH MEDICAL GROUP CAROLLTON
523 S MAIN
CARROLLTON, IL 62016
(217)942-3326
Greene
148539
JCH MEDICAL GROUP HARDIN
106 WATER STREET
HARDIN, IL 62047
(618)576-9407
Calhoun
148538
JCH MEDICAL GROUP JERSEYVILLE
390 MAPLE SUMMIT ROAD PO BOX 279
JERSEYVILLE, IL 62052
(618)498-2101
Jersey
148540
JCH MEDICAL GROUP ROODHOUSE
205 S MORSE STREET
ROODHOUSE, IL 62082
(217)589-4383
Greene
143495
KIRBY MEDICAL GROUP
1000 MEDICAL CENTER DRIVE
MONTICELLO, IL 61856
(217)762-6241
Piatt
143951
LAWRENCE COUNTY HEALTH DEPT RH
RR3, BOX 414
LAWRENCEVILLE, IL 62439
(618)943-3302
Lawrence
143499
2111 LEXINGTON AVENUE
LAWRENCEVILLE, IL 62439
(618)943-7216
Lawrence
148950
LAWRENCE COUNTY MEMORIAL HOSPITAL
PRIMARY CARE CLI
LAWRENCE P JENNINGS MD, MSC
1430 COLLEGE DRIVE-SUITE A
MOUNT CARMEL, IL 62863
(618)262-5113
Wabash
143925
LINCOLN RURAL HEALTH
100 STAHLNUT DRIVE
LINCOLN, IL 62656
(217)735-9955
Logan
143822
LITCHFIELD FAMILY PRACTICE CTR
1285 FRANCISCAN DRIVE
LITCHFIELD, IL 62056
(217)324-6127
Montgomery
143870
LOGAN PRIMARY CARE
405 RUSHING DRIVE
HERRIN, IL 62948
(618)942-4640
Williamson
148969
LOGAN PRIMARY CARE SERVICES
502 WEST ST LOUIS STREET
WEST FRANKFORT, IL 62896
(618)937-3400
Franklin
143487
LOUISIVILLE MEDICAL CLINIC
935 BRYANT STREET
LOUISVILLE, IL 62858
(618)665-4500
Clay
783825
MARION DIAGNOSTIC CENTER, LLC
3003 CIVIC CIRCLE BLVD STE 200
MARION, IL 62959
(618)993-1400
Williamson
143490
MARISSA MEDICAL CLINIC
521 NORTH BORDERS
MARISSA, IL 62257
(618)295-1591
St. Clair
148504
MARSHALL BROWING HOSPITAL ASSOCIATION
900 NORTH WASHINGTON
DU QUOIN, IL 62832
(618)542-8958
Perry
148938
MARSHALL CLINIC EFFINGAHM SC - ALTAMONT 3 DO IT DRIVE
ALTAMONT, IL 62411
(618)483-6131
Effingham
783812
MARSHALL CLINIC EFFINGHAM SC
223 EAST SIXTH STREET
NEOGA, IL 62447
(217)895-2320
Cumberland
148928
MARSHALL CLINIC EFFINGHAM SC LOUISVILLE
134 SOUTH CHURCH STREET
LOUISVILLE, IL 62858
(618)665-4612
Clay
148997
MARSHALL CLINIC EFFINGHAM, SC
300 NORTH MAPLE
EFFINGHAM, IL 62401
(217)342-4151
Effingham
783800
MARSHALL CLINIC EFFINGHAM, SC-NEWTON
507 WEST WASHINGTON
NEWTON, IL 62448
(618)783-5094
Jasper
143462
MASON CITY MEDICAL ASSOCIATES
122 E ELM STREET
MASON CITY, IL 62664
(309)543-8542
Mason
143478
MASSAC MEMORIAL MEDICAL CLINIC
1204 W 10TH STREET
METROPOLIS, IL 62960
(618)524-2176
Massac
148519
MCCRACKEN DAWDY FAMILY PRACTIC
201 HEALTH CARE DR
GREENVILLE, IL 62246
(618)664-1380
Bond
148520
MCCRACKEN DAWDY FAMILY PRACTIC
507 W STATE, BOX 450
POCAHONTAS, IL 62275
(618)669-2270
Bond
143871
MEDICAL ARTS CLINIC
19 E SHAWNEE DRIVE, SUITE 2
MURPHYSBORO, IL 62966
(618)684-2172
Jackson
143892
MEDICAL ASSOCIATES OF JERSEYVI
270 MAPLE SUMMIT RD
JERSEYVILLE, IL 62052
(618)498-7108
Jersey
143936
MEMORIAL PHYSICANS SERVICES
1 CENTRE DRIVE
PETERSBURG, IL 62675
(217)632-7761
Menard
148905
MEMORIAL PHYSICIAN SERVICES
800 W STATE STREET
JACKSONVILLE, IL 62650
(217)243-9471
Morgan
Run Date: 10/08/2015
Job # 41303463
Last Update: 10/07/2015
Page 5 of 7
CASPER Report 0006D
Name and Address Listing
For Rural Health Clinic
Based on Current Survey
Illinois
CCN
Provider Name
Address
City, State and ZIP
Telephone # County Name
143895
MEMORIAL PHYSICIANS SERVICES
515 N COLLEGE
LINCOLN, IL 62656
(217)732-9681
Logan
143829
MERCER HEALTH CENTER SC
409 NW FOURTH ST
ALEDO, IL 61231
(309)582-7259
Mercer
148958
MICHAEL W ELLIOTT, MD RURAL HEALTH CLINIC 807 WEST CRAFT STREET
ROBINSON, IL 62454
(618)546-5052
Crawford
148962
MID IL MEDICAL CARE ASSOC
206 NORTH PEARL
TEUTOPOLIS, IL 62467
(217)857-6481
Effingham
148960
MID ILLINOIS MEDICAL CARE ASSOC
512 N MAPLE ST
EFFINGHAM, IL 62401
(217)347-7030
Effingham
148955
MID ILLINOIS MEDICAL CARE ASSOCIATES
8 NORTH 3RD STREET
ALTAMONT, IL 62411
(217)347-2707
Effingham
148959
EFFINGHAM, IL 62401
(217)347-0458
Effingham
783811
MID-IL MEDICAL CARE ASSOC D/B/A DR
900 W TEMPLE AVENUE, STE 205 PO BOX 1209
EUGENE DUST
MID-ILLINOIS MEDICAL CARE ASSOCIATES, LLC 910 SOUTH VAN BUREN STREET
NEWTON, IL 62448
(618)783-3800
Jasper
148511
MIDWEST HEALTH CLINIC
ONE MEDICAL CENTER DRIVE
GALENA, IL 61036
(815)776-7381
Jo Daviess
148526
MILFORD MEDICAL CLINIC
322 CHICAGO STREET
MILFORD, IL 60953
(815)889-4011
Iroquois
783807
MMG AT LACON
1112 FIFTH STREET
LACON, IL 61540
(309)246-2676
Marshall
783806
MMG AT PRINCEVILLE
223 MAIN STREET
PRINCEVILLE, IL 61559
(309)385-4371
Stark
783804
MMG-CHILLICOTHE
525 SWEETBRIAR DRIVE
CHILLICOTHE, IL 61523
(309)274-2102
Peoria
143981
MORRISON COMM HOSP FAMILY CARE
303 N JACKSON ST
MORRISON, IL 61270
(815)772-4003
Whiteside
148510
MORTHLAND COLLEGE HEALTH SERVICES
309 W ST LOUIS STREET
WEST FRANKFORT, IL 62896
(618)932-2200
Franklin
143863
MT OLIVE FAMILY PRACTICE CENTE
115 N POPLAR
MOUNT OLIVE, IL 62069
(217)999-4157
Macoupin
143886
MT STERLING RURAL HEALTH CLINI
521 E MAIN P O BOX 264
MOUNT STERLING, IL 62353
(217)773-3963
Brown
143855
MURPHYSBORO FAMILY MEDICINE CL
628 N 14TH ST
MURPHYSBORO, IL 62966
(618)687-2353
Jackson
143944
NEIL R NELSON
8 DOCTOR'S PARK
GIBSON CITY, IL 60936
(217)784-8580
Ford
143435
NEOGA CLINIC
650 OAK AVE
NEOGA, IL 62447
(217)895-2222
Cumberland
783814
NOKOMIS RURAL HEALTH CLINIC
105 EAST STATE STREET
NOKOMIS, IL 62075
(217)563-2882
Montgomery
148968
NORRIS CITY HEALTHCARE CLINIC
110 A EAST MAIN STREET
NORRIS CITY, IL 62869
(618)378-3440
White
148514
OLDER ADULT HEALTH CENTER
325 SPRING STREET
RED BUD, IL 62278
(618)282-7373
Randolph
143440
ONARGA CLINIC, THE
912 W SEMINARY AVENUE
ONARGA, IL 60955
(815)268-4843
Iroquois
143461
OSF HOLY FAMILY CLINICS
1000 WEST HARLEM AVENUE
MONMOUTH, IL 61462
(309)734-1400
Warren
143954
OSF MEDICAL GROUP - CHATSWORTH
416 E LOCUST
CHATSWORTH, IL 60921
(815)635-3177
Livingston
143956
OSF MEDICAL GROUP - CHENOA
918 E LINCOLN
CHENOA, IL 61726
(815)945-2261
Mclean
143947
OSF MEDICAL GROUP - CLINTON
1231 KLEEMAN DR
CLINTON, IL 61727
(217)935-5022
De Witt
143953
OSF MEDICAL GROUP - CULLOM
105 HACK STREET
CULLOM, IL 60929
(815)689-2126
Livingston
143445
OSF MEDICAL GROUP-KEWANEE
1051 W SOUTH STREET
KEWANEE, IL 61443
(309)852-7700
Henry
143408
PAXTON CLINIC,THE
227 N MARKET
PAXTON, IL 60957
(217)379-4864
Ford
783817
PEDIATRIC GROUP
3412 OFFICE PARK DRIVE
MARION, IL 62959
(618)993-0404
Williamson
143976
PEMBROKE COMMUNITY HEALTH CLINIC
3400 S MAIN STREET
HOPKINS PARK, IL 60944
(815)944-5545
Kankakee
783808
PEMBROKE MEDICAL CENTER
13043 SE 2260 ROAD
MOMENCE, IL 60954
(815)944-5410
Kankakee
Run Date: 10/08/2015
Job # 41303463
Last Update: 10/07/2015
Page 6 of 7
CASPER Report 0006D
Name and Address Listing
For Rural Health Clinic
Based on Current Survey
Illinois
CCN
Provider Name
Address
City, State and ZIP
Telephone # County Name
148535
PHYSICIAN SERVICES MENDOTA COMMUNITY
1405 EAST 12TH STREET
MENDOTA, IL 61342
(815)538-7200
La Salle
143949
PHYSICIANS RURAL HEALTH CLINIC
3307 BROADWAY SUITE 130
MOUNT VERNON, IL 62864
(618)244-2560
Jefferson
143885
PITTSFIELD RURAL HEALTH AFFILI
320 NORTH MADISON
PITTSFIELD, IL 62363
(217)285-9601
Pike
148505
PRAIRIE FAMILY MEDICINE & OBSTETRICS
122 EAST WABASH
FORREST, IL 61741
(815)657-8707
Livingston
143883
PRIMARY CARE GROUP
117 EAST CLARK
HARRISBURG, IL 62946
(618)252-8625
Saline
148923
QUINCY MEDICAL GROUP
405 E STATE STREET
PLEASANT HILL, IL 62366
(217)734-2545
Pike
148919
QUINCY MEDICAL GROUP
231 W CHERRY ST
WINCHESTER, IL 62694
(217)742-3117
Scott
783819
QUINCY MEDICAL GROUP
1025 MAINE STREET
QUINCY, IL 62301
(217)222-6550
Adams
148900
QUINCY MEDICAL GROUP BARRY RURAL
HEALTH AFFILIATE
RAYMOND RURAL HEALTH
868 MORTIMER ST
BARRY, IL 62312
(217)335-2343
Pike
801 N OBANNON ST
RAYMOND, IL 62560
(217)229-3711
Montgomery
783829
148963
REGIONAL HEALTH PARTNERS LLC
101 SOUTH GALENA STREET
WYOMING, IL 61491
(309)695-6448
Stark
148964
REGIONAL HEALTH PARTNERS LLC
1258 W SOUTH STREET SUITE 2
KEWANEE, IL 61443
(309)853-3677
Henry
148961
REGIONAL HEALTH PARTNERS LLC
336 FRONT ST
GALVA, IL 61434
(309)932-2604
Henry
148946
RIVERA MEDICAL, LLC
1110 MULLIKIN STREET
CARLYLE, IL 62231
(618)594-3613
Clinton
143496
ROSSVILLE MEDICAL CLINIC
619 N CHICAGO STREET
ROSSVILLE, IL 60963
(217)748-4141
Vermilion
143476
RURAL HEALTH CENTER OF ROODHOUSE
132 WEST LORTON
ROODHOUSE, IL 62082
(217)589-4629
Greene
143847
2 WEST ADMAS
SULLIVAN, IL 61951
(217)728-8329
Moultrie
148970
RURAL HEALTH CLINIC OF MOULTRIE COUNTY
LLC
S B JANI MD, PC
1106 OAK STREET
MOUNT CARMEL, IL 62863
(618)263-6575
Wabash
148931
SABEEHA HAQUE ALI MD LLC
102 N LOGAN STREET
DANVILLE, IL 61832
(217)442-5863
Vermilion
143413
SALEM TOWNSHIP HOSPITAL
1201 RICKER ROAD
SALEM, IL 62881
(618)548-3194
Marion
148995
SIU CARE-A-VAN
305 WEST JACKSON STREET, SUITE 200
CARBONDALE, IL 62901
(618)536-6621
Jackson
148965
SIU HEALTHCARE QUINCY FAMILY MEDICINE
612 NORTH 11TH STREET, SUITE B
QUINCY, IL 62301
(217)224-9484
Adams
143958
SLOAN MEDICAL CLINIC
7211 US HWY 45 SOUTH
CARRIER MILLS, IL 62917
(618)252-8625
Saline
143862
SOUTHERN IL UNIVERSITY FMLY PR
305 WEST JACKSON
CARBONDALE, IL 62901
(618)536-6621
Jackson
783823
SOUTHERN OB/GYN - HIGHLAND
100 WOODCREST DRIVE
HIGHLAND, IL 62249
(618)654-4836
Madison
783824
SOUTHERN OBSTETRIC & GYNECOLOGIC
ASSOCIATES SC
SPARTA COMMUNITY HOSPITAL, NORTH
CAMPUS
SPARTA MEDICAL OFFICE
9447 HOLY CROSS LANE
BREESE, IL 62230
(618)526-2209
Clinton
1300 NORTH MARKET
SPARTA, IL 62286
(618)443-4138
Randolph
143464
143489
783822
143907
SPRINGFIELD CLINIC JACKSONVILLE RURAL
HEALTH
SPRINGFIELD CLINIC LLC DBA BRIAN J CADY
215 SOUTH BURNS AVENUE, PO BOX 378
SPARTA, IL 62286
(618)443-2297
Randolph
610 N WESTGATE
JACKSONVILLE, IL 62650
(217)245-9931
Morgan
1280 EAST TREMONT
HILLSBORO, IL 62049
(217)532-2320
Montgomery
143850
SPRINGFIELD CLINIC TAYLORVILLE
1025 S 6TH STREET
SPRINGFIELD, IL 62703
(217)824-8191
Sangamon
148947
SPRINGFIELD CLINIC, LLP D/B/A ACORN
MEDICAL ASSOC
SPRINGFIELD CLINIC- HILLSBORO
101 MCCAUSLAND AVENUE
CARLINVILLE, IL 62626
(217)854-5099
Macoupin
1250 E TREMONT ST
HILLSBORO, IL 62049
(217)532-6911
Montgomery
143887
Run Date: 10/08/2015
Job # 41303463
Last Update: 10/07/2015
Page 7 of 7
CASPER Report 0006D
Name and Address Listing
For Rural Health Clinic
Based on Current Survey
Illinois
CCN
Provider Name
Address
City, State and ZIP
Telephone # County Name
783802
#8 CUSUMANO PLAZA
MOUNT VERNON, IL 62864
(618)242-7819
Jefferson
148974
ST MARY'S GOOD SAMITAN FAMILY HEALTH
CENTER
STAUNTON CLINIC, LLC
444 NORTH EDWARDSVILLE STREET
STAUNTON, IL 62088
(618)635-3800
Macoupin
783810
STEELEVILLE FAMILY PRACTICE
602 WEST SHAWNEETOWN TRAIL
STEELEVILLE, IL 62288
(618)826-2388
Randolph
143467
STEELVILLE CLINIC
#9 STEELVILLE CLINIC
STEELEVILLE, IL 62288
(618)965-3466
Randolph
143998
SULLIVAN CLINIC
7 HAWTHORNE LANE
SULLIVAN, IL 61951
(217)728-8441
Moultrie
143475
THOMAS H BOYD RURAL HEALTH CLINIC
800 SCHOOL STREET
CARROLLTON, IL 62016
(217)942-3600
Greene
148501
WABASH GENERAL CONVENIENT CARE
1418 COLLEGE DRIVE
MOUNT CARMEL, IL 62863
(618)263-6331
Wabash
148994
WABASH PRIMARY CARE ASSOCIATES
1123 CHESTNUT STREET
MOUNT CARMEL, IL 62863
(618)263-4376
Wabash
143472
WASHINGTON COUNTY HEALTH CENTER
70 SOUTH GRAND AVENUE
NASHVILLE, IL 62263
(618)327-2200
Washington
143454
WEST FRANKFORT FAMILY PRACTICE
2553 KEN GRAY BLVD
WEST FRANKFORT, IL 62896
(618)932-3937
Franklin
143900
WEST SALEM MEDICAL CENTER
100 SOUTH MAIN P O BOX 306
WEST SALEM, IL 62476
(618)456-3727
Edwards
143405
WOMEN & FAMILY MEDICAL CENTER
630 LOCUS STREET
CARTHAGE, IL 62321
(217)357-0617
Hancock
783826
WOMENS HEALTH CENTER OF MACOMB
505 E GRANT STREET SUITE 102
MACOMB, IL 61455
(309)833-5959
Mcdonough
Total Providers for this State = 215
Run Date: 10/08/2015
Job # 41303463
Last Update: 10/07/2015
Page 1 of 2
CASPER Report 0006D
Name and Address Listing
For Rural Health Clinic
Based on Current Survey
Indiana
CCN
Provider Name
Address
City, State and ZIP
Telephone # County Name
153907
ACUTE MEDICAL CARE PC
1145 INDIANAPOLIS ROAD
GREENCASTLE, IN 46135
(765)653-8453
Putnam
153869
BRAZIL FAMILY MEDICINE
1214 E NATIONAL AVE STE 100
BRAZIL, IN 47834
(812)442-2100
Clay
158502
BROOK HEALTH CENTRE
420 E MAIN ST PO BOX 118
BROOK, IN 47922
(219)275-2521
Newton
153896
CAMBRIDGE CITY FAMILY MEDICINE
1 E CHURCH ST
CAMBRIDGE CITY, IN 47327
(765)478-6108
Wayne
153906
CARLISLE MEDICAL CLINIC
8685 OLD HW 41 S
CARLISLE, IN 47838
(812)398-5202
Sullivan
153804
CLAY CITY CENTER FOR FAMILY MEDICINE
315 LANKFORD ST
CLAY CITY, IN 47841
(812)939-2126
Clay
153891
COMPREHENSIVE HEALTH CARE
420 W LONGEST ST PO BOX 270
PAOLI, IN 47454
(812)723-3944
Orange
153871
COUNTRY HEALTH CENTER
5066 N 900 E
MONTGOMERY, IN 47558
(812)254-4650
Daviess
153825
CRAWFORD COUNTY FAMILY HEALTHCARE
CENTER
CRAWFORD COUNTY FAMILY MEDICINE
5604 EAST WHITE OAK LANE
MARENGO, IN 47140
(812)365-3221
Crawford
6402 EAST INDUSTRIAL LANE
LEAVENWORTH, IN 47137
(877)291-6488
Crawford
153903
153859
DALE FAMILY MEDICINE
4 W VINE ST PO BOX 599
DALE, IN 47523
(812)937-7140
Spencer
158506
DAVIESS MARTIN MEDICAL CLINIC
12546 E US HWY 50
LOOGOOTEE, IN 47553
(812)295-5095
Martin
158500
DCH MEDICAL CLINIC
1402 GRAND AVE
WASHINGTON, IN 47501
(812)254-6696
Daviess
153843
DEACONESS CLINIC INC
106 W PIKE AVE
PETERSBURG, IN 47567
(812)354-1052
Pike
153829
DR ROBERT E JUDGE MD
1521 W MAIN ST
153888
FAMILY & OCCUPATIONAL MEDICINE OF LYNN & 105 E SECOND ST
RIDGEVI
FAMILY MEDICINE OF CLOVERDALE
51 E MARKET STREET
158513
153868
2229 MARY SHERMAN DR
BERNE, IN 46711
(260)589-2312
Adams
RIDGEVILLE, IN 47380
(765)857-2523
Randolph
CLOVERDALE, IN 46120
(765)795-4242
Putnam
SULLIVAN, IN 47882
(812)268-3318
Sullivan
153883
FAMILY PRACTICE ASSOCIATES OF SULLIVAN
COUNTY
FOUNDATIONS FAMILY MEDICINE PC
25 W MAIN STREET
AUSTIN, IN 47102
(812)794-8100
Scott
158507
FRENCH LICK FAMILY MEDICINE
679 STATE HIGHWAY 145
FRENCH LICK, IN 47432
(812)936-6400
Orange
153904
611 EAST MAIN STREET, STE 110
PETERSBURG, IN 47567
(812)354-8426
Pike
158503
GOOD SAMARITAN HOSPITAL PHYSICIAN
SERVICES INC
GRAND AVENUE PEDIATRICS
1402 GRAND AVE
WASHINGTON, IN 47501
(812)257-0383
Daviess
153886
GREENE COUNTY GENERAL HOSPITAL LLC
1210 NORTH 1000 WEST
LINTON, IN 47441
(812)847-7005
Greene
153837
GREENE COUNTY HEALTH - WORTHINGTON
102 E MAIN ST
WORTHINGTON, IN 47471
(812)875-2000
Greene
153878
HEARTLAND OB/GYN
1401 MEMORIAL AVE STE B
WASHINGTON, IN 47501
(812)254-2400
Daviess
153821
JOANNE GUTTMAN MD
11137 US HWY 52 STE B
BROOKVILLE, IN 47012
(765)647-3547
Franklin
153870
JOHN A EGLI MD PC
315 LEHMAN AVE
TOPEKA, IN 46571
(260)593-2902
Lagrange
153899
JOHNSON NICHOLS HEALTH CLINIC INC
645 WEST MORGAN STREET
SPENCER, IN 47460
(812)829-0303
Owen
153864
KENNETH D WATKINS MD
108 HOSPITAL DR
WINCHESTER, IN 47394
(765)584-1639
Randolph
153979
KENTLAND CLINIC
303 N 7TH
KENTLAND, IN 47951
(219)474-5464
Newton
153987
KNIGHTSTOWN FAMILY HEALTH CARE
224 W MAIN ST
KNIGHTSTOWN, IN 46148
(765)345-5572
Henry
153857
KNOX FAMILY MEDICAL CENTER
402 W CULVER RD
KNOX, IN 46534
(574)772-7918
Starke
153809
KNOX FAMILY PRACTICE
1520 S HEATON ST
KNOX, IN 46534
(574)772-2188
Starke
Run Date: 10/08/2015
Job # 41303463
Last Update: 10/07/2015
Page 2 of 2
CASPER Report 0006D
Name and Address Listing
For Rural Health Clinic
Based on Current Survey
Indiana
CCN
Provider Name
Address
City, State and ZIP
Telephone # County Name
158508
LOOGOOTEE FAMILY MEDICINE
105 COOPER STREET
LOOGOOTEE, IN 47553
(812)295-2812
Martin
153860
MARTIN COUNTY HEALTH CENTER
229 HIGH ST
SHOALS, IN 47581
(812)247-2733
Martin
153890
MONTGOMERY MEDICAL ASSOCIATES LLC
542 N 3RD ST
MONTGOMERY, IN 47558
(812)486-2842
Daviess
153828
MONTICELLO MEDICAL CENTER
826 N SIXTH ST
MONTICELLO, IN 47960
(574)585-3333
White
153832
NASHVILLE FAMILY MEDICINE
103 WILLOW ST STE B
NASHVILLE, IN 47448
(812)988-2223
Brown
153908
NEW CASTLE FAMILY AND INTERNAL MEDICINE 2200 FOREST RIDGE PKWY
NEW CASTLE, IN 47362
(765)599-3400
Henry
153863
NEW CASTLE PEDIATRICS
NEW CASTLE, IN 47362
(765)521-0901
Henry
1000 N 16TH ST STE G-10
153999
NORTH DAVIESS MEDICAL CLINIC
202 N WEST ST
ODON, IN 47562
(812)636-7300
Daviess
158511
OSGOOD PRIMARY CARE
112 N BUCKEYE STREET
OSGOOD, IN 47037
(812)689-3424
Ripley
153850
PATOKA FAMILY HEALTH CARE CENTER
307 S INDIANA AVE
ENGLISH, IN 47118
(812)338-2924
Crawford
153872
PETERSBURG FAMILY MEDICINE
1003 E ILLINOIS ST
PETERSBURG, IN 47567
(812)354-3458
Pike
158501
PETERSBURG MEDICAL CLINIC
611 MAIN ST
PETERSBURG, IN 47567
(812)354-6666
Pike
153816
PREMIER HEALTHCARE LLC
1043 N 1000 W
LINTON, IN 47441
(812)847-4481
Greene
158512
540 HOSPITAL DRIVE
WINAMAC, IN 46996
(574)946-2194
Pulaski
153900
PULASKI MEMORIAL HOSPITAL MEDICAL AND
SURGICAL GRO
RANDOLPH MEDICAL CENTER
400 S OAK STREET
WINCHESTER, IN 47394
(765)584-6600
Randolph
153823
REDI-CARE INC PC
2120 N DETROIT ST
LAGRANGE, IN 46761
(260)463-2468
Lagrange
153901
REID FAMILY HEALTH CENTER
1250 CHESTER BLVD SUITE 2
RICHMOND, IN 47374
(765)935-8581
Wayne
153882
ST LUKE'S MEDICAL MINISTRY PC
1441 N GARDNER
SCOTTSBURG, IN 47170
(812)752-4055
Scott
153897
ST VINCENT MEDICAL GROUP INC
301 HENRY ST BLDG B
NORTH VERNON, IN 47265
(812)352-4300
Jennings
153879
ST VINCENT MEDICAL GROUP INC
330 WEST DEERFIELD ROAD
UNION CITY, IN 47390
(317)964-6200
Randolph
153887
ST VINCENT MEDICAL GROUP INC
301 N HENRY ST
NORTH VERNON, IN 47265
(812)352-4300
Jennings
153881
ST VINCENT MEDICAL GROUP, INC
409 GREENVILLE AVE
WINCHESTER, IN 47394
(765)584-0480
Randolph
153993
ST VINCENT NORTH CLINIC
1731 RINGER LN
WILLIAMSPORT, IN 47993
(765)762-4170
Warren
153994
ST VINCENT SOUTH CLINIC
440 W SONGER LN
VEEDERSBURG, IN 47987
(765)762-4180
Fountain
153905
STROUD MEDICAL
1401 MEMORIAL AVENUE, SUITE C
WASHINGTON, IN 47501
(812)254-4399
Daviess
153862
727 US HWY 56 STE 300
VEVAY, IN 47043
(812)427-4038
Switzerland
153853
SWITZERLAND COUNTY NURSE MANAGED
CLINIC
THOMAS L MILLER MD
1500 W MAUMEE
ANGOLA, IN 46703
(260)665-8494
Steuben
153855
THOROUGHCARE PC
4808 N HILLSBORO RD
NEW CASTLE, IN 47362
(765)836-4874
Henry
153909
UNION COUNTY HEALTH DEPARTMENT
6 WEST SOUTH STREET SUITE 2
LIBERTY, IN 47353
(765)458-5393
Union
153902
VALLEY HEALTH
9529 WEST STATE ROAD 56
FRENCH LICK, IN 47432
(812)936-2425
Orange
153895
WAYNE CO HEALTH DEPT, NURSING DIVISION
203 E MAIN STREET
RICHMOND, IN 47374
(765)973-9294
Wayne
153990
WHEATFIELD HEALTH CENTRE
492 S BIERMA ST PO BOX 247
WHEATFIELD, IN 46392
(219)956-2110
Jasper
Total Providers for this State = 65
Run Date: 10/08/2015
Job # 41303463
Last Update: 10/07/2015
Page 1 of 6
CASPER Report 0006D
Name and Address Listing
For Rural Health Clinic
Based on Current Survey
Michigan
CCN
Provider Name
Address
City, State and ZIP
Telephone # County Name
233823
ALLEGAN MEDICAL CLINIC PC
551 LINN ST
ALLEGAN, MI 49010
(616)673-8402
Allegan
233900
ALPENA MEDICAL ARTS PC
211 LONG RAPIDS RD
ALPENA, MI 49707
(989)354-2142
Alpena
238661
ASPIRUS GRAND VIEW CLINIC
N10565 GRAND VIEW LN
IRONWOOD, MI 49938
(906)932-1500
Gogebic
238617
ASPIRUS HOUGHTON CLINIC
1000 CEDAR ST
HOUGHTON, MI 49931
(906)487-1710
Houghton
238552
ASPIRUS KEWEENAW LAKE LINDEN CLINIC
110 CALUMET ST
LAKE LINDEN, MI 49945
(906)337-5040
Houghton
238653
ASPIRUS KEWEENAW LAURIUM WELLNESS
300 HECLA ST
LAURIUM, MI 49913
(906)337-9355
Houghton
238598
601 SOUTH SEVENTH STREET
ONTONAGON, MI 49953
(906)884-4134
Ontonagon
238537
ASPIRUS ONTONAGON FAMILY PRACTICE
CLINIC
AUSTIN STREET HEALTH CLINIC
51 AUSTIN STREET
SANDUSKY, MI 48471
(810)648-5244
Sanilac
238650
BAY CARE MEDICAL CENTER
1500 SAND POINT RD
MUNISING, MI 49862
(906)387-4338
Alger
238646
BCMH PHYSICIAN GROUP
18341 US HIGHWAY 41
L' ANSE, MI 49946
(906)524-6118
Baraga
233813
BEAVER ISLAND RURAL HEALTH CENTER
37304 KINGS HIGHWAY
BEAVER ISLAND, MI 49782
(231)448-2275
Charlevoix
233944
BEAVERTON MEDICAL CENTER PC
129 W BROWN STREET
BEAVERTON, MI 48612
(989)435-2937
Gladwin
238901
BOARDMAN FAMILY PRACTICE
4713 PINE STREET
SOUTH BOARDMAN, MI 49680
(231)369-2656
Kalkaska
238595
BORGESS FAMILY MEDICINE
345 NAOMI STREET
PLAINWELL, MI 49080
(616)692-6661
Allegan
238544
BORGESS LEE MEDICAL GROUP
520 MAIN STREET SUITE A
DOWAGIAC, MI 49047
(269)783-3052
Cass
238580
BORGESS LEE MEDICAL GROUP
520 MAIN STREET SUITE C
DOWAGIAC, MI 49047
(269)783-2080
Cass
238578
BORGESS LEE MEDICAL GROUP
117 SOUTH BROADWAY STREET
CASSOPOLIS, MI 49031
(269)445-0771
Cass
238626
400 W DIVISION ST
DOWAGIAC, MI 49047
(269)782-2111
Cass
233870
BORGESS LEE MEDICAL GROUP DIVISION
STREET CLINIC
BORGESS WOMEN'S HEALTH
671 ALLEGAN
PLAINWELL, MI 49080
(616)685-1777
Allegan
238665
BOYNE AREA MEDICAL CENTER
223 N PARK ST
BOYNE CITY, MI 49712
(231)582-5314
Charlevoix
238546
BRONSON LAKEVIEW FAMILY CARE - DECATUR 319 W DELAWARE ST
DECATUR, MI 49045
(616)423-7028
Van Buren
238613
MATTAWAN, MI 49071
(269)657-0243
Van Buren
238601
BRONSON LAKEVIEW FAMILY CARE 52375 N MAIN STREET
MATTAWAN
BRONSON LAKEVIEW FAMILY CARE - PAW PAW 451 HEALTH PARKWAY
PAW PAW, MI 49079
(269)657-2550
Van Buren
238635
CADILLAC PRIMARY CARE & OB/GYN
7985 MACKINAW TRAIL
CADILLAC, MI 49601
(231)876-6100
Wexford
233962
639 EAST MAIN STREET PO BOX 670
CARSON CITY, MI 48811
(989)584-3107
Montcalm
238669
CARSON CITY CENTER FOR WOMEN'S
HEALTHCARE PC
CASS CITY FAMILY PRACTICE
4675 HILL STREET
CASS CITY, MI 48726
(989)872-8303
Tuscola
238649
CASS CITY MEDICAL PRACTICE
4675 HILL STREET
CASS CITY, MI 48726
(989)872-8202
Tuscola
238917
1320 W STATE ST, 3A
BELDING, MI 48809
(616)794-1810
Ionia
238679
CHARLES R BARKER JR DO FAMILY PRACTICE
PC
CLARKSVILLE FAMILY MEDICINE
155 EAST CROSS STREET
CLARKSVILLE, MI 48815
(616)693-2350
Ionia
238603
COLOMA MEDICAL CENTER
6701 PAW PAW AVENUE
COLOMA, MI 49038
(269)468-0015
Berrien
238672
COLON MEDICAL CLINIC
111 SAINT JOSEPH STREET
COLON, MI 49040
(269)432-3221
St. Joseph
238541
COMMUNITY CARE CLINIC
509 OSBORNE BLVD
SAULT SAINTE MARIE, MI 49783
(906)635-4401
Chippewa
Run Date: 10/08/2015
Job # 41303463
Last Update: 10/07/2015
Page 2 of 6
CASPER Report 0006D
Name and Address Listing
For Rural Health Clinic
Based on Current Survey
Michigan
CCN
Provider Name
Address
City, State and ZIP
Telephone # County Name
238615
COMMUNITY HEALTH CENTER PEDIATRIC &
ADOLESCENT CTR
COMMUNITY MEDICAL CENTER
358 EAST CHICAGO STREET, SUITE 202
COLDWATER, MI 49036
(517)279-5252
Branch
400 MEDICAL PARK DRIVE
WATERVLIET, MI 49098
(269)463-3600
Berrien
238605
238540
DCHS AFTER HOURS CLINIC
1721 S STEPHENSON AVE
IRON MOUNTAIN, MI 49801
(906)776-5660
Dickinson
238666
DECKERVILLE HEALTHCARE SERVICES INC
2433 BLACK RIVER ST
DECKERVILLE, MI 48427
(810)376-2835
Sanilac
238643
DICKINSON FAMILY AND GERIATRIC CLINIC
500 MAIN ST
NORWAY, MI 49870
(906)563-9255
Dickinson
238559
DICKINSON FAMILY PRACTICE CENTER
844 PYLE DR
KINGSFORD, MI 49801
(906)774-6383
Dickinson
238654
NORWAY, MI 49870
(906)776-5648
Dickinson
IRON MOUNTAIN, MI 49801
(906)776-5648
Dickinson
238634
DICKINSON FAMILY PRACTICE CENTERN1667 US HIGHWAY 8
NORWAY
DICKINSON INTERNAL MEDICINE/NEPHROLOGY 1711 SOUTH STEPHENSON AVE
CLINIC
DICKINSON PEDIATRIC CLINIC
1711 S STEPHENSON AVE SUITE 210
IRON MOUNTAIN, MI 49801
(906)776-5800
Dickinson
233869
EASTSIDE FAMILY MEDICAL
8540 105TH AVENUE
STANWOOD, MI 49346
(231)972-2710
Mecosta
238564
EDMORE CARE CLINIC
223 W MAIN ST
EDMORE, MI 48829
(517)427-3331
Montcalm
238906
FAIRVIEW CLINIC, PLC
1392 MAPLE DR
FAIRVIEW, MI 48621
(517)848-5644
Oscoda
238577
FAMILY HEALTHCARE OF BROWN CITY
4472 MAIN STREET
BROWN CITY, MI 48416
(810)346-2751
Sanilac
238671
FAMILY HEALTHCARE OF CASS CITY
6230 HOSPITAL DRIVE
CASS CITY, MI 48726
(989)872-2410
Tuscola
238521
FAMILY MEDICAL CARE - BRECKENRIDGE
302 W CHESTNUT
BRECKENRIDGE, MI 48615
(989)842-3118
Gratiot
238545
FAMILY MEDICINE CENTER
370 EAST CHICAGO STREET
COLDWATER, MI 49036
(517)279-5378
Branch
238656
233981
GIBSON FAMILY HEALTH CENTER
502 W HARRIE ST
NEWBERRY, MI 49868
(906)293-9233
Luce
238926
GLADWIN URGENT CARE CENTER
1277 E CEDAR AVE, SUITE A
GLADWIN, MI 48624
(989)426-1100
Gladwin
238572
GRANT MEDICAL CENTER
71 S FRONT ST
GRANT, MI 49327
(231)834-5995
Newaygo
238618
GRATIOT MEDICAL CENTER
121 N. PINE RIVER STREET
ITHACA, MI 48847
(989)875-5111
Gratiot
238561
GRAYLING COMMUNITY HEALTH CENTER
1250 E MICHIGAN AVE
GRAYLING, MI 49738
(989)348-1212
Crawford
238928
GREAT LAKES MEDICAL PC
555 S MISSION ST
MOUNT PLEASANT, MI 48858
(989)773-9700
Isabella
238925
GREAT LAKES URGENT CARE
5511 WEST US 10, SUITE A
LUDINGTON, MI 49431
(231)843-1553
Mason
238538
HALE ST JOSEPH FAMILY CLINIC
116 S CHURCH
HALE, MI 48739
(989)728-4334
Iosco
233903
HEALTH SPECIALISTS OF LENAWEE
6869 OCCIDENTAL HWY
TECUMSEH, MI 49286
(517)423-4777
Lenawee
233990
HESPERIA MEDICAL CENTER
78 N DIVISION
HESPERIA, MI 49421
(616)854-6415
Oceana
233845
HILLSDALE MEDICAL ASSOCIATES
1456 HUDSON RD
HILLSDALE, MI 49242
(517)439-0200
Hillsdale
233967
HONOR FAMILY PRACTICE
10524 MAIN STREET
HONOR, MI 49640
(231)325-2277
Benzie
238584
INTERNAL MEDICINE SERVICES
740 SOUTH MAIN STREET
CHEBOYGAN, MI 49721
(231)627-7118
Cheboygan
233882
IONIA FAMILY PRACTICE
330 LOVELL
IONIA, MI 48846
(616)527-5732
Ionia
238637
ITHACA FAMILY PRACTICE
820 N PINE RIVER ST
ITHACA, MI 48847
(989)875-3722
Gratiot
238927
JONESVILLE HEALTHCARE
216 OLDS STREET
JONESVILLE, MI 49250
(517)849-7100
Hillsdale
233975
KALKASKA MEMORIAL HEALTH CENTER
419 S CORAL
KALKASKA, MI 49646
(616)258-7500
Kalkaska
238551
KEWEENAW MEMORIAL LAURIUM CLINIC
205 OSCEOLA STREET
LAURIUM, MI 49913
(906)337-6560
Houghton
Run Date: 10/08/2015
Job # 41303463
Last Update: 10/07/2015
Page 3 of 6
CASPER Report 0006D
Name and Address Listing
For Rural Health Clinic
Based on Current Survey
Michigan
CCN
Provider Name
Address
City, State and ZIP
Telephone # County Name
238582
KINGSTON FAMILY HEALTHCARE
5988 STATE ST
KINGSTON, MI 48741
(989)683-2221
Tuscola
238670
KINGSTON FAMILY PRACTICE
5915 STATE STREET
KINGSTON, MI 48741
(989)872-2121
Tuscola
238624
LAKESHORE MEDICAL CENTER-SHELBY
71 BEVIER ST
SHELBY, MI 49455
(231)861-2187
Oceana
238647
LAKEVIEW FAMILY MEDICINE
418 WASHINGTON ST
LAKEVIEW, MI 48850
(989)352-6474
Montcalm
238639
LONG RAPIDS FAMILY CARE
393 LONG RAPIDS ROAD
ALPENA, MI 49707
(989)356-0504
Alpena
233979
MACKINAC STRAITS RURAL HEALTH CLINIC
1140 NORTH STATE STREET
SAINT IGNACE, MI 49781
(906)643-7999
Mackinac
238651
MACKINAW CITY MEDICAL CLINIC
450 S NICOLET ST
MACKINAW CITY, MI 49701
(231)436-9900
Cheboygan
233940
MACKINAW TRAIL PEDIATRICS
7917 MACKINAW TRAIL
CADILLAC, MI 49601
(231)779-9700
Wexford
238632
MAIN STREET INTERNAL MEDICINE AND
PEDIATRICS
MANCELONA FAMILY PRACTICE
204 W MAIN STREET
FREMONT, MI 49412
(231)924-1800
Newaygo
419 W STATE ST
MANCELONA, MI 49659
(231)587-9181
Antrim
233811
233968
MANISTEE FAMILY HEALTHCARE
110 WASHINGTON STREET
MANISTEE, MI 49660
(231)723-9190
Manistee
238610
MANISTIQUE LAKES FAMILY CLINIC
W 17530 CO RD 4-42
CURTIS, MI 49820
(906)586-3300
Mackinac
233837
MARQUETTE GENERAL HOSPITAL FAMILY
MEDICINE TRENARY
MARQUTTE GENERAL HOSPITAL KINGSFORD
CLINIC
MAYVILLE FAMILY HEALTHCARE
E 2995 STATE HWY M67
TRENARY, MI 49891
(906)446-3336
Alger
800 EAST BOULEVARD
KINGSFORD, MI 49801
(906)774-4000
Dickinson
2180 OHMER ROAD
MAYVILLE, MI 48744
(989)843-5135
Tuscola
124 AMES
ELK RAPIDS, MI 49629
(231)264-8282
Antrim
233885
238575
233846
233852
MCLAREN NORTHERN MICHIGAN ELK RAPIDS
FAMILY MEDICI
MEDICS PC
220 N ENSLEY
HOWARD CITY, MI 49329
(231)937-6226
Montcalm
233850
MEDICS PC
1131 E M-46
EDMORE, MI 48829
(989)427-5070
Montcalm
238918
MEMORIAL HEALTHCARE
9099 E LANSING ROAD
DURAND, MI 48429
(989)288-2651
Shiawassee
238921
MEMORIAL HEALTHCARE
1975 W M 21, ST 104
OWOSSO, MI 48867
(989)725-8171
Shiawassee
233861
MENOMINEE MEDICAL CLINIC
1100 TENTH ST
MENOMINEE, MI 49858
(906)863-7897
Menominee
238623
905 E COLBY ST
WHITEHALL, MI 49461
(231)728-5910
Muskegon
611 EAST MAIN STREET
HART, MI 49420
(231)873-5675
Oceana
300 S RATH AVENUE, STE 102
LUDINGTON, MI 49431
(231)843-2543
Mason
233872
MERCY HEALTH PHYSICIAN PARTNERS
LAKESHORE MEDICAL
MERCY HEALTH PHYSICIAN PARTNERS-HART
FAMILY MEDICA
MERCY HEALTH PHYSICIANS PARTNERS-SABLE
POINT FAMIL
MI-WI FAMILY PRACTICE ASSOCIATES PC
1711 S STEPHENSON AVE SUITE 300
IRON MOUNTAIN, MI 49801
(906)774-1633
Dickinson
238645
MIDMICHIGAN HEALTH PARK - MT PLEASANT
4851 E PICKARD ST
MOUNT PLEASANT, MI 48858
(989)775-1610
Isabella
238644
MIDMICHIGAN MEDICAL OFFICE FARWELL
2812 W CADILLAC DR
FARWELL, MI 48622
(989)802-5050
Clare
238642
MIDMICHIGAN MEDICAL OFFICE-CLARE
602 BEECH STREET
CLARE, MI 48617
(989)802-8730
Clare
238659
MIDMICHIGAN MEDICAL OFFICES SIXTH/MAPLE 212 W 6TH STREET
CLARE, MI 48617
(989)802-8445
Clare
238641
MIDMICHIGAN MEDICAL OFFICES-GLADWIN
609 QUARTER STREET
GLADWIN, MI 48624
(989)246-6490
Gladwin
238640
MIDMICHIGAN MEDICAL OFFICES-HARRISON
815 N CLARE AVE
HARRISON, MI 48625
(989)539-2114
Clare
238625
MIDMICHIGAN URGENT CARE - CLARE
700 WEST 5TH STREET
CLARE, MI 48617
(989)386-9911
Clare
238627
238678
Run Date: 10/08/2015
Job # 41303463
Last Update: 10/07/2015
Page 4 of 6
CASPER Report 0006D
Name and Address Listing
For Rural Health Clinic
Based on Current Survey
Michigan
CCN
Provider Name
Address
City, State and ZIP
Telephone # County Name
238522
MIDMICHIGAN URGENT CARE ALMA
321 WARWICK DRIVE
ALMA, MI 48801
(989)466-3348
Gratiot
238558
NORDIC MEDICAL CENTER
4243 WEST M-69, BOX 139
FELCH, MI 49831
(906)246-3800
Dickinson
233935
NORTH REACH HEALTHCARE - DAGGETT
MEDICAL CLINIC
NORTHERN PINES HEALTH CENTER
106 S SCHOOL RD, BOX 37
DAGGETT, MI 49821
(906)753-2155
Menominee
233937
11293 NORTH M37, SUITE A
BUCKLEY, MI 49620
(231)269-4185
Wexford
1328 US HIGHWAY 2
CRYSTAL FALLS, MI 49920
(906)875-4486
Iron
233974
NORTHSTAR HEALTH SYSTEMS CRYSTAL
FALLS
OAKLAWN MEDICAL GROUP HOMER
420 SOUTH HILLSDALE
HOMER, MI 49245
(616)789-8814
Calhoun
238620
OMH MEDICAL GROUP LEWISTON RHC
3040 BOURN STREET
LEWISTON, MI 49756
(989)786-4877
Montmorency
238662
OMH MEDICAL GROUP-BOYNE VALLEY RHC
2572 N US HIGHWAY 131
ELMIRA, MI 49730
(989)731-7700
Otsego
238660
OMH MEDICAL GROUP-INDIAN RIVER RHC
3696 S STRAITS HIGHWAY
INDIAN RIVER, MI 49749
(231)238-0581
Cheboygan
238680
238590
OSF MEDICAL GROUP - ESCANABA
3409 LUDINGTON ST
ESCANABA, MI 49829
(906)789-4040
Delta
238589
OSF MEDICAL GROUP - GLADSTONE
128 MICHIGAN AVE
GLADSTONE, MI 49837
(906)428-3273
Delta
238616
N 15995 MAIN STREET
POWERS, MI 49874
(906)497-4360
Menominee
1996 WALDEN DRIVE
GAYLORD, MI 49735
(989)731-4111
Otsego
825 NORTH CENTER AVENUE
GAYLORD, MI 49735
(989)731-7708
Otsego
238612
OSF ST FRANCIS HOSPITAL MEDICAL GROUPPOWERS CLINI
OTSEGO MEMORIAL HOSPITAL MEDCARE
RURAL HEALTH CLIN
OTSEGO MEMORIAL HOSPITAL RURAL HEALTH
CLINIC
PARADISE COMMUNITY HEALTH CLINIC
1414 HWY M-123 NORTH
PARADISE, MI 49768
(906)492-3881
Chippewa
233997
PEDIATRIC & ADOLESCENT SPECIALISTS
245 S SECOND ST
CARSON CITY, MI 48811
(989)584-3981
Montcalm
233932
PEDIATRIC CENTER OF ADRIAN
770 RIVERSIDE AVE, SUITE 17
ADRIAN, MI 49221
(517)265-8134
Lenawee
233939
PERRY FAMILY PRACTICE
3337 W BRITTON RD
PERRY, MI 48872
(517)625-3004
Shiawassee
238606
238607
233873
PRESCOTT CLINIC PC
125 WASHINGTON STREET
PRESCOTT, MI 48756
(989)873-3352
Ogemaw
233928
PRIMARY CARE
5170 RIFLE RIVER TRAIL
ALGER, MI 48610
(989)873-5323
Ogemaw
233821
PRIMARY CARE
2990 CAMPBELL ROAD
ROSE CITY, MI 48654
(989)685-6969
Ogemaw
238916
100 E CHICAGO STREET
JONESVILLE, MI 49250
(517)849-9090
Hillsdale
238902
PRIMARY CARE ASSOCIATES OF JONESVILLE
LLC
PRIMARY CARE INC
558 LOCKWOOD LANE
MIO, MI 48647
(989)826-3271
Oscoda
233820
PRIMARY CARE, INC
1360 NORTH ST HELEN ROAD
SAINT HELEN, MI 48656
(989)389-4944
Roscommon
233842
PRIMARY CARE, INC
2331 PROGRESS, SUITE D, PO BOX 340
WEST BRANCH, MI 48661
(989)345-1184
Ogemaw
233954
PRIMARY HEALTH SERVICES, PC
505 W LUDINGTON AVENUE
LUDINGTON, MI 49431
(231)843-8452
Mason
238562
PRUDENVILLE COMMUNITY HEALTH CENTER
2585 W HOUGHTON LAKE DR
PRUDENVILLE, MI 48651
(517)422-2400
Roscommon
233956
RANDALL STREET MEDICAL, PC
675 WEST RANDALL STREET
COOPERSVILLE, MI 49404
(616)837-9777
Ottawa
233965
READING HEALTH CLINIC
143 SOUTH MAIN STREET
READING, MI 49274
(517)283-1772
Hillsdale
238633
RIVERSIDE FAMILY PRACTICE
1500 S MAIN ST
EATON RAPIDS, MI 48827
(517)857-4500
Eaton
233864
RIVERSIDE MEDICAL ASSOCIATES PC
560 OSBORN BLVD
SAULT SAINTE MARIE, MI 49783
(906)632-1800
Chippewa
238573
ROSCOMMON COMMUNITY HEALTH CENTER
234 LAKE ST
ROSCOMMON, MI 48653
(989)348-0448
Roscommon
Run Date: 10/08/2015
Job # 41303463
Last Update: 10/07/2015
Page 5 of 6
CASPER Report 0006D
Name and Address Listing
For Rural Health Clinic
Based on Current Survey
Michigan
CCN
Provider Name
Address
City, State and ZIP
Telephone # County Name
233998
SAINT MARY'S STANDISH COMMUNITY HOSP
RHC
SCHEURER FAMILY MEDICAL CENTER
441 WEST CEDAR
STANDISH, MI 48658
(989)846-4521
Arenac
168 N CASEVILLE RD
PIGEON, MI 48755
(989)453-2141
Huron
7870 W US HIGHWAY 2
MANISTIQUE, MI 49854
(906)341-2153
Schoolcraft
238565
SCHOOLCRAFT MEMORIAL HOSPITAL RURAL
HEALTH CLINIC
SHERIDAN CARE CLINIC
303 CONGRESS STREET, SUITE B
SHERIDAN, MI 48884
(517)291-5077
Montcalm
238636
SHGM OB/GYN
212 S SULLIVAN AVE
FREMONT, MI 49412
(231)924-1212
Newaygo
238631
SMG PORTLAND
9751 EAST GRAND RIVER AVENUE, SUITE 1
PORTLAND, MI 48875
(517)641-7672
Ionia
238591
SMG PRACTICE
1717 EAST CHICAGO ROAD, SUITE 2
STURGIS, MI 49091
(269)651-1471
St. Joseph
238533
BANGOR, MI 49013
(269)427-5811
Van Buren
233987
SOUTH HAVEN COMMUNITY HOSPITAL COOPER 520 RAILROAD ST
MEDICAL CLIN
SOUTH HAVEN COMMUNITY HOSPITAL RHC
965 S BAILEY AVE
SOUTH HAVEN, MI 49090
(269)639-2810
Van Buren
238664
SOUTHWESTERN MEDICAL CLINIC
2002 SOUTH ELEVENTH STREET
NILES, MI 49120
(269)687-0200
Berrien
238550
SPARROW IONIA HOSPITAL
550 EAST WASHINGTON STREET SUITE 101
IONIA, MI 48846
(616)527-4290
Ionia
233996
SPARROW MEDICAL GROUP - GREENVILLE
1014 E WASHINGTON ST
GREENVILLE, MI 48838
(616)754-7145
Montcalm
238673
SPARROW MEDICAL GROUP LYONS
505 E BRIDGE STREET
LYONS, MI 48851
(989)855-3345
Ionia
238518
SPARROW MEDICAL GROUP- ASHLEY
320 S STERLING ST
ASHLEY, MI 48806
(989)847-2621
Gratiot
233994
SPARROW MEDICAL GROUP- CARSON
102 S THIRD, SUITE 100
CARSON CITY, MI 48811
(989)584-1308
Montcalm
238517
SPARROW MEDICAL GROUP- ITHACA
114 N MAIN ST
ITHACA, MI 48847
(989)875-4166
Gratiot
238594
SPECTRUM HEALTH - EVART CLINIC
5991 S 95TH AVENUE
EVART, MI 49631
(616)734-5561
Osceola
238668
SPECTRUM HEALTH BELDING FAMILY MEDICINE 1227 W STATE ST
BELDING, MI 48809
(616)794-0940
Ionia
238667
SPECTRUM HEALTH BIG RAPIDS HOSPITAL
FAMILY MEDICIN
SPECTRUM HEALTH BIG RAPIDS HOSPITAL
FAMILY MEDICIN
SPECTRUM HEALTH REED CITY FAMILY
PRACTICE
SPECTRUM HEALTH TUSTIN FAMILY PRACTICE
8354 100TH AVE, STE 1
STANWOOD, MI 49346
(231)972-6000
Mecosta
650 LINDEN STREET, SUITE 1
BIG RAPIDS, MI 49307
(231)796-3200
Mecosta
300 N PATTERSON ROAD
REED CITY, MI 49677
(616)832-3271
Osceola
111 EAST CHURCH STREET
TUSTIN, MI 49688
(231)829-3423
Osceola
SPECTRUM HEALTH UNITED HOSPITAL FAMILY
MEDICINE
SPRINGPORT MEDICAL CLINIC
1202 WEST OAK STREET
GREENVILLE, MI 48838
(616)754-2944
Montcalm
400 EAST MAIN STREET SUITE 200
SPRINGPORT, MI 49284
(517)857-4500
Jackson
5935 N HURON ROAD - OSCODA HEALTH PARK
OSCODA, MI 48750
(989)739-1441
Iosco
3210 E HURON RD
AU GRES, MI 48703
(989)876-7104
Arenac
295 MAPLE ST
TAWAS CITY, MI 48763
(989)362-6108
Iosco
238534
ST JOESPH HEALTH SYSTEMS OSCODA
HEALHT PARK & AFTE
ST JOSEPH HEALTH SYSTEM AUGRES FAMILY
CLINIC
ST JOSEPH HEALTH SYSTEM INTERNAL
MEDICINE CLINIC
ST JOSEPH HEALTH SYSTEM WOMENS CLINIC
25 E M-55
TAWAS CITY, MI 48763
(989)362-2540
Iosco
233991
ST JOSEPH HURON FAMILY MEDICINE CLINIC
700 EAST GERMAN STREET
TAWAS CITY, MI 48763
(989)362-4470
Iosco
238911
ST JOSEPH PEDIATRICS
325 M-55
TAWAS CITY, MI 48763
(989)984-3770
Iosco
238608
ST LOUIS FAMILY CLINIC
224 N MILL ST
SAINT LOUIS, MI 48880
(989)681-3524
Gratiot
233977
238588
238652
238504
238621
238648
238614
233985
238570
233986
Run Date: 10/08/2015
Job # 41303463
Last Update: 10/07/2015
Page 6 of 6
CASPER Report 0006D
Name and Address Listing
For Rural Health Clinic
Based on Current Survey
Michigan
CCN
Provider Name
Address
City, State and ZIP
Telephone # County Name
238604
STAGG MEDICAL CENTER
525 SOUTH CENTER STREET
HARTFORD, MI 49057
(269)621-4063
Van Buren
238566
STANTON 1ST CARE
620 W MAIN STREET
STANTON, MI 48888
(517)831-7200
Montcalm
238574
STANTON FAMILY CARE CENTER
545 N STATE ST
STANTON, MI 48888
(517)831-8301
Montcalm
238597
STURGIS PEDIATRIC AND WOMENS CENTER
1555 E CHICAGO RD
STURGIS, MI 49091
(269)651-7114
St. Joseph
233906
SUPERIOR FAMILY MEDICAL ASSOC
550 OSBORN BLVD
SAULT SAINTE MARIE, MI 49783
(906)632-0370
Chippewa
233835
TAWAS BAY FAMILY PRACTICE
541 LAKE ST
TAWAS CITY, MI 48764
(989)362-3447
Iosco
238599
721 SIXTH AVE, SUITE A
THREE RIVERS, MI 49093
(269)273-9749
St. Joseph
601 E CHICAGO RD
WHITE PIGEON, MI 49099
(269)483-7624
St. Joseph
711 S HEALTH PARKWAY, SUITE 1
THREE RIVERS, MI 49093
(269)273-8557
St. Joseph
238602
THREE RIVERS HEALTH FAMILY CARE THREE
RIVER
THREE RIVERS HEALTH FAMILY CARE WHITE
PIGEON
THREE RIVERS HEALTH FAMILY, INTERNAL
MEDICINE AND
THUMB PEDIATRICS
6190 HOSPITAL DRIVE
CASS CITY, MI 48726
(989)872-8503
Tuscola
238586
UBLY FAMILY PRACTICE/WALK-IN CLINIC
2269 MAIN STREET
UBLY, MI 48475
(989)658-2159
Huron
238593
UNION CITY MEDICAL CENTER
624 WEST M 60
UNION CITY, MI 49094
(517)741-7989
Branch
233919
WELLSTON MEDICAL CENTER
17081 CABERFAE HWY
WELLSTON, MI 49689
(616)848-4777
Manistee
238611
WEST MACKINAC HEALTH CLINIC
W 14034 MELVILLE ROAD
ENGADINE, MI 49827
(906)477-6066
Mackinac
238663
1400 E PARKDALE AVE
MANISTEE, MI 49660
(231)398-1840
Manistee
233808
WEST SHORE MEDICAL CENTER PHYSICIAN
SERVICES
WHITE PINE FAMILY MEDICINE
261 NORTH MAIN STREET
CEDAR SPRINGS, MI 49319
(616)696-2020
Kent
238658
WMH COMMUNITY CARE-KINROSS
16523 S WATERTOWER DRIVE
KINCHELOE, MI 49788
(906)495-1344
Chippewa
238583
WOMEN'S AND CHILDREN'S HEALTH
722 SOUTH MAIN STREET
CHEBOYGAN, MI 49721
(231)627-1493
Cheboygan
238506
238655
Total Providers for this State = 179
Run Date: 10/08/2015
Job # 41303463
Last Update: 10/07/2015
Page 1 of 3
CASPER Report 0006D
Name and Address Listing
For Rural Health Clinic
Based on Current Survey
Minnesota
CCN
Provider Name
Address
City, State and ZIP
Telephone # County Name
243995
320 THIRD AVENUE NORTH
ALBANY, MN 56307
(320)845-2121
Stearns
108 STRATFORD STREET
AVON, MN 56310
(320)356-7602
Stearns
243467
ALBANY AREA HOSPITAL & MED CNTR-ALBANY
CLINIC
ALBANY AREA HOSPITAL & MEDICAL CNTR AVON CLINIC
APPLETON MUNICIPAL HOSPITAL & NH
30 SOUTH BEHL STREET
APPLETON, MN 56208
(320)289-1580
Swift
243456
BROOTEN MEDICAL CENTER
111 PLEASANT AVENUE PO BOX 69
BROOTEN, MN 56316
(320)346-2272
Stearns
243465
CENTRACARE CLINIC- SAUK CENTRE
433 ELM STREET NORTH
SAUK CENTRE, MN 56378
(320)952-6591
Stearns
243454
CENTRACARE HEALTH SYSTEM - MELROSE
525 WEST MAIN STREET
MELROSE, MN 56352
(320)256-4228
Stearns
243451
CENTRACARE HEALTH SYSTEM LONG PRAIRIE
24 9TH STREET SE
LONG PRAIRIE, MN 56347
(320)732-2131
Todd
243466
CRMC-LONGVILLE
180 JORDAN LANE
LONGVILLE, MN 56655
(218)363-3300
Cass
243996
DASSEL MEDICAL CENTER
460 FIFTH STREET NORTH BOX 367
DASSEL, MN 55325
(320)275-3358
Meeker
243993
243979
DAWSON CLINIC
1272 WALNUT STREET
DAWSON, MN 56232
(320)769-4393
Lac Qui Parle
243416
ESSENTIA HEALTH - ADA CLINIC
201 9TH STREET WEST
ADA, MN 56510
(218)784-2727
Norman
243461
ESSENTIA HEALTH BAGLEY CLINIC
121 CENTRAL STREET WEST
BAGLEY, MN 56621
(218)694-6281
Clearwater
243405
ESSENTIA HEALTH CHOKIO CLINIC
101 MAIN STREET
CHOKIO, MN 56221
(320)748-7223
Stevens
243997
ESSENTIA HEALTH GRACEVILLE CLINIC
115 WEST SECOND STREET
GRACEVILLE, MN 56240
(320)324-7500
Big Stone
243464
ESSENTIA HEALTH OKLEE CLINIC
GOVERNOR STREET & THIRD AVENUE
OKLEE, MN 56742
(218)796-4525
Red Lake
243471
ESSENTIA HEALTH PARK RAPIDS CLINIC
705 PLEASANT AVENUE
PARK RAPIDS, MN 56470
(218)732-2800
Hubbard
243472
ESSENTIA PELICAN RAPIDS CLINIC
301 NORTH BROADWAY
PELICAN RAPIDS, MN 56572
(218)863-2000
Otter Tail
243468
ESSENTIA ST MARYS MAHNOMEN CLINIC
117 NORTH MAIN STREET
MAHNOMEN, MN 56557
(218)936-5616
Mahnomen
243449
FAMILY MEDICAL CENTER
200 SOUTH FIRST AVENUE
PIERZ, MN 56364
(320)468-2536
Morrison
243463
FIRSTLIGHT HINCKLEY
620 SANDY LANE ROAD
HINCKLEY, MN 55037
(320)629-7505
Pine
243462
FIRSTLIGHT PINE CITY
1425 MAIN STREET NORTH
PINE CITY, MN 55063
(320)629-7505
Pine
243859
GATEWAY FAMILY CLINIC
204 LUNDORFF DRIVE
SANDSTONE, MN 55072
(320)245-2250
Pine
243861
GATEWAY FAMILY HEALTH CLINIC
206 MAIN STREET EAST, PO BOX 309
HINCKLEY, MN 55037
(320)384-6618
Pine
243860
GATEWAY FAMILY HEALTH CLINIC LTD
4570 COUNTY ROAD 61
MOOSE LAKE, MN 55767
(218)485-4491
Carlton
243437
GLENWOOD MEDICAL CENTER
417 SOUTH FRANKLIN
GLENWOOD, MN 56334
(320)634-5157
Pope
243856
HEALTH CARE TODAY/AVERA HEALTH
1444 WEST HIGHWAY #30
SLAYTON, MN 56172
(507)836-8538
Murray
243455
HENDRICKS CLINIC
501 EAST LINCOLN STREET
HENDRICKS, MN 56136
(507)275-3134
Lincoln
243457
IVANHOE MEDICAL CENTER
366 EAST GEORGE STREET
IVANHOE, MN 56142
(507)694-1100
Lincoln
243426
JOHNSON MEMORIAL BOYD CLINIC
115 3RD STREET
BOYD, MN 56218
(320)769-4323
Lac Qui Parle
243977
KITTSON MEMORIAL CLINIC
1010 SOUTH BIRCH, BOX 700
HALLOCK, MN 56728
(218)843-3612
Kittson
243427
KITTSON MEMORIAL CLINIC OF KARLSTAD
205 ROOSEVELT AVENUE WEST, PO BOX 199
KARLSTAD, MN 56732
(218)843-3612
Kittson
243990
LAC QUI PARLE CLINIC MADISON
900 SECOND AVE
MADISON, MN 56256
(320)598-7551
Lac Qui Parle
243470
LAKE BENTON MEDICAL CLINIC
109 EAST BENTON STREET
LAKE BENTON, MN 56149
(507)368-4323
Lincoln
243423
LAKEWOOD CLINIC BROWERVILLE
30535 241ST AVENUE
BROWERVILLE, MN 56438
(320)594-2231
Todd
Run Date: 10/08/2015
Job # 41303463
Last Update: 10/07/2015
Page 2 of 3
CASPER Report 0006D
Name and Address Listing
For Rural Health Clinic
Based on Current Survey
Minnesota
CCN
Provider Name
Address
City, State and ZIP
Telephone # County Name
243421
LAKEWOOD CLINIC EAGLE BEND
815 HIGHWAY 71
EAGLE BEND, MN 56446
(218)738-2804
Todd
243431
LAKEWOOD CLINIC MOTLEY
1233 HIGHWAY 10
MOTLEY, MN 56466
(218)352-6911
Morrison
243436
LAKEWOOD CLINIC PILLAGER
653 PILLSBURY STREET NORTH
PILLAGER, MN 56473
(218)746-4550
Cass
243422
LAKEWOOD CLINIC STAPLES
49725 COUNTY 83
STAPLES, MN 56479
(218)894-1033
Todd
243450
LAKEWOOD HEALTH CENTER CLINIC
600 MAIN AVENUE SOUTH
BAUDETTE, MN 56623
(218)634-2120
Lake Of The Woods
243987
LITTLEFORK MEDICAL CENTER
P O BOX N
LITTLEFORK, MN 56653
(218)278-6634
Koochiching
243445
LONG PRAIRIE MEM HOSPITAL - EAGLE VALLEY 815 HIGHWAY 71 SOUTH
CLIN
MANKATO CLINIC AT MAPLETON FAMILY
305 MAIN STREET EAST
PRACTICE
MILLE LACS FAMILY CLINIC
26362 370TH AVENUE
EAGLE BEND, MN 56446
(218)738-2804
Todd
MAPLETON, MN 56065
(507)524-3835
Blue Earth
HILLMAN, MN 56338
(320)277-3682
Morrison
243873
243434
243975
MILLE LACS FAMILY CLINIC ISLE
375 WEST ISIE STREET
ISLE, MN 56342
(320)676-3661
Mille Lacs
243976
MILLE LACS FAMILY CLNC ONAMIA
200 NORTH ELM STREET, PO BOX A
ONAMIA, MN 56359
(320)532-3154
Mille Lacs
243417
MURRAY COUNTY CLINIC
2040 JUNIPER AVENUE
SLAYTON, MN 56172
(507)836-6153
Murray
243446
MURRAY COUNTY CLINIC FULDA
119 NORTH ST PAUL AVENUE
FULDA, MN 56131
(507)425-2300
Murray
243409
NORTH VALLEY HLTH CTR CLINIC
300 WEST GOOD SAMARITAN DRIVE
WARREN, MN 56762
(218)745-4211
Marshall
243469
RAINY LAKE MEDICAL CENTER RHC
1400 HIGHWAY 71
INTERNATIONAL FALLS, MN 56649
(218)283-4481
Koochiching
243447
RANDALL LAKES AREA CLINIC
250 WHITE OAK DRIVE
RANDALL, MN 56475
(320)749-2877
Morrison
243443
131 BIRCH AVENUE WEST
HECTOR, MN 55342
(320)848-6294
Renville
420 NORTH MAIN STREET
RENVILLE, MN 56284
(320)329-8395
Renville
600 EAST PARK AVENUE
OLIVIA, MN 56277
(320)523-1460
Renville
243428
RENVILLE COUNTY HOSPITAL & CLINIC HECTOR CLINIC
RENVILLE COUNTY HOSPITAL & CLINICS
RENVILLE CLINIC
RENVILLE COUNTY HOSPITAL AND CLINICS OLIVIA CLIN
RIDGEVIEW ARLINGTON CLINIC
607 WEST CHANDLER
ARLINGTON, MN 55307
(507)964-2285
Sibley
243429
RIDGEVIEW GAYLORD CLINIC
315 4TH STREET
GAYLORD, MN 55334
(507)237-5523
Sibley
243438
RIDGEVIEW HENDERSON CLINIC
505 MAIN STREET
HENDERSON, MN 56044
(507)248-3433
Sibley
243444
243442
243430
RIDGEVIEW WINTHROP CLINIC
223 NORTH CARVER
WINTHROP, MN 55396
(507)647-5318
Sibley
243458
RIVERVIEW CLINIC
323 SOUTH MINNESOTA STREET
CROOKSTON, MN 56716
(218)281-9200
Polk
243460
RIVERVIEW CLINIC
105 INTERNATIONAL DRIVE SUITE 25
RED LAKE FALLS, MN 56750
(218)253-4606
Red Lake
243459
RIVERVIEW CLINIC
306 NORTH MILL STREET
FERTILE, MN 56540
(218)945-6695
Polk
243406
RIVERWOOD CLINIC AITKIN
200 BUNKER HILL DRIVE
AITKIN, MN 56431
(218)927-2157
Aitkin
243441
RIVERWOOD HLTH CC GARRISON
27278 STATE HIGHWAY 18
GARRISON, MN 56450
(320)525-3400
Crow Wing
243407
RIVERWOOD MCGREGOR CLINIC
2 EAST CENTER AVE PO BOX 340
MCGREGOR, MN 55760
(218)768-4011
Aitkin
243419
SANFORD BAGLEY CLEARBROOK CLINIC
22 ELM STREET
CLEARBROOK, MN 56634
(218)776-3124
Clearwater
243418
SANFORD BAGLEY CLINIC
1656 CENTRAL STREET WEST
BAGLEY, MN 56621
(218)694-2384
Clearwater
243420
SANFORD CLINIC BALATON
HIGHWAY 14E
BALATON, MN 56115
(507)629-3200
Lyon
243411
SANFORD CLINIC CANBY
112 ST OLAF AVENUE
CANBY, MN 56220
(507)223-7221
Yellow Medicine
Run Date: 10/08/2015
Job # 41303463
Last Update: 10/07/2015
Page 3 of 3
CASPER Report 0006D
Name and Address Listing
For Rural Health Clinic
Based on Current Survey
Minnesota
CCN
Provider Name
Address
City, State and ZIP
Telephone # County Name
243403
SANFORD CLINIC LAKEFIELD
209 MAIN STREET PO BOX 546
LAKEFIELD, MN 56150
(507)662-6611
Jackson
243831
SANFORD CLINIC MOUNTAIN LAKE
308 EIGHTH STREET
MOUNTAIN LAKE, MN 56159
(507)427-3332
Cottonwood
243414
SANFORD CLINIC TRACY
251 FIFTH STREET EAST
TRACY, MN 56175
(507)629-3520
Lyon
243415
SANFORD CLINIC WESTBROOK
920 BELL AVENUE
WESTBROOK, MN 56183
(507)274-6121
Cottonwood
243857
SANFORD CLINIC WINDOM
591 2ND AVENUE NORTH
WINDOM, MN 56101
(507)831-2223
Cottonwood
243812
SANFORD HEALTH HALSTAD CLINIC
445 1ST STREET EAST
HALSTAD, MN 56548
(218)456-2158
Norman
243850
SANFORD HEALTH MAHNOMEN CLINIC
414 WEST JEFFERSON, PO BOX 396
MAHNOMEN, MN 56557
(218)935-2514
Mahnomen
243862
SANFORD HEALTH PELICAN RAPIDS CLINIC
211 EAST MILL STREET
PELICAN RAPIDS, MN 56572
(701)234-6207
Otter Tail
243846
SANFORD HEALTH TWIN VALLEY CLINIC
501 2ND STREET NORTHWEST
TWIN VALLEY, MN 56584
(218)584-5142
Norman
243847
SANFORD HEALTH ULEN CLINIC
108 VIKING AVENUE WEST
ULEN, MN 56585
(218)494-3404
Clay
243848
SANFORD HEALTH WALKER CLINIC
614 MICHIGAN AVENUE
WALKER, MN 56484
(218)547-3938
Cass
243985
SANFORD JACKSON CLINIC
1430 NORTH HIGHWAY
JACKSON, MN 56143
(507)847-2200
Jackson
243433
SANFORD TRACY WALNUT GROVE CLINIC
830 EIGHTH STREET
WALNUT GROVE, MN 56180
(507)859-2157
Redwood
243435
SANFORD WHEATON
401 12TH STREET NORTH
WHEATON, MN 56296
(320)563-8226
Traverse
243439
SLEEPY EYE MEDICAL CENTER
400 4TH AVENUE NORTHWEST
SLEEPY EYE, MN 56085
(507)794-3571
Brown
243988
TRI COUNTY HEALTH CARE HENNING CLINIC
401 DOUGLAS AVENUE
HENNING, MN 56551
(218)583-2953
Otter Tail
243452
TRI COUNTY HEALTH CARE OTTERTAIL CLINIC
232 HIGHWAY 78 NORTH PO BOX 129
OTTERTAIL, MN 56571
(218)367-6262
Otter Tail
243453
TRI COUNTY HEALTH CARE WADENA CLINIC
4 NORTHWEST DEERWOOD AVENUE
WADENA, MN 56482
(218)631-1100
Wadena
243978
TRI COUNTY HEALTH CARE, BERTHA CLINIC
PO BOX 67, FIRST STREET NORTH
BERTHA, MN 56437
(218)924-2250
Todd
243986
TRI COUNTY HEALTHCARE SEBEKA CLINIC
106 MINNESOTA AVENUE EAST
SEBEKA, MN 56477
(218)837-5333
Wadena
243413
TYLER MEDICAL CLINIC
240 WILLOW STREET
TYLER, MN 56178
(507)247-5921
Lincoln
Total Providers for this State = 88
Run Date: 10/08/2015
Job # 41303463
Last Update: 10/07/2015
Page 1 of 2
CASPER Report 0006D
Name and Address Listing
For Rural Health Clinic
Based on Current Survey
Ohio
CCN
Provider Name
Address
City, State and ZIP
Telephone # County Name
363851
AMJAD RASS, INC
61353 SOUTHGATE PARKWAY
CAMBRIDGE, OH 43725
(740)435-8585
Guernsey
363836
CHANDRA SHAKER, MD
120 STURGES AVENUE, SUITE 1
MANSFIELD, OH 44903
(419)522-5454
Richland
363803
CLERMONT PEDIATRIC CENTER
3003 HOSPITAL DRIVE
BATAVIA, OH 45103
(513)732-2277
Clermont
363849
CROOKSVILLE FAMILY PRACTICE
712 CHINA STREET
CROOKSVILLE, OH 43731
(740)982-6872
Perry
363982
1450 COLUMBUS AVENUE, SUITE 103
WASHINGTON CH, OH 43160
(740)333-2236
Fayette
363983
FAYETTE CTY MEMORIAL HOSP MEDICAL &
SURGICAL ASSOC
FCMH MEDICAL AND SURGICAL ASSOCIATES
1510 COLUMBUS AVENUE, SUITE 230
WASHINGTON CH, OH 43160
(740)333-3333
Fayette
363995
GCH PHYSICIAN PRACTICE - EAST HILL STREET 130 HILL STREET
BUCYRUS, OH 44820
(419)562-3264
Crawford
363992
GCH PHYSICIAN PRACTICE- CRESTLINE
330 NORTH STELZER STREET
CRESTLINE, OH 44827
(419)689-3200
Crawford
363991
1323 EAST MANSFIELD STREET
BUCYRUS, OH 44820
(419)563-0300
Crawford
955 BUCYRUS ROAD
GALION, OH 44833
(419)468-0503
Crawford
120 WEST MAIN STREET
NEW WASHINGTON, OH 44854
(419)492-2200
Crawford
629 NORTH SANDUSKY AVENUE
BUCYRUS, OH 44820
(419)563-9865
Crawford
269 PORTLAND WAY SOUTH
GALION, OH 44833
(419)468-0503
Crawford
270 PORTLAND WAY SOUTH
GALION, OH 44833
(419)468-0503
Crawford
385 NORTH SELTZER
CRESTLINE, OH 44827
(419)468-0503
Crawford
363850
GCH PHYSICIAN PRACTICE- MAPLE CREEK
MEDICAL CENTER
GCH PHYSICIAN PRACTICES BUCYRUS ROAD
CAMPUS
GCH PHYSICIAN PRACTICES NEW
WASHINGTON CAMPUS
GCH PHYSICIAN PRACTICES, BCH PRIMARY
CARE
GCH PHYSICIAN PRACTICES, HOSPITAL
CAMPUS
GCH PHYSICIAN PRACTICES, PORTLAND WAY
CAMPUS
GCH PHYSICIAN PRACTICES, SELTZER STATION
CAMPUS
GENESIS MEDICAL GROUP
401 LINCOLN PARK DRIVE
NEW LEXINGTON, OH 43764
(740)342-5107
Perry
363844
GREENFIELD MEDICAL SERVICES
1092 WEST JEFFERSON STREET
GREENFIELD, OH 45123
(937)981-1121
Highland
363843
HIGHLAND FAMILY HEALTHCARE
1402 NORTH HIGH STREET
HILLSBORO, OH 45133
(937)840-9150
Highland
363999
MCH PRIMARY CARE CARDINAL CENTER
73 SPORTMAN DRIVE
MARENGO, OH 43334
(419)949-3030
Morrow
363987
363994
363993
363985
363984
363986
363998
MCH PRIMARY CARE NORTHFIELD
6519 US HIGHWAY 42
MOUNT GILEAD, OH 43338
(419)362-6033
Morrow
363989
105 OPPORTUNITY WAY
LAGRANGE, OH 44050
(440)355-4206
Lorain
508 DICKSON STREET, SUITE 2
WELLINGTON, OH 44090
(440)647-2225
Lorain
363829
MERCY ALLEN RURAL HEALTH CLINIC
LAGRANGE
MERCY ALLEN RURAL HEALTH CLINIC
WELLINGTON
PERRY COUNTY FAMILY PRACTICE
1625 AIRPORT ROAD
NEW LEXINGTON, OH 43764
(740)342-5158
Perry
363852
POMERENE EXPRESS CARE
4900 OAK STREET
BERLIN, OH 44610
(330)893-1318
Holmes
363855
102 EAST WATER STREET
PROSPECT, OH 43342
(740)494-2624
Marion
363858
PROSPECT FAMILY MEDICINE RURAL HEALTH
CLINIC
SHAWNEE FAMILY HEALTH CENTER
192 CHESTNUT RIDGE ROAD
WEST UNION, OH 45693
(937)544-5581
Adams
363857
SHAWNEE FAMILY HEALTH CENTER
901 WASHINGTON STREET
PORTSMOUTH, OH 45662
(740)354-7770
Scioto
363981
210 NORTH UNION STREET
BETHEL, OH 45106
(513)734-9050
Clermont
363997
SOUTHWEST REGIONAL MEDICAL CENTER
BETHEL RHC
TRINITY MEDICAL GROUP
110 NORTH WALNUT STREET
GNADENHUTTEN, OH 44629
(740)254-9443
Tuscarawas
363996
TRINITY MEDICAL GROUP
819 NORTH FIRST STREET
DENNISON, OH 44621
(740)922-8042
Tuscarawas
363988
Run Date: 10/08/2015
Job # 41303463
Last Update: 10/07/2015
Page 2 of 2
CASPER Report 0006D
Name and Address Listing
For Rural Health Clinic
Based on Current Survey
Ohio
CCN
Provider Name
Address
City, State and ZIP
Telephone # County Name
363859
TRUSTED HEALTH CARE INC
128 EAST MAIN STREET
BAINBRIDGE, OH 45612
(740)634-2013
Ross
363860
TURJOMAN PEDIATRICS
8930 OHIO RIVER ROAD
WHEELERSBURG, OH 45694
(740)574-1903
Scioto
363800
TUSCARAWAS COUNTY GENERAL HEALTH
DISTRICT
897 EAST IRON AVENUE
DOVER, OH 44622
(330)343-4928
Tuscarawas
Total Providers for this State = 33
Run Date: 10/08/2015
Job # 41303463
Last Update: 10/07/2015
Page 1 of 3
CASPER Report 0006D
Name and Address Listing
For Rural Health Clinic
Based on Current Survey
Wisconsin
CCN
Provider Name
Address
City, State and ZIP
Telephone # County Name
528569
ASPIRUS BIRNAMWOOD CLINIC
400 RAILROAD ST
BIRNAMWOOD, WI 54414
(715)449-2539
Marathon
528570
ASPIRUS ELCHO CLINIC
W10618 CLINIC ST
ELCHO, WI 54428
(715)275-4011
Langlade
528535
ASPIRUS GILMAN CLINIC
320 EAST MAIN ST
GILMAN, WI 54433
(715)447-8293
Taylor
528560
ASPIRUS GRAND VIEW CLINIC
501 GRANITE ST
HURLEY, WI 54534
(715)561-2255
Iron
528559
ASPIRUS MEDFORD CLINIC
143 S GIBSON ST
MEDFORD, WI 54451
(715)748-2121
Taylor
528537
ASPIRUS PHILLIPS CLINIC
625 PETERSON AVE
PHILLIPS, WI 54555
(715)339-4035
Price
528536
ASPIRUS PRENTICE CLINIC
1511 RAILROAD AVE
PRENTICE, WI 54556
(715)428-2521
Price
528538
ASPIRUS RIB LAKE CLINIC
1121 HIGHWAY 102
RIB LAKE, WI 54470
(715)427-5701
Taylor
523810
AURORA NOR DOOR CLINIC
2521 S BAY SHORE DR
SISTER BAY, WI 54234
(920)854-2347
Door
528504
BALDWIN CLINIC
730 10TH AVE
BALDWIN, WI 54002
(715)684-3311
St. Croix
528554
BELLIN HEALTH OCONTO CLINIC
820 ARBITUS AVE
OCONTO, WI 54153
(920)834-8833
Oconto
528501
BLAND CLINIC VMH
100 MELBY ST
WESTBY, WI 54667
(608)634-3126
Vernon
528517
BURNETT MEDICAL CTR CLINIC
257 W ST GEORGE AVE
GRANTSBURG, WI 54840
(715)463-5317
Burnett
528562
CLEAR LAKE CLINIC
357 THIRD AVE
CLEAR LAKE, WI 54005
(715)263-3100
Polk
528563
CUMBERLAND HC MEDICAL CLINIC
1110 7TH AVE
CUMBERLAND, WI 54829
(715)822-2741
Barron
528571
CUMBERLAND HC TURTLE LAKE CENTER
632 US HIGHWAY 8
CUMBERLAND, WI 54829
(715)822-2741
Barron
523984
ELROY FAMILY MEDICAL CENTER
1515 ACADEMY ST
ELROY, WI 53929
(608)462-8466
Juneau
523991
FLORENCE MEDICAL CTR
1010 OLIVE AVE
FLORENCE, WI 54121
(715)528-4775
Florence
523865
FMC ALGOMA
831 PARKER ST
ALGOMA, WI 54201
(920)487-3676
Kewaunee
523864
FMC KEWAUNEE
575 4TH ST
KEWAUNEE, WI 54216
(920)388-4640
Kewaunee
523866
FMC OCONTO FALLS
833 S MAIN ST
OCONTO FALLS, WI 54154
(920)846-3092
Oconto
528555
FREDERIC CLINIC
205 OAK ST WEST
FREDERIC, WI 54837
(715)327-5700
Polk
528572
GRANT REGIONAL COMMUNITY CLINIC
507 S MONROE ST
LANCASTER, WI 53813
(608)723-3202
Grant
528523
208 PARKER ST
BOSCOBEL, WI 53805
(608)375-2424
Grant
220 LINCOLN AVE
FENNIMORE, WI 53809
(608)822-3737
Grant
525 N WISCONSIN AVE
MUSCODA, WI 53573
(608)739-3138
Grant
35791 OSSEO RD
INDEPENDENCE, WI 54747
(715)985-2351
Trempealeau
420 S PETERSON AVE
BLAIR, WI 54616
(608)989-2505
Trempealeau
18606 ERVIN ST
WHITEHALL, WI 54773
(715)538-4355
Trempealeau
523996
GUNDERSEN BOSCOBEL AREA HOSPITAL AND
CLINICS
GUNDERSEN BOSCOBEL AREA HSPTL &
CLINICS FENNIMORE
GUNDERSEN BOSCOBEL AREA HSPTL AND
CLINICS MUSCODA
GUNDERSEN TRI COUNTY HSPTL & CLINICS
INDEPENDENCE
GUNDERSEN TRI COUNTY HSPTL AND CLINICS
BLAIR
GUNDERSEN TRI COUNTY HSPTL AND CLINICS
WHITEHALL
HIRSCH CLINIC
407 S MAIN ST STE 400
VIROQUA, WI 54665
(608)637-3174
Vernon
528556
INGALLS CLINIC
7456 MAIN ST
WEBSTER, WI 54893
(715)866-4271
Burnett
523999
KICKAPOO VALLEY MEDICAL CLINIC
102 SUNSET BLVD
SOLDIERS GROVE, WI 54655
(608)624-5203
Crawford
528526
LAFARGE MEDICAL CLINIC
206 N MILL ST
LA FARGE, WI 54639
(608)625-2494
Vernon
528534
528533
528551
528552
528553
Run Date: 10/08/2015
Job # 41303463
Last Update: 10/07/2015
Page 2 of 3
CASPER Report 0006D
Name and Address Listing
For Rural Health Clinic
Based on Current Survey
Wisconsin
CCN
Provider Name
Address
City, State and ZIP
Telephone # County Name
528516
LUCK CLINIC
137 1ST AVE
LUCK, WI 54853
(715)472-2177
Polk
523998
MAYO CLINIC HS FRANCISCAN HEALTHCARE
310 W MAIN ST
SPARTA, WI 54656
(608)269-2132
Monroe
523981
MEMORIAL MEDICAL CTR GREENWOOD
201 S MAIN ST
GREENWOOD, WI 54437
(715)267-3399
Clark
523979
MEMORIAL MEDICAL CTR LOYAL
502 E ELM ST
LOYAL, WI 54446
(715)255-8551
Clark
523980
MEMORIAL MEDICAL CTR NEILSVILLE
216 SUNSET PLACE
NEILLSVILLE, WI 54456
(715)743-3101
Clark
523828
MILE BLUFF CLINIC
1040 DIVISION ST
MAUSTON, WI 53948
(608)847-5000
Juneau
528541
MINISTRY MEDICAL GROUP CRANDON
400 W GLEN ST
CRANDON, WI 54520
(715)478-3318
Forest
528543
MINISTRY MEDICAL GROUP LAONA
4876 MILL ST
LAONA, WI 54541
(715)674-5233
Forest
528518
MINISTRY MEDICAL GROUP OWEN
6 JOHNSON ST
OWEN, WI 54460
(715)229-2177
Clark
528521
MINISTRY MEDICAL GROUP STANLEY
1120 PINE ST
STANLEY, WI 54768
(715)644-5530
Chippewa
528519
MINISTRY MEDICAL GROUP THORP
704 S CLARK ST
THORP, WI 54771
(715)669-7279
Clark
528520
MOUNDVIEW MEMORIAL CLINIC
402 W LAKE ST
FRIENDSHIP, WI 53934
(608)339-6350
Adams
528513
MUSCODA HEALTH CENTER
1075 N WISCONSIN AVE
MUSCODA, WI 53573
(608)739-3113
Grant
523990
NECEDAH FAMILY MEDICAL CTR
1408 WHEELIHAN AVE
NECEDAH, WI 54646
(608)565-2000
Juneau
523829
NEW LISBON FAMILY MEDICAL CTR
901 W BRIDGE ST
NEW LISBON, WI 53950
(608)562-3111
Juneau
528530
NORTH SHORE MED CLINIC ALGOMA
815 JEFFERSON ST
ALGOMA, WI 54201
(920)487-3496
Kewaunee
528532
NORTH SHORE MED CLINIC FISH CREEK
3711 HIGHWAY 42
FISH CREEK, WI 54212
(920)868-3511
Door
528531
NORTH SHORE MED CLINIC STURGEON BAY
323 SOUTH 18TH AVE
STURGEON BAY, WI 54235
(920)746-0510
Door
528515
910 MAIN RD
WASHINGTON ISLAND, WI 54246
(920)847-2424
Door
523860
NORTH SHORE MED CLINIC WASHINGTON
ISLAND
NORTHREACH HEALTHCARE CRIVITZ
218 S US HWY 141
CRIVITZ, WI 54114
(715)854-7477
Marinette
523862
NORTHREACH HEALTHCARE FAMILY CARE
3123 SHORE DR SUITE 202
MARINETTE, WI 54143
(715)732-4120
Marinette
523863
PESHTIGO FAMILY MEDICINE CLINIC
441 FRENCH ST
PESHTIGO, WI 54157
(715)582-9949
Marinette
528524
PLAIN MEDICAL CLINIC
825 MAIN ST
PLAIN, WI 53577
(608)546-4211
Sauk
528525
RIVER VALLEY MEDICAL CLINIC
436 SUNRISE DR
SPRING GREEN, WI 53588
(608)588-2502
Sauk
528564
SOUTHWEST HEALTH PLATTEVILLE CLINIC
1450 EASTSIDE ROAD
PLATTEVILLE, WI 53818
(608)348-4330
Grant
528514
SPRING GREEN MEDICAL CENTER
150 E JEFFERSON ST
SPRING GREEN, WI 53588
(608)588-7413
Sauk
528542
340 N GREEN BAY AVE
GILLETT, WI 54124
(920)855-2823
Oconto
200 S ROSERA ST
LENA, WI 54139
(920)829-6400
Oconto
14353 HIGHWAY 32 / 64
MOUNTAIN, WI 54149
(715)276-1600
Oconto
835 S MAIN ST
OCONTO FALLS, WI 54154
(920)846-8187
Oconto
913 E MAIN ST
SURING, WI 54174
(920)842-1147
Oconto
528540
ST CLARE MEM HOSPITAL GILLETT HEALTH
CENTER
ST CLARE MEM HOSPITAL LENA HEALTH
CENTER
ST CLARE MEM HOSPITAL MOUNTAIN HEALTH
CENTER
ST CLARE MEM HOSPITAL OCONTO FALLS
HEALTH CENTER
ST CLARE MEM HOSPITAL SURING HEALTH
CENTER
ST JOSEPHS HEALTH SVCS HILLSBORO CLINIC
400 WATER AVE
HILLSBORO, WI 54634
(608)489-8280
Vernon
528539
ST JOSEPHS HEALTH SVCS WONEWOC CLINIC
301 RAILROAD ST
WONEWOC, WI 53968
(608)464-3575
Juneau
528544
528545
528546
528547
Run Date: 10/08/2015
Job # 41303463
Last Update: 10/07/2015
Page 3 of 3
CASPER Report 0006D
Name and Address Listing
For Rural Health Clinic
Based on Current Survey
Wisconsin
CCN
Provider Name
Address
City, State and ZIP
Telephone # County Name
528528
STONE LAKE MEDICAL CLINIC
16887 SECOND ST SOUTH
STONE LAKE, WI 54876
(715)865-6510
Sawyer
528561
TURTLE LAKE CLINIC
550 MARTIN AVE
TURTLE LAKE, WI 54889
(715)986-4101
Barron
528557
UPLAND HILLS HEALTH CLINIC HIGHLAND
551 N MAIN ST
HIGHLAND, WI 53543
(608)929-4518
Iowa
528558
UPLAND HILLS HEALTH CLINIC MONTFORT
202 HIGHWAY 18 WEST
MONTFORT, WI 53569
(608)943-6308
Grant
523989
WAUSAUKEE HEALTH CTR
536 KENNY DR
WAUSAUKEE, WI 54177
(715)856-6983
Marinette
Total Providers for this State = 71
Run Date: 10/08/2015
Job # 41303463
Last Update: 10/07/2015
Page 1 of 3
CASPER Report 0006D
Name and Address Listing
For Rural Health Clinic
Based on Current Survey
Arkansas
CCN
Provider Name
Address
City, State and ZIP
Telephone # County Name
043877
ACCESS MEDICAL CLINIC MARKED TREE
3519 HIGHWAY 63
BLACK ROCK, AR 72415
(870)994-7301
Lawrence
043879
ACCESS MEDICAL CLINIC MARKED TREE
202 NEWSOME DRIVE
MARKED TREE, AR 72365
(870)358-4355
Poinsett
043432
AHRENS CLINIC
400 NORTH FIRST STREET
YELLVILLE, AR 72687
(870)449-4221
Marion
043490
ASHLEY HEALTH SERVICES
1003 FRED LAGRONE DRIVE
CROSSETT, AR 71635
(870)364-9519
Ashley
043853
BANISTER LIEBLONG CLINIC
2425 DAVE WARD DRIVE, #401
CONWAY, AR 72032
(501)329-3824
Faulkner
043457
BAPTIST HEALTH - FAMILY CLINIC BRINKLEY
110 NORTH NEW YORK STREET
BRINKLEY, AR 72021
(870)734-4405
Monroe
043492
BAPTIST HEALTH - FAMILY CLINIC DEWITT
1703 SOUTH WHITEHEAD DRIVE
DE WITT, AR 72042
(870)673-3511
Arkansas
043489
BAPTIST HEALTH - FAMILY CLINIC HAZEN
151 SOUTH LIVERMORE STREET
HAZEN, AR 72064
(870)673-3511
Prairie
043480
BAPTIST HEALTH - STUTTGART MEDICAL CLINIC 1609 NORTH MEDICAL DRIVE
STUTTGART, AR 72160
(870)673-7211
Arkansas
043990
BAPTIST HEALTH CENTER GREERS FERRY
8544 EDGEMOUNT RD
GREERS FERRY, AR 72067
(501)825-6283
Cleburne
048505
221 NE 2ND STREET
ENGLAND, AR 72046
(501)842-3819
Lonoke
048504
BAPTIST HEALTH FAMILY CLINIC - ENGLAND
BHMCS
BAPTIST HEALTH FAMILY CLINIC - GURDON
200 EAST WALNUT STREET
GURDON, AR 71743
(870)353-2800
Clark
048508
BAPTIST HEALTH FAMILY CLINIC-BISMARCK
6679 HIGHWAY 7
BISMARCK, AR 71929
(501)865-2755
Hot Spring
048507
BAPTIST HEALTH FAMILY CLINIC-CADDO
10 MONTGOMERY DRIVE
VALLEY
BAPTIST HEALTH FAMILY CLINIC-FAIRFIELD BAY 110 VILLAGE PLACE 2B
CADDO VALLEY, AR 71923
(870)245-2198
Clark
FAIRFIELD BAY, AR 72088
(501)887-3212
Van Buren
106 SOUTH SEVENTH STREET
HEBER SPRINGS, AR 72543
(501)362-7538
Cleburne
048511
BAPTIST HEALTH FAMILY CLINIC-HEBER
SPRINGS
BAPTIST HEALTH FAMILY CLINIC-PRESCOTT
1484 WEST FIRST STREET NORTH, #2
PRESCOTT, AR 71857
(870)887-0155
Nevada
043456
BAPTIST HEALTH-FAMILY CLINIC CLARENDON
198 SOUTH MAIN STREET
CLARENDON, AR 72029
(870)747-3349
Monroe
043829
BELL-WINSTON CLINIC, PA
626 POPLAR STREET
HELENA, AR 72342
(870)338-8163
Phillips
043982
CAVE CITY MEDICAL CLINIC
301 SOUTH MAIN STREET
CAVE CITY, AR 72521
(870)283-5353
Sharp
043868
234 EAST BROADWAY
GLENWOOD, AR 71943
(870)356-4821
Pike
320 LUZERNE
MT IDA, AR 71957
(870)867-2175
Montgomery
319 EAST 13TH STREET
MURFREESBORO, AR 71958
(870)285-3118
Pike
043424
CHI ST VINCENT MEDICAL GROUP HOT
SPRINGS
CHI ST VINCENT MEDICAL GROUP HOT
SPRINGS
CHI ST VINCENT MEDICAL GROUP HOT
SPRINGS
CLAUDE PARRISH COMMUNITY HEALTH CLINIC
131 EAST HIGHWAY 14
LEAD HILL, AR 72644
(870)436-5271
Boone
043851
CLINTON MEDICAL CLINIC
2526 HWY 65 S, SUITE 203
CLINTON, AR 72031
(501)745-4914
Van Buren
043497
COMMUNITY MEDICAL CENTER CLINIC OF
CALICO ROCK
COOPER CLINIC PA
61 GRASSE STREET
CALICO ROCK, AR 72519
(870)297-3726
Izard
303 SOUTH 5TH STREET
PARIS, AR 72855
(479)963-2132
Logan
201 NORTH CLIFTON STREET
FORDYCE, AR 71742
(870)352-6363
Dallas
043808
DALLAS COUNTY MEDICAL CENTER FAMILY
CLINIC
DE PAUL HEALTH CENTER
145 WEST WATERMAN STREET
DUMAS, AR 71639
(870)382-4878
Desha
043812
DECATUR MEDI-CLINIC
346 NORTH MAIN
DECATUR, AR 72722
(479)752-3233
Benton
043495
DELTA HEALTH SERVICES
803 HIGHWAY 65 SOUTH
DUMAS, AR 71639
(870)382-4303
Desha
043455
DRASCO MEDICAL CLINIC
60 GREERS FERRY ROAD
DRASCO, AR 72530
(870)668-3200
Cleburne
048510
048506
043870
043869
043831
043494
Run Date: 10/08/2015
Job # 41303463
Last Update: 10/07/2015
Page 2 of 3
CASPER Report 0006D
Name and Address Listing
For Rural Health Clinic
Based on Current Survey
Arkansas
CCN
Provider Name
Address
City, State and ZIP
Telephone # County Name
043867
EARLE FAMILY MEDICAL CLINIC
1605 SECOND STREET
EARLE, AR 72331
(870)792-8825
Crittenden
043463
EUDORA MEDICAL CLINIC
200 SOUTH MAIN STREET
EUDORA, AR 71640
(870)355-2300
Chicot
043448
FAMILY CARE CLINIC OF RECTOR
715 EAST NINTH STREET
RECTOR, AR 72461
(870)595-3596
Clay
043864
FAMILY HEALTH CARE, LLC
350 SOUTH MAIN, SUITE 4
MAMMOTH SPRING, AR 72554
(870)625-3111
Fulton
043479
FAMILY MEDICAL CENTER
1309 WEST MAIN
WALNUT RIDGE, AR 72476
(870)886-3211
Lawrence
043486
FERGUSON RURAL HEALTH CLINIC
1641 SOUTH WHITEHEAD DRIVE
DE WITT, AR 72042
(870)946-3637
Arkansas
043875
FORE FAMILY PRACTICE LLC
307 NORTH MAIN STREET
CAVE CITY, AR 72521
(870)283-5550
Sharp
043872
GREENBRIER CHILDREN'S CLINIC
10 LOIS LANE
GREENBRIER, AR 72058
(501)679-6796
Faulkner
043854
GREENBRIER FAMILY MEDICINE
110 NORTH BROADVIEW
GREENBRIER, AR 72058
(501)679-3551
Faulkner
048501
HAMBURG HEALTH CLINIC
319 WEST PARKER STREET
HAMBURG, AR 71646
(870)853-8271
Ashley
043832
HOPE MEDICAL CLINIC, INC
145 SHAKERAG ROAD
CLINTON, AR 72031
(501)745-7161
Van Buren
043838
LAKE VILLAGE CLINIC, PA
2918 LOUIS SESSIONS STREET
LAKE VILLAGE, AR 71653
(870)265-5343
Chicot
043839
LAWRENCE COUNTY FAMILY CLINIC, PA
1210 WEST MAIN
WALNUT RIDGE, AR 72476
(870)886-3543
Lawrence
043976
MAMMOTH SPRING MEDICAL CLINIC
236 SOUTH MAIN STREET
MAMMOTH SPRING, AR 72554
(870)625-3228
Fulton
043414
MARSHALL FAMILY PRACTICE CLINIC
211 AIRPORT ROAD
MARSHALL, AR 72650
(870)448-3327
Searcy
043852
MAYFLOWER MEDICAL CLINIC
587 HIGHWAY 365
MAYFLOWER, AR 72106
(501)470-7413
Faulkner
043844
MCCRORY FAMILY CLINIC, P A
908 NORTH EDMONDS AVENUE
MCCRORY, AR 72101
(870)731-1100
Woodruff
048509
MCGEHEE HOSPITAL INCORPORATED
601 HOLLY ST
MC GEHEE, AR 71654
(870)222-6131
Desha
043997
MELBOURNE MEDICAL CLINIC
1526 EAST MAIN STREET
MELBOURNE, AR 72556
(870)368-4344
Izard
043491
MERCY CLINIC PRIMARY CARE - BOONEVILLE
128 DANIEL AVENUE
BOONEVILLE, AR 72927
(479)675-2800
Logan
048502
351 B EAST PRIDDY STREET
MAGAZINE, AR 72943
(479)969-8640
Logan
1341 WEST 6TH STREET
WALDRON, AR 72958
(479)637-2136
Scott
100 NORTH WALNUT STREET, SUITE A
MANSFIELD, AR 72944
(479)928-4404
Scott
043981
MERCY HOSPITAL BOONEVILLE PRIMARY
CARE-MAGAZINE
MERCY HOSPITAL SCOTT CO RURAL HEALTH
CLINIC
MERCY HOSPITAL WALDRON-MANSFIELD
FAMILY MEDICINE
MIDWAY MEDICAL CLINIC
195 HOSPITAL DRIVE A
CHEROKEE VILLAGE, AR 72529
(870)257-6000
Sharp
043878
MORRILTON MEDICAL CLINIC PA
10 HOSPITAL DRIVE
MORRILTON, AR 72110
(501)354-0052
Conway
043423
NEWTON COUNTY FAMILY PRACTICE CLINIC
502 WEST COURT STREET
JASPER, AR 72641
(870)446-2203
Newton
043876
NUTT-WALLEY CLINIC
110 NORTH CLIFTON STREET
FORDYCE, AR 71742
(870)352-3525
Dallas
043871
OZARK MEDICAL CLINIC
2526 HIGHWAY 65 SOUTH, SUITE 201
CLINTON, AR 72031
(501)745-3388
Van Buren
043822
PARAGOULD DOCTORS CLINIC
4000 LINWOOD DRIVE, SUITE A
PARAGOULD, AR 72450
(870)239-8503
Greene
043834
PIGGOTT FAMILY MEDICAL CENTER
425 WEST JACKSON
PIGGOTT, AR 72454
(870)598-2236
Clay
043866
PILLOW CLINIC AT MARVELL
1008 MAIN STREET
MARVELL, AR 72366
(870)829-2521
Phillips
043861
PILLOW CLINIC, PLLC
101 SHIRLEY HICKS DRIVE
HELENA, AR 72342
(870)572-5996
Phillips
043422
PLEASANT PLAINS MEDICAL CLINIC
6200 BATESVILLE BOULEVARD
PLEASANT PLAINS, AR 72568
(501)345-2182
Independence
043873
POTTSVILLE PRIMARY CARE
5395 WEST ASH STREET, SUITE 2
POTTSVILLE, AR 72858
(479)880-1118
Pope
043488
043493
Run Date: 10/08/2015
Job # 41303463
Last Update: 10/07/2015
Page 3 of 3
CASPER Report 0006D
Name and Address Listing
For Rural Health Clinic
Based on Current Survey
Arkansas
CCN
Provider Name
Address
City, State and ZIP
Telephone # County Name
043826
HWY 49 NORTH
RECTOR, AR 72461
(870)595-3527
Clay
048500
RECTOR MEDICAL CLINIC RURAL HEALTH
CLINIC
RIVER VALLEY MEDICINE
515 HOLLY STREET
MC GEHEE, AR 71654
(870)222-9301
Desha
043975
SALEM 1ST CARE
172 HIGHWAY 62 EAST, SUITE 1
SALEM, AR 72576
(870)895-1911
Fulton
043802
ST ELIZABETH HEALTH CENTER
407 SOUTH GOULD AVENUE
GOULD, AR 71643
(870)263-4317
Lincoln
043477
ST VINCENT MEDICAL CLINIC MORRILTON
4 HOSPITAL DRIVE
MORRILTON, AR 72110
(501)354-4637
Conway
043460
STEPHENS COMMUNITY CLINIC
113 WEST RUBY
STEPHENS, AR 71764
(870)786-9114
Ouachita
043467
STRAWBERRY MEDICAL CLINIC
58 EAST RIVER DRIVE
STRAWBERRY, AR 72469
(870)528-4081
Lawrence
043874
UAMS FAMILY MEDICAL CLINIC-MAGNOLIA
1617 N WASHINGTON
MAGNOLIA, AR 71753
(870)235-7676
Columbia
043880
URGENT TEAM OF ARKANSAS PHYSICIANS, LLC 411 FALLS S BOULEVARD
WYNNE, AR 72396
(870)238-3115
Cross
043881
URGENT TEAM OF ARKANSAS PHYSICIANS, LLC 6134 HEBER SPRINGS WEST ROAD
QUITMAN, AR 72131
(501)589-3015
Cleburne
043860
URGENT TEAM OF ARKANSAS PHYSICIANS, LLC 700 W KEISER
OSCEOLA, AR 72370
(870)563-6512
Mississippi
043402
VALLEY HEALTH SERVICES OF HECTOR
11720 SR 27
HECTOR, AR 72843
(479)284-5001
Pope
043859
W K BRADLEY HEALTH CLINIC
409 WOODRUFF STREET
BRADLEY, AR 71826
(870)894-3366
Lafayette
048503
WADLEY RURAL HEALTH CLINIC AT HOPE
302 BILL CLINTON DRIVE
HOPE, AR 71801
(870)777-8115
Hempstead
043856
WAGNER MEDICAL CLINIC
434 HWY 18 BYPASS
MANILA, AR 72442
(870)561-3300
Mississippi
043863
WEBBER FAMILY PRACTICE
504 PECAN STREET
HELENA, AR 72342
(870)338-9244
Phillips
043865
WEBBER FAMILY PRACTICE
207 WEST CHESTNUT STREET
MARIANNA, AR 72360
(870)295-2367
Lee
Total Providers for this State = 83
Run Date: 10/08/2015
Job # 41303463
Last Update: 10/07/2015
Page 1 of 4
CASPER Report 0006D
Name and Address Listing
For Rural Health Clinic
Based on Current Survey
Louisiana
CCN
Provider Name
Address
City, State and ZIP
Telephone # County Name
193465
ABBEVILLE GENERAL HOSPITAL CLINIC
2419 ALONZO STREET
ABBEVILLE, LA 70510
(337)893-2302
Vermilion
193889
ACADIA FAMILY CLINIC
1325 WRIGHT AVE SUITE E
CROWLEY, LA 70526
(337)788-1081
Acadia
193830
ACADIANA FAMILY PRACTICE ASSOCIATES, L L
P
ALLEN PARISH HOSPITAL RURAL MEDICAL
CENTER
AMITE RURAL HEALTH CLINIC
1501 BETHIA STREET
FRANKLIN, LA 70538
(337)828-3507
St. Mary
204 6TH AVENUE
KINDER, LA 70648
(337)738-9494
Allen
409 NW CENTRAL AVE
AMITE, LA 70422
(985)748-7141
Tangipahoa
143 HWY 402
NAPOLEONVILLE, LA 70390
(985)369-3600
Assumption
193470
193985
193426
193910
ASSUMPTION COMMUNITY HOSPITAL RURAL
HEALTH CLINIC
ASWELL RURAL HEALTH CLINIC
503 JACK MILLER RD, SUITE A
VILLE PLATTE, LA 70586
(337)363-7474
Evangeline
193902
AVOYELLES PEDIATRICS
338 MOREAU STREET, SUITE E
MARKSVILLE, LA 71351
(318)253-7022
Avoyelles
193484
BASTROP OUTPATIENT RURAL HEALTH CLINIC
510 S WASHINGTON STREET
BASTROP, LA 71220
(318)665-9950
Morehouse
193845
BIENVILLE FAMILY CLINIC
1175 PINE STREET
ARCADIA, LA 71001
(318)263-7970
Bienville
193854
BRIAN LEBLANC, M D
160 HOSPITAL ROAD SUITE
NEW ROADS, LA 70760
(225)638-4686
Pointe Coupee
193460
BUNKIE GENERAL HOSPITAL FAMILY CARE
CLINIC
BUNKIE GENERAL HOSPITAL RURAL HEALTH
CLINIC
BUTLER ABSHIRE MEDICAL CLINIC APMC
510 S COTTONWOOD STREET
BUNKIE, LA 71322
(318)346-3339
Avoyelles
109 NORTH LEXINGTON
BUNKIE, LA 71322
(318)346-7283
Avoyelles
926 FRANCES DRIVE
HAYNESVILLE, LA 71038
(318)624-0554
Claiborne
193987
193808
193857
CARL MCLEMORE JR M D
230 ROBERT DRIVE SUITE B
NEW ROADS, LA 70760
(225)638-8661
Pointe Coupee
193873
CHADHA MEDICAL CLINIC
140 WEST FOURTH STREET
DEQUINCY, LA 70633
(337)786-5007
Calcasieu
193483
CHATHAM MEDICAL CLINIC
804 CHATHAM AVENUE
CHATHAM, LA 71226
(318)249-3200
Jackson
193489
CHATHAM RURAL HEALTH CLINIC
6619 HWY 34
CHATHAM, LA 71226
(318)649-6111
Jackson
193881
CHILDREN FIRST KIDMED
1828 WEST THOMAS
HAMMOND, LA 70401
(985)419-2250
Tangipahoa
193447
CHRISTUS COUSHATTA RINGGOLD RURAL
HEALTH CLINIC
CHRISTUS COUSHATTA RURAL HEALTH CLINIC
3342 BIENVILLE ROAD
RINGGOLD, LA 71068
(318)894-9611
Bienville
1633 MARVEL STREET
COUSHATTA, LA 71019
(318)932-2222
Red River
5541 HWY 1
MARKSVILLE, LA 71351
(318)253-6583
Avoyelles
193446
CHRISTUS MEDICAL GROUP MARKSVILLE
FAMILY CARE CENT
CITIZENS RURAL CLINIC
484 COLLINS ROAD
COLUMBIA, LA 71418
(318)649-5300
Caldwell
193409
COMMUNITY MEDICAL CLINIC
712 SETTOON STREET
OAK GROVE, LA 71263
(318)428-3237
West Carroll
193445
193820
193869
COTTONPORT FAMILY CLINIC
1007 SYCAMORE STREET SUITE B
COTTONPORT, LA 71327
(318)876-3696
Avoyelles
193906
CROSSROADS-HOLLOWAY HEALTH CLINIC
12805 HIGHWAY 28 EAST, SUITE B
PINEVILLE, LA 71360
(318)466-5151
Rapides
193488
CROWVILLE HEALTH CENTER
5745 HIGHWAY 17
WINNSBORO, LA 71295
(318)435-9411
Franklin
193895
1633 MARVEL STREET (POD B)
COUSHATTA, LA 71019
(318)932-2141
Red River
193417
D GREGORY BELL, MD AND WILLIS-KNIGHTON
MEDICAL CTR
DELHI RURAL HEALTH CLINIC
508 BROADWAY STREET
DELHI, LA 71232
(318)878-3739
Richland
193901
DESOTO HEALTHCARE CENTER INC
7356 HIGHWAY 509
MANSFIELD, LA 71052
(318)871-1633
De Soto
193448
DESOTO REGIONAL FAMILY MEDICINE LOGANSPORT
808 MAIN STREET
LOGANSPORT, LA 71049
(318)697-2273
De Soto
Run Date: 10/08/2015
Job # 41303463
Last Update: 10/07/2015
Page 2 of 4
CASPER Report 0006D
Name and Address Listing
For Rural Health Clinic
Based on Current Survey
Louisiana
CCN
Provider Name
Address
City, State and ZIP
Telephone # County Name
193480
130 JEFFERSON STREET
MANSFIELD, LA 71052
(318)872-2700
De Soto
193908
DESOTO REGIONAL FAMILY MEDICINE MANSFIELD
DUSON FAMILY HEALTHCARE
9023 CAMERON STREET
DUSON, LA 70529
(337)873-8244
Lafayette
193467
ELIZABETH FAMILY HEALTH CLINIC
504 WEST MAIN STREET
ELIZABETH, LA 70638
(318)634-5475
Allen
193977
ELTON RURAL HEALTH CLINIC
907 MAIN STREET
ELTON, LA 70532
(337)584-2237
Jefferson Davis
193490
ERATH DELCAMBRE COMMUNITY CARE CLINIC
220 NORTH ROAD
ERATH, LA 70533
(337)937-5944
Vermilion
193905
FAMILY CARE CLINIC
107 LELA STREET
MANGHAM, LA 71259
(318)248-4100
Richland
193864
FAMILY FIRST MEDICINE, APMC
902 S VIENNA STREET
RUSTON, LA 71273
(318)513-1950
Lincoln
193464
FAMILY MEDICAL CLINIC
300 SCARBOROUGH STREET
LAKE PROVIDENCE, LA 71254
(318)559-2814
East Carroll
193890
FAMILY MEDICINE ASSOCIATES OF MINDEN LLC 1111 HOMER ROAD
MINDEN, LA 71055
(318)377-7500
Webster
193866
FAMILY MEDICINE CENTER OF RESERVE
147 CENTRAL AVENUE
RESERVE, LA 70084
(985)536-8388
St. John The Baptist
193862
FLEUR-DE-LIS COMMUNITY, INC
376 MAIN STREET
CANKTON, LA 70584
(337)984-2623
St. Landry
193461
FRANKLIN MEDICAL CENTER RHC - ST JOSEPH
448 NEWTON STREET
ST JOSEPH, LA 71366
(318)766-8506
Tensas
193459
2104-C LOOP ROAD
WINNSBORO, LA 71295
(318)435-4571
Franklin
193442
FRANKLIN MEDICAL CENTER RHC WINNSBORO
FRANKLIN MEDICAL CENTER RURAL - TENSAS
104 VERONA STREET
NEWELLTON, LA 71357
(137)467-9949
Tensas
193441
FRANKLINTON RURAL HEALTH CLINI
2004 J MARVIN MAGEE DRIVE
FRANKLINTON, LA 70438
(985)839-3555
Washington
193863
GARDINER CENTER HEALTH CLINIC
710 5TH STREET
GUEYDAN, LA 70542
(337)536-9263
Vermilion
193997
HACKBERRY RURAL HEALTH CLINIC
1020 MAIN STREET
HACKBERRY, LA 70645
(337)762-3762
Cameron
193493
HARDTNER FAMILY CLINIC
1136-A NORTH PINE ROAD
OLLA, LA 71465
(318)495-3131
Laqsalle
193456
HARDTNER MEDICAL CLINIC
1049 -A NORTH PINE ROAD
OLLA, LA 71465
(318)495-3229
Laqsalle
193891
HEALTH CARE FIRST MEDICAL CLINIC L L C
18015 WILLOW STREET
GROSSE TETE, LA 70740
(225)648-3433
Iberville
193491
HEALTHCARE PRACTICE OF MARKSVILLE
448 NORTH WASHINGTON STREET
MARKSVILLE, LA 71351
(318)253-7511
Avoyelles
193887
HEALTHY STEPS PEDIATRICS
192 STILLY ROAD
PINEVILLE, LA 71360
(318)484-3401
Rapides
193907
HOPE'S CHILDREN & FAMILY CARE CLINIC LLC
338 MOREAU STREET, SUITE B
MARKSVILLE, LA 71351
(318)253-2299
Avoyelles
193888
HUSAM SUKEREK M D
210 HIGHLAND DRIVE
MANY, LA 71449
(318)256-5722
Sabine
193911
IOTA FAMILY HEALTHCARE,LLC
119 S 5TH STREET
IOTA, LA 70543
(337)779-6000
Acadia
193408
IOWA HEALTH CTR LAKE CHARLES MEM HOSP
203 E MILLER
IOWA, LA 70647
(337)582-7632
Calcasieu
193457
107 WATTS
JONESBORO, LA 71251
(318)395-2121
Jackson
193404
JACKSON PARISH HOSPITAL FAMILY CARE
CLINIC
JEANERETTE RURAL HEALTH CLINIC
217 BOURG STREET
JEANERETTE, LA 70544
(337)276-7002
Iberia
193479
JOHNSON BAYOU RURAL HEALTH CLINIC
6240 GULF BEACH HWY
CAMERON, LA 70631
(337)569-2245
Cameron
193463
JONESBORO FAMILY CARE CLINIC
121 WATTS STREET SUITES A, B, E, & F
JONESBORO, LA 71251
(318)395-0521
Jackson
193451
LADY OF THE SEA MEDICAL CLINIC - CUT OFF
144 WEST 134TH PLACE
CUT OFF, LA 70345
(985)632-6233
Lafourche
193452
LADY OF THE SEA MEDICAL CLINIC - GOLDEN
MEADOW
LADY OF THE SEA MEDICAL CLINIC - LAROSE
176 WASHINGTON STREET
GOLDEN MEADOW, LA 70357
(985)475-5664
Lafourche
13030 HWY 308
LAROSE, LA 70373
(985)798-7021
Lafourche
193453
Run Date: 10/08/2015
Job # 41303463
Last Update: 10/07/2015
Page 3 of 4
CASPER Report 0006D
Name and Address Listing
For Rural Health Clinic
Based on Current Survey
Louisiana
CCN
Provider Name
Address
City, State and ZIP
Telephone # County Name
193846
LAKE ARTHUR HEALTH CLINIC
328 KELLOGG AVENUE
LAKE ARTHUR, LA 70549
(337)774-0100
Jefferson Davis
193999
LAKE PROVIDENCE MEDICAL CLINIC
319 NORTH HOOD STREET
LAKE PROVIDENCE, LA 71254
(318)428-3237
East Carroll
193481
LASALLE FAMILY MEDICINE CLINIC
155-A NINTH STREET
JENA, LA 71342
(318)992-4275
Laqsalle
193454
LASALLE PRIMARY HEALTHCARE CENTER
2801 FOURTH STREET
JONESVILLE, LA 71343
(318)339-9990
Catahoula
193823
LEONARD P NEUMANN JR MD, APMC
800 JOHNSON STREET
TALLULAH, LA 71284
(318)574-4731
Madison
193477
808 JOHNSON STREET
TALLULAH, LA 71282
(318)574-8584
Madison
193904
MADISON PARISH HOSPITAL RURAL HEALTH
CLINIC
MALINDA'S PATIENT CARE
19115 FLORIDA BLVD, SUITE A
ALBANY, LA 70711
(225)567-7150
Livingston
193880
MANSURA FAMILY CLINIC
2104 CLECO STREET
MANSURA, LA 71350
(318)964-2551
Avoyelles
193472
MAURICE COMMUNITY CARE CLINIC
207 MILTON ROAD
MAURICE, LA 70555
(337)893-5466
Vermilion
193486
205 E DAVENPORT
MER ROUGE, LA 71261
(318)647-3720
Morehouse
193811
MER ROUGE OUTPATIENT RURAL HEALTH
CLINIC
MINDEN FAMILY CARE CENTER
208 MORRIS DRIVE
MINDEN, LA 71055
(318)377-8260
Webster
193909
MONTGOMERY FAMILY CLINIC
641 ROWENA STREET
MONTGOMERY, LA 71454
(318)646-3000
Grant
193487
420 GUNBY AVE
BASTROP, LA 71220
(318)283-3601
Morehouse
193476
MOREHOUSE GENERAL HOSPITAL RURAL
HEALTH CLINIC
NCMC MEDICAL AND SURGICAL CLINIC
1003 S SPRUCE STREET
VIVIAN, LA 71082
(318)375-3239
Caddo
193485
NCMC PLAIN DEALING MEDICAL CLINIC
112 FOREST STREET
PLAIN DEALING, LA 71064
(318)326-7282
Bossier
193478
NORTH NATCHITOCHES MEDICAL CLINIC
3194 HWY 71
CAMPTI, LA 71411
(318)476-3991
Natchitoches
193810
NORTH OAKS OB/GYN RURAL HEALTH CLINIC
15778 MEDICAL ARTS PLAZA
HAMMOND, LA 70403
(985)542-0663
Tangipahoa
193482
NORTH WEBSTER MEDICAL CLINIC
106 TRI-STATE DRIVE
SAREPTA, LA 71071
(318)539-1000
Webster
193412
NORTHEAST LOUISIANA HEALTH CENTER
1012 LOUISA STREET
RAYVILLE, LA 71269
(318)728-2046
Richland
193984
OAK GROVE MEDICAL CLINIC
708 EAST MAIN
OAK GROVE, LA 71263
(318)428-3200
West Carroll
193856
230 ROBERTS DRIVE SUITE E
NEW ROADS, LA 70760
(225)638-3347
Pointe Coupee
193855
OUR LADY OF THE LAKE PHYSICIAN GROUP
NEW ROADS
PAUL RACHEL, MD
230 ROBERTS DRIVE, SUITE H
NEW ROADS, LA 70760
(225)638-7033
Pointe Coupee
193883
PEDIATRIC & ADOLESCENT CLINIC
1806 CARTER STREET
VIDALIA, LA 71373
(318)336-7172
Concordia
193912
PELICAN PEDIATRICS, L L C
911 WEST MAIN STREET SUITE C
HOMER, LA 71040
(318)927-3255
Claiborne
193886
1302 ED BROUSSARD RD
NEW IBERIA, LA 70563
(337)229-7929
Iberia
193900
RAYMOND F SCHNEIDER MEMORIAL CLINIC,
LLC
RAYVILLE FAMILY CLINIC
1962 JULIA STREET
RAYVILLE, LA 71269
(318)728-8833
Richland
193832
REDDY FAMILY MED CLINIC PIERRE PART
3407 HWY 70
PIERRE PART, LA 70339
(985)252-1000
Assumption
193836
32985 BOWIE STREET
WHITE CASTLE, LA 70788
(225)545-3631
Iberville
217 RAIL ROAD AVENUE
DONALDSONVILLE, LA 70346
(225)473-3931
Ascension
193838
REDDY FAMILY MEDICAL CENTER WHITE
CASTLE
REDDY FAMILY MEDICAL CLINIC
DONALDSONVILLE
REDDY FAMILY MEDICAL CLINIC PLAQUEMINE
58725 BELLEVIEW STREET
PLAQUEMINE, LA 70764
(225)687-6200
Iberville
193850
REDDY FAMILY MEDICAL OF NAPOLEONVILLE
154 HWY 1008
NAPOLEONVILLE, LA 70390
(980)369-9191
Assumption
193416
REEVES MEMORIAL MEDICAL CENTER - RHC
402 SECOND STREET
BERNICE, LA 71222
(318)285-9069
Union
193813
Run Date: 10/08/2015
Job # 41303463
Last Update: 10/07/2015
Page 4 of 4
CASPER Report 0006D
Name and Address Listing
For Rural Health Clinic
Based on Current Survey
Louisiana
CCN
Provider Name
Address
City, State and ZIP
Telephone # County Name
193858
RIVERPARK MEDICAL CLINIC-JONESVILLE
800 AUDUBON DRIVE
JONESVILLE, LA 71343
(318)339-6388
Catahoula
193876
RIVERSIDE FAMILY MEDICINE, LLC
18740 HWY 22
MAUREPAS, LA 70449
(225)698-3435
Livingston
193833
RURAL HEALTH CLINIC OF LOREAUVILLE
411 SOUTH MAIN STREET
LOREAUVILLE, LA 70552
(337)229-8288
Iberia
193474
395 S CAPITOL STREET
MANY, LA 71449
(318)256-1136
Sabine
1015 OBRIE STREET
ZWOLLE, LA 71486
(318)256-2000
Sabine
193401
SABINE MEDICAL CENTER RURAL HEALTH
CLINIC #1
SABINE MEDICAL CENTER RURAL HEALTH
CLINIC #2
SAVOY FAMILY CARE
102 SOUTH 2ND STREET
EUNICE, LA 70535
(337)457-3135
St. Landry
193851
SHIRLEY MEDICAL CLINIC
711 NORTH MAIN ST
JENNINGS, LA 70546
(337)824-2002
Jefferson Davis
193871
SIMMESPORT FAMILY CLINIC
417 NORTH MARTIN LUTHER KING DRIVE
SIMMESPORT, LA 71369
(318)941-2336
Avoyelles
193466
SMC DOCTORS CLINIC
401 11TH N E
SPRINGHILL, LA 71075
(318)539-1700
Webster
193875
ST JAMES PRIMARY CARE
502 RUE DE SANTE
LA PLACE, LA 70068
(985)652-5475
St. John The Baptist
193870
ST JAMES PRIMARY CARE
827 PINE STREET
GRAMERCY, LA 70052
(225)869-9200
St. James
193860
ST JOSEPH MEDICAL CLINIC AMC
22080 LA HWY 20 W
VACHERIE, LA 70090
(225)265-3061
St. James
193885
ST MARTINVILLE MATERNAL-CHILD CLINIC
1119 N MAIN STREET
SAINT MARTINVILLE, LA 70582
(337)394-7774
St. Martin
193492
START COMMUNITY CLINIC, LLC
5975 FEDERAL HWY 80
RAYVILLE, LA 71269
(318)728-4368
Richland
193473
10374 HIGHWAY 165
STERLINGTON, LA 71280
(318)665-4543
Ouachita
193896
STERLINGTON OUTPATIENT RURAL HEALTH
CLINIC
STEWART FAMILY MEDICINE & AFTER HOURS
29565 FROST RD SUITE C (HWY 63)
LIVINGSTON, LA 70754
(225)686-1114
Livingston
193431
THE FAMILY PRACTICE CLINIC
320 NORTH HOOD STREET
LAKE PROVIDENCE, LA 71254
(318)559-2404
East Carroll
193879
THE WOMEN'S CLINIC
427 HOMER ROAD
MINDEN, LA 71055
(318)377-8855
Webster
193897
THIBODAUX MEDICAL CLINIC
931 NORTH CANAL BLVD
THIBODAUX, LA 70301
(985)446-6381
Lafourche
193913
TOTAL FAMILY MEDICAL LLC
44354 HWY 445 SUITE D
ROBERT, LA 70455
(985)542-2466
Tangipahoa
193444
UNION GENERAL RURAL HEALTH CLINIC
1025 MARION HWY
FARMERVILLE, LA 71241
(318)368-9745
Union
193914
VILLE PLATTE PEDIATRICS, PA
504 JACK MILLER ROAD SUITE 3
VILLE PLATTE, LA 70586
(337)363-3560
Evangeline
193458
VINTON MEDICAL CLINIC
1611 HAMPTON STREET
VINTON, LA 70668
(337)589-5951
Calcasieu
193843
W K CLAIBORNE REGIONAL HEALTH
104 MORRIS CIRCLE
HOMER, LA 71040
(318)927-1110
Claiborne
193992
WEST CARROLL MEDICAL CLINIC
502 ROSS STREET
OAK GROVE, LA 71263
(318)428-3237
West Carroll
193436
WINTERS CLINIC
412 MAIN STREET
COLUMBIA, LA 71418
(318)649-6157
Caldwell
193471
WISNER RURAL HEALTH CLINIC
3286 OAK STREET
WISNER, LA 71378
(318)649-6111
Franklin
193878
WOMEN'S CLINIC
2602 NORTH DRIVE
ABBEVILLE, LA 70510
(337)893-1101
Vermilion
193898
WOMEN'S CLINIC OF OAKDALE LLC
119 N HOSPITAL DRIVE
OAKDALE, LA 71463
(318)335-0260
Allen
193882
WOODWORTH FAMILY MEDICINE, INC
9372 HWY 165 S
WOODWORTH, LA 71485
(318)484-9588
Rapides
193449
ZWOLLE RURAL CLINIC
2026 OBRIE STREET
ZWOLLE, LA 71486
(318)871-1081
Sabine
193475
Total Providers for this State = 127
Run Date: 10/08/2015
Job # 41303463
Last Update: 10/07/2015
Page 1 of 1
CASPER Report 0006D
Name and Address Listing
For Rural Health Clinic
Based on Current Survey
New Mexico
CCN
Provider Name
Address
City, State and ZIP
Telephone # County Name
323831
CARRIZOZO HEALTH CENTER
710 AVENUE E
CARRIZOZO, NM 88301
(575)648-2317
Lincoln
323855
CORONA HEALTH CLINIC
HIGHWAY 54/MAIN STREET
CORONA, NM 88318
(575)849-1561
Lincoln
323996
HOLY CROSS HOSPITAL RURAL HEALTH
#24 STATE ROAD 73
PENASCO, NM 87553
(575)587-1833
Taos
323400
LOVINGTON CLINIC
1600 A NORTH MAIN
LOVINGTON, NM 88260
(575)396-3529
Lea
323401
702 NORTH 13TH
ARTESIA, NM 88210
(575)746-3119
Eddy
323402
MEMORIAL FAMILY PRACTICE AT ARTESIA
GENERAL HOSP
RGH CLINIC - PORTALES
42121 US HWY 70
PORTALES, NM 88130
(575)356-6652
Roosevelt
323999
SIERRA VISTA COMMUNITY HEALTH CENTER
800 EAST NINTH AVENUE
T OR C, NM 87901
(575)743-1202
Sierra
323984
TATUM CLINIC
204 NORTH MAIN
TATUM, NM 88267
(505)398-2111
Lea
323988
VALLEY HEALTH CLINIC OF EASTERN NM
116 EAST SECOND STREET
DEXTER, NM 88230
(505)734-5817
Chaves
Total Providers for this State = 9
Run Date: 10/08/2015
Job # 41303463
Last Update: 10/07/2015
Page 1 of 2
CASPER Report 0006D
Name and Address Listing
For Rural Health Clinic
Based on Current Survey
Oklahoma
CCN
Provider Name
Address
City, State and ZIP
Telephone # County Name
373862
A B C MEDICAL CLINIC, PLLC
1510 SOUTH VIRGINIA
ATOKA, OK 74525
(580)889-3355
Atoka
373999
BUSTER RURAL HEALTH CLINIC
101 F K BUSTER AVENUE
CHEYENNE, OK 73628
(580)497-3333
Roger Mills
373875
CHEROKEE FAMILY CLINIC
221 SOUTH GRAND
CHEROKEE, OK 73728
(580)596-3516
Alfalfa
373459
CIMARRON MEMORIAL RURAL HEALTH CLINIC
102 SOUTH ELLIS
BOISE CITY, OK 73933
(580)544-3008
Cimarron
373868
CLINICO, L L C
103 EAST MAIN
BEGGS, OK 74421
(918)267-7000
Okmulgee
373422
COMANCHE COUNTY HOSPITAL AUTHORITY
624 SOUTH COBB LAKE
APACHE, OK 73006
(580)588-3257
Caddo
373402
COMMUNITY CLINIC OF BEAVER
718 AVENUE A
BEAVER, OK 73932
(580)625-3477
Beaver
373408
COMMUNITY CLINIC OF TURPIN
104 NORTH HIBBS
TURPIN, OK 73950
(580)778-3966
Beaver
373828
DOCTORS CLINIC OF DURANT, INC
1400 BRYAN DRIVE, SUITE 300
DURANT, OK 74701
(580)924-1700
Bryan
373464
DRUMRIGHT RURAL HEALTH CLINIC
610 WEST BYPASS
DRUMRIGHT, OK 74030
(918)382-2300
Creek
373468
FAIRFAX RURAL HEALTH CLINIC
40 HOSPITAL ROAD
FAIRFAX, OK 74637
(918)642-3291
Osage
373400
FAIRVIEW FAMILY CLINIC
519 EAST STATE ROAD
FAIRVIEW, OK 73837
(580)227-2585
Major
373442
FAMILY CLINIC OF RINGLING
502 SOUTH 6TH STREET
RINGLING, OK 73456
(580)662-2316
Jefferson
373819
FAMILY CLINIC OF WELEETKA
315 WEST 9TH
WELEETKA, OK 74880
(405)786-2248
Okfuskee
373479
FAMILY MEDICAL CLINIC
104 WALL STREET
POTEAU, OK 74953
(918)647-8635
Le Flore
373478
FIVE OAKS FAMILY MEDICAL CLINIC
2100 W IOWA AVENUE, SUITE A
CHICKASHA, OK 73018
(405)224-2100
Grady
373874
GARBER FAMILY CLINIC
316 MAIN STREET
GARBER, OK 73738
(580)863-2204
Garfield
373461
GRAND LAKE MEDICAL PARK
36488 SOUTH HIGHWAY 82
LANGLEY, OK 74350
(918)782-1881
Mayes
373465
GRAND LAKE MEDICAL PARK
26300 SOUTH HWY 125
AFTON, OK 74331
(918)257-8585
Ottawa
373860
GREEN COUNTRY MEDICAL CLINIC
238 WILLOW STREET
SOUTH COFFEYVILLE, OK 74072
(918)255-6000
Nowata
373480
HEAVENER MEDICAL CLINIC
304 HWY 59 NORTH
HEAVENER, OK 74937
(918)647-8161
Le Flore
373823
HELTON RURAL HEALTH CLINIC
108 WEST OHIO
COALGATE, OK 74538
(580)927-2334
Coal
373879
HINTON FAMILY MEDICAL CLINIC
1500 NORTH BROADWAY
HINTON, OK 73047
(405)542-6131
Caddo
373994
100 MCDOUGAL DRIVE
HOLDENVILLE, OK 74848
(405)379-6631
Hughes
1401 WEST 1ST STREET
WEWOKA, OK 74884
(405)257-3396
Seminole
373833
HOLDENVILLE GENERAL HOSPITAL RURAL
HEALTH CLINIC
HOLDENVILLE GENERAL HOSPITAL WEWOKA
HEALTH CLINIC
HUGO RURAL HEALTH CLINIC
1201 EAST JACKSON
HUGO, OK 74743
(580)326-6423
Choctaw
373876
HUSSAINS FAMILY PRACTICE
139 EAST MAIN STREET
WILBURTON, OK 74578
(918)465-5727
Latimer
373870
INTEGRIS KINGSTON MEDICAL CLINIC
701 EAST HIGHWAY 70
KINGSTON, OK 73439
(580)564-4944
Marshall
373977
MAYSVILLE MEDICAL CENTER
504 WILLIAMS
MAYSVILLE, OK 73057
(405)867-4404
Garvin
373455
MCALESTER REGIONAL RURAL HEALTH CLINIC
ROUTE 1, BOX 51
EUFAULA, OK 74432
(918)452-2330
Mcintosh
373873
MEDFORD FAMILY CLINIC
158-B SUNSET DRIVE
MEDFORD, OK 73759
(580)395-2319
Grant
373429
MERCY HEALTH LOVE COUNTY RURAL HEALTH 301 WANDA
CLINIC
MERCY HOSPITAL HEALDTON - PRIMARY CARE 3472 HOSPITAL ROAD
MARIETTA, OK 73448
(580)276-2400
Love
HEALDTON, OK 73438
(580)229-0701
Carter
373477
373472
Run Date: 10/08/2015
Job # 41303463
Last Update: 10/07/2015
Page 2 of 2
CASPER Report 0006D
Name and Address Listing
For Rural Health Clinic
Based on Current Survey
Oklahoma
CCN
Provider Name
Address
City, State and ZIP
Telephone # County Name
373993
MERCY HOSPITAL LOGAN COUNTY - GUTHRIE
DIVISION
MERCY HOSPITAL LOGAN COUNTY, INC
2919 SOUTH DIVISION STREET
GUTHRIE, OK 73044
(405)282-6301
Logan
400 SOUTH GRAND
CRESCENT, OK 73028
(405)969-2818
Logan
373990
373830
NOWATA COUNTY RURAL HEALTH CLI
712 EAST OSAGE
NOWATA, OK 74048
(918)273-0140
Nowata
373462
PRAGUE FAMILY CLINIC
1322 KLABZUBA AVENUE
PRAGUE, OK 74864
(405)567-4922
Lincoln
373463
QUARTZ MOUNTAIN MEDICAL CLINIC MANGUM
118 LOUIS TITTLE AVE
MANGUM, OK 73554
(580)782-2113
Greer
373449
RUSH SPRINGS FAMILY MEDICAL CLINIC
113 SOUTH RUSH
RUSH SPRINGS, OK 73082
(580)476-2527
Grady
373979
RYAN HEALTH CLINIC
1104 SOUTH 6TH STREET
RYAN, OK 73565
(580)757-2451
Jefferson
373834
RYAN MEDICAL CLINIC, L L C
514 WASHINGTON STREET
RYAN, OK 73565
(580)757-2224
Jefferson
373824
SIGGINS MEMORIAL CLINIC
112 NORTH 5TH STREET
BARNSDALL, OK 74002
(918)847-2558
Osage
373470
SMHA RHC
US HIGHWAY 60 NORTHEAST
SEILING, OK 73663
(580)922-7361
Dewey
373443
SNYDER MEDICAL CLINIC
823 'D' STREET
SNYDER, OK 73566
(580)569-2373
Kiowa
373878
SOUTHEASTERN OKLAHOMA FAMILY
SERVICES, INC
THE PAWNEE CLINIC
39 EAST FOLEY
EUFAULA, OK 74432
(918)618-4766
Mcintosh
535 6TH STREET
PAWNEE, OK 74058
(918)762-3972
Pawnee
373471
373469
VICI RURAL HEALTH CLINIC
104 WEST BROADWAY STREET
VICI, OK 73859
(580)995-3004
Dewey
373854
WATONGA FAMILY CARE
407 NORTH CLARENCE NASH BOULEVARD
WATONGA, OK 73772
(580)623-4954
Blaine
373872
WAYNOKA FAMILY CLINIC
503 SOUTH NICKERSON
WAYNOKA, OK 73860
(580)824-2291
Woods
373466
WELCH FAMILY CLINIC
343 SOUTH COMMERCIAL STREET
WELCH, OK 74369
(918)788-3919
Craig
373475
WOODWARD CLINIC
1101 HILLCREST DRIVE
WOODWARD, OK 73801
(580)256-3608
Woodward
373474
WOODWARD CLINIC
1810 KANSAS AVENUE
WOODWARD, OK 73801
(580)254-3174
Woodward
373473
WOODWARD CLINIC
908 19TH STREET
WOODWARD, OK 73801
(580)256-1789
Woodward
373476
WOODWARD CLINIC
1818 KANSAS AVENUE
WOODWARD, OK 73801
(580)254-3396
Woodward
Total Providers for this State = 54
Run Date: 10/08/2015
Job # 41303463
Last Update: 10/07/2015
Page 1 of 9
CASPER Report 0006D
Name and Address Listing
For Rural Health Clinic
Based on Current Survey
Texas
CCN
Provider Name
Address
City, State and ZIP
Telephone # County Name
673916
ALFONSO H LUEVANO, MD PA
302 S 5TH STREET
CARRIZO SPRINGS, TX 78834
(830)876-9458
Dimmit
453956
ALICE PEDIATRIC CLINIC
305 EAST THIRD ST
ALICE, TX 78332
(361)664-5291
Jim Wells
453955
ALPINE MEDICAL CENTER
202 NORTH 2ND ST
ALPINE, TX 79830
(432)837-5505
Brewster
453934
ALVORD MEDICAL CLINIC
115 E BYPASS 287
ALVORD, TX 76225
(940)427-2858
Wise
458655
ANDREWS FAMILY MEDICINE
700 HOSPITAL DRIVE
ANDREWS, TX 79714
(915)523-6624
Andrews
673989
ANSON FAMILY WELLNESS CLINIC
215 N AVE J
ANSON, TX 79501
(325)823-3209
Jones
673413
ARCHER CITY RHC
404 E CHESTNUT
ARCHER CITY, TX 76351
(940)564-5521
Archer
673927
AUSTIN OBGYN
301 HIGHWAY 71 W, SUITE 111
BASTROP, TX 78602
(512)304-0318
Bastrop
458813
AUSTWELL TIVOLI MEDICAL CLINIC
106 W WILSON
TIVOLI, TX 77990
(361)286-0115
Refugio
458867
BALLINGER HOSPITAL CLINIC
2001 HUTCHINS AVE, SUITE C
BALLINGER, TX 76821
(325)365-2531
Runnels
673835
BEEVILLE FAMILY PRACTICE LLP
302 S HILLSIDE DRIVE
BEEVILLE, TX 78102
(361)358-9912
Bee
458572
BOGATA MEDICAL CLINIC
600 PARIS RD
BOGATA, TX 75417
(903)632-5632
Red River
673821
BORGER MEDICAL CLINIC
104 NORTH BRYAN
BORGER, TX 79007
(806)274-2986
Hutchinson
458828
BRADY MEDICAL CLINIC
2010 NINE ROAD
BRADY, TX 76825
(325)597-2114
Mcculloch
458881
BRECKENRIDGE MEDICAL CENTER
101 S HARTFORD
BRECKENRIDGE, TX 76424
(254)559-3363
Stephens
453828
BRENHAM CLINIC
600 N PARK
BRENHAM, TX 77833
(979)836-6153
Washington
673862
BRENHAM CLINIC-BELLVILLE
235 WEST PALM SUITE 106
BELLVILLE, TX 77418
(979)865-9391
Austin
458832
BRIDGE TO HEALTH MOBILE CLINIC
400 SOUTHWEST 25TH AVENUE
MINERAL WELLS, TX 76067
(940)325-7891
Palo Pinto
458821
BROWNFIELD REGIONAL MEDICAL CENTER
703 EAST FELT STREET
BROWNFIELD, TX 79316
(806)637-1955
Terry
673926
BSZ MEDICAL PA
256 MEDICAL DR
JOURDANTON, TX 78026
(830)769-9900
Atascosa
673844
BUNA MEDICAL CLINIC
35607 HWY 96 SOUTH
BUNA, TX 77612
(409)994-9323
Jasper
458940
CADENHEAD RURAL HEALTH CLINIC
1417 NORTH 1ST SUITE A
HASKELL, TX 79521
(940)864-2636
Haskell
673902
CAMPBELL CLINIC
1517 TEXAS DRIVE
WEATHERFORD, TX 76086
(817)458-3300
Parker
673878
CANYON LAKE MEDICAL CLINIC
1356 FM 2673
CANYON LAKE, TX 78133
(830)964-3019
Comal
458906
CENTER RURAL HEALTH CLINIC
620 TENAHA
CENTER, TX 75935
(936)598-2716
Shelby
673855
CHILDRENS CLINIC OF DIMMIT AND
403 SOUTH 7TH STREET
CARRIZO SPRINGS, TX 78834
(830)876-9870
Dimmit
453426
CHRISTUS FAMILY PRACTICE CENTER KIRBYVILLE
CHRISTUS FAMILY PRACTICE CENTER JASPER
205 E LAVIELLE
KIRBYVILLE, TX 75956
(409)423-2217
Jasper
1276 SOUTH PEACHTREE STREET
JASPER, TX 75951
(409)384-5701
Jasper
2427 W RECREATIONAL RD 255
BROOKELAND, TX 75931
(409)698-9600
Sabine
1038 TEXAS YES BLVD
ROBSTOWN, TX 78380
(361)767-1200
Nueces
458855
CHRISTUS FAMILY PRACTICE CENTER SAM
RAYBURN
CHRISTUS SPOHN FAMILY HEALTH CENTER
ROBSTOWN
CHRISTUS SPOHN FAMILY HEALTH FREER
111 RILEY STREET
FREER, TX 78357
(361)394-7311
Duval
458771
CHRISTUS SPOHN WOMEN'S CENTER
301 SOUTH HILLSIDE, SUITE 4
BEEVILLE, TX 78102
(361)358-6249
Bee
673810
CLARENDON FAMILY MEDICAL CENTER
ONE MEDICAL CENTER DR POD K
CLARENDON, TX 79226
(806)874-3531
Donley
673819
CLAUDE FAMILY MEDICAL CLINIC LLC
201 PARKS STREET
CLAUDE, TX 79019
(806)226-5611
Armstrong
453480
458514
458612
Run Date: 10/08/2015
Job # 41303463
Last Update: 10/07/2015
Page 2 of 9
CASPER Report 0006D
Name and Address Listing
For Rural Health Clinic
Based on Current Survey
Texas
CCN
Provider Name
Address
City, State and ZIP
Telephone # County Name
458779
CLEARFORK HEALTH CENTER
774 STATE HWY 70N, PO DRAWER L
ROTAN, TX 79546
(325)735-2256
Fisher
673995
CLIFTON MEDICAL CLINIC
201 S AVE T
CLIFTON, TX 76634
(254)675-8621
Bosque
673897
CLINIC FOR FAMILY WELLNESS, PLLC
1645 N 18TH STREET
MEMPHIS, TX 79245
(806)259-1058
Hall
453928
COASTAL BEND PEDIATRIC CTR
160 S 13TH ST
ARANSAS PASS, TX 78336
(361)758-1984
San Patricio
673904
COASTAL MEDICAL CLINIC
1704 JENKINS STREET
ROCKPORT, TX 78382
(361)790-9047
Aransas
458838
COGDELL CLINIC
320 NORTH MAIN
LOCKNEY, TX 79241
(806)652-3373
Floyd
458875
COGDELL CLINIC BRISCOE COUNTY
701 COMMERCE STREET
SILVERTON, TX 79257
(806)823-2449
Briscoe
458827
COGDELL FAMILY CLINIC
5009 COLLEGE AVENUE
SNYDER, TX 79549
(432)574-7166
Scurry
673402
COLEMAN MEDICAL ASSOCIATES
310 SOUTH PECOS 2ND FLOOR
COLEMAN, TX 76834
(915)625-3533
Coleman
458842
COLLINGSWORTH FAMILY MEDICINE
1014 15TH STREET
WELLINGTON, TX 79095
(806)447-5311
Collingsworth
458608
COLUMBUS MEDICAL CLINIC
2122 HIGHWAY 71 SOUTH
COLUMBUS, TX 78934
(979)732-2318
Colorado
453862
COMMUNITY HEALTH CLINIC LLP
160 RIVER NORTH BLVD
STEPHENVILLE, TX 76401
(254)965-2500
Erath
458910
COMPLETE HEALTHCARE SERVICE PA
315 WEST HOUSTON
JASPER, TX 75951
(409)384-3430
Jasper
458896
COOKE COUNTY MEDICAL CENTER
801 N GRAND AVENUE STE 1
GAINESVILLE, TX 76240
(940)668-7231
Cooke
673910
COVENANT FAMILY HEALTHCARE CENTER
409 8TH ST
ABERNATHY, TX 79311
(806)298-5884
Hale
673992
COVENANT HEALTHCARE CENTER PLAINVIEW
2222 W 24TH ST SUITE 6
PLAINVIEW, TX 79072
(806)293-5113
Hale
453423
CRANE COUNTY RURAL HEALTH CLINIC
1310 SOUTH ALFORD STREET
CRANE, TX 79731
(432)558-3758
Crane
673889
CRANE MEDICAL CLINIC PA
102 S GASTON ST
CRANE, TX 79731
(432)558-2223
Crane
458829
710 WEST MAIN
CROSBYTON, TX 79322
(806)675-7382
Crosby
453898
CROSBYTON CLINIC HOSPITAL RURAL HEALTH
CLINIC
CUERO MEDICAL CLINIC
2500 N ESPLANADE STREET SUITE 102
CUERO, TX 77954
(361)275-3466
De Witt
458816
DALHART FAMILY MEDICINE CLINIC
206 EAST 16TH STREET
DALHART, TX 79022
(806)249-5668
Dallam
673876
DEWEYVILLE RURAL HEALTH CLINIC
2493 HWY 12 E
DEWEYVILLE, TX 77614
(409)746-7000
Newton
458562
DOCTORS MEDICAL CENTER
10201 HWY 16N
COMANCHE, TX 76442
(254)879-4910
Comanche
673830
DUBLIN FAMILY MEDICINE
305 N PATRICK STREET
DUBLIN, TX 76446
(254)445-4900
Erath
453944
DUMAS FAMILY PRACTICE
202 S MEREDITH
DUMAS, TX 79029
(806)935-9005
Moore
453819
EAGLE PASS PEDIATRIC HLTH CLIN
2198 EAST GARRISON STREET
EAGLE PASS, TX 78852
(830)773-1103
Maverick
458846
409 COTTAGE ROAD SUITE A
CARTHAGE, TX 75633
(903)693-6626
Panola
300 WILSON STREET 2E
HENDERSON, TX 75652
(903)655-6536
Rusk
458763
EAST TEXAS MED CNTR CARTHAGE HEALTH
CTR
EAST TEXAS MEDICAL CENTER HENDERSON
FAMILY HEALTH
EAST TEXAS PEDIATRICS
618 S GROVE STE 100
MARSHALL, TX 75670
(903)935-5242
Harrison
453832
EDUARDO MORENO M D RHC
210 S AVE C
CRYSTAL CITY, TX 78839
(830)374-2952
Zavala
453911
ELLINGTON RHC
1011 S WILLIAM ST
ATLANTA, TX 75551
(903)796-2868
Cass
458782
ETMC COMMUNITY HEALTH CLINIC
315 PROSPECT DR
TRINITY, TX 75862
(936)594-3595
Trinity
453411
ETMC FAMILY MEDICAL CENTER RHC
1050 LOOP 304 EAST
CROCKETT, TX 75835
(936)544-7856
Houston
453447
ETMC FIRST PHYSICIAN CLINIC MINEOLA
5875 S STATE HWY 37
MINEOLA, TX 75773
(903)569-6124
Wood
458714
Run Date: 10/08/2015
Job # 41303463
Last Update: 10/07/2015
Page 3 of 9
CASPER Report 0006D
Name and Address Listing
For Rural Health Clinic
Based on Current Survey
Texas
CCN
Provider Name
Address
City, State and ZIP
Telephone # County Name
458854
ETMC FIRST PHYSICIANS CLINIC
702 DAVIS ST
CARTHAGE, TX 75633
(903)694-2213
Panola
458852
ETMC FIRST PHYSICIANS CLINIC - QUITMAN
108 PARKER ST STE 100
QUITMAN, TX 75783
(903)763-6322
Wood
673410
ETMC FIRST PHYSICIANS CLINIC ATHENS
2000 SOUTH PALESTINE
ATHENS, TX 75751
(903)676-1134
Henderson
458892
ETMC FIRST PHYSICIANS CLINIC CENTER II
1743 SOUTHVIEW CIRCLE
CENTER, TX 75935
(936)591-8888
Shelby
673408
ETMC FIRST PHYSICIANS CLINIC CENTER III
233 HURST STREET
CENTER, TX 75935
(903)590-4035
Shelby
458502
ETMC FIRST PHYSICIANS CLINIC FAIRFIELD
734 WEST COMMERCE
FAIRFIELD, TX 75840
(903)389-2181
Freestone
458888
ETMC FIRST PHYSICIANS CLINIC FRANKSTON
580 N FRANKSTON HWY
FRANKSTON, TX 75763
(903)876-5888
Anderson
673400
ETMC FIRST PHYSICIANS CLINIC JACKSONVILLE 203 NACOGDOCHES ST, STE 280
JACKSONVILLE, TX 75766
(903)541-5378
Cherokee
458891
ETMC FIRST PHYSICIANS CLINIC RUSK
1325 N DICKINSON DR
RUSK, TX 75785
(903)683-3600
Cherokee
458850
ETMC FIRST PHYSICIANS HEALTH CLINIC
2701 US HWY 271
PITTSBURG, TX 75686
(903)856-4242
Camp
453977
FALLS COMMUNITY CLINIC
307 LIVE OAK ST
MARLIN, TX 76661
(254)803-3561
Falls
458547
FAMILY CARE CENTER
387 WEST IH 10, STE 1
FORT STOCKTON, TX 79735
(432)336-2058
Pecos
673403
FAMILY CARE CENTER
1700 BRAZOS STREET STE A&B
ROCKDALE, TX 76567
(512)446-4535
Milam
453863
FAMILY CARE CLINIC
119 EAST ACADEMY
DEL RIO, TX 78840
(830)774-4094
Val Verde
458617
FAMILY CARE CLINIC
1010 SOUTH MAIN
SHAMROCK, TX 79079
(806)256-5148
Wheeler
458913
FAMILY DIAGNOSTIC MEDICAL CENT
1323 E FRANKLIN STREET STE 105
HILLSBORO, TX 76645
(254)582-7481
Hill
453812
FAMILY HEALTH CENTER L L P
2768 PHARMACY ROAD
RIO GRANDE CITY, TX 78582
(956)487-5621
Starr
673841
FAMILY HEALTH CENTER OF OZONA
104 NORTH AVENUE H
OZONA, TX 76943
(325)392-3788
Crockett
673416
FAMILY HEALTH CLINIC OF SANTO
13965 SOUTH FM 4
SANTO, TX 76472
(940)769-2303
Palo Pinto
673913
FAMILY HEALTHCARE- WOODVILLE
920 N MAGNOLIA
WOODVILLE, TX 75979
(409)283-5556
Tyler
673880
FAMILY HEALTHCARE-KIRBYVILLE
1905 N MARGARET AVE
KIRBYVILLE, TX 75956
(409)420-0816
Jasper
453849
FAMILY MEDICAL & SPECIALTY CLINIC
2790 PHARMACY ROAD
RIO GRANDE CITY, TX 78582
(956)487-5621
Starr
453403
FAMILY MEDICAL ASSOCIATES
997 WEST I 20
COLORADO CITY, TX 79512
(325)728-2693
Mitchell
458707
FAMILY MEDICAL CLINIC OF HANSFORD
705 WEST 7TH
SPEARMAN, TX 79081
(806)659-2846
Hansford
453943
FAMILY MEDICAL CTR OF MONAHANS
405 SOUTH MAIN, SUITE 100
MONAHANS, TX 79756
(432)943-7537
Ward
453984
FAMILY MEDICINE CENTER
701 MCCLINTIC DRIVE
GROESBECK, TX 76642
(254)729-3411
Limestone
673920
FAMILY MEDICINE CLINIC
2401 WALKER PLACE BLVD
COPPERAS COVE, TX 76522
(254)547-5516
Coryell
458822
FAMILY MEDICINE CLINIC OF SUNDOWN
209 EAST RICHARDSON
SUNDOWN, TX 79372
(806)229-3229
Hockley
458605
FAMILY MEDICINE OF LEVELLAND
116 JOHN DUPRE DRIVE
LEVELLAND, TX 79336
(806)894-7900
Hockley
458905
FAMILY MEDICINE RURAL HEALTH CLINIC, PA
207 WEST AVENUE E
LAMPASAS, TX 76550
(512)556-3621
Lampasas
453818
FAMILY PRACTICE CENTER OF UVALDE
126 W NOPAL
UVALDE, TX 78801
(830)278-7101
Uvalde
458895
FAMILY PRACTICE CLINIC OF MILLS COUNTY
1501 W FRONT STREET
GOLDTHWAITE, TX 76844
(325)648-2850
Mills
458540
FAMILY PRACTICE RURAL HEALTH C
400 N BROWN STREET
HAMILTON, TX 76531
(254)386-3102
Hamilton
458527
FCHC BREMOND CLINIC
201 SOUTH MAIN
BREMOND, TX 76629
(254)746-7264
Robertson
458870
FCHC ROSEBUD MEDICAL CLINIC
312 NORTH STALLWORTH
ROSEBUD, TX 76570
(254)803-3561
Falls
Run Date: 10/08/2015
Job # 41303463
Last Update: 10/07/2015
Page 4 of 9
CASPER Report 0006D
Name and Address Listing
For Rural Health Clinic
Based on Current Survey
Texas
CCN
Provider Name
Address
City, State and ZIP
Telephone # County Name
453405
FLATONIA COMMUNITY CLINIC
113 W SOUTH MAIN STREET
FLATONIA, TX 78941
(512)865-3561
Fayette
673853
FLORESVILLE FAMILY MEDICAL CENTER
921 10TH STREET SUITE 111
FLORESVILLE, TX 78114
(830)216-7979
Wilson
458848
FOARD COUNTY MEDICAL CLINIC
200 NORTH FIRST STREET
CROWELL, TX 79227
(940)684-1515
Foard
453415
FOUR OAKS MEDICAL CLINIC
109 SHULT DR
COLUMBUS, TX 78934
(979)732-5794
Colorado
453996
FOX RURAL HEALTH CLINIC
1001 HWY 83 N
CHILDRESS, TX 79201
(940)937-3636
Childress
673899
FRED HEALTH CARE PLLC
20290 S FM 92
FRED, TX 77616
(409)429-9494
Tyler
673418
FRIONA RHC
1307 CLEVELAND
FRIONA, TX 79035
(806)250-2781
Parmer
458778
FRITCH MEDICAL CLINIC
700 WEST BROADWAY
FRITCH, TX 79036
(806)857-2311
Hutchinson
673907
FRONTERA PEDIATRICS PA
109 W MARTIN STREET
DEL RIO, TX 78840
(830)778-5439
Val Verde
673909
GARFIELD MEDICAL CLINIC
404 E SAN MARCOS ST
PEARSALL, TX 78061
(830)334-3336
Frio
673888
GARFIELD MEDICAL CLINIC
205 N COMMERCE STREET
DILLEY, TX 78017
(830)965-4466
Frio
458927
GARFIELD MEDICAL CLINIC
408 N GIRAUD
COTULLA, TX 78014
(830)879-2279
La Salle
453936
GARNER FIELD FAMILY MEDICINE, PA
524 E NOPAL ST
UVALDE, TX 78801
(830)278-4588
Uvalde
458894
GEORGE RURAL HEALTH CLINIC
511 NORTH MAIN
FORT STOCKTON, TX 79735
(432)336-2291
Pecos
673903
GEORGE WEST FAMILY MEDICAL CLINIC
801 HOUSTON
GEORGE WEST, TX 78022
(361)449-1947
Live Oak
673924
GOLDEN PLAINS RURAL HEALTH CLINIC
100 S MCGEE
BORGER, TX 79007
(806)273-5131
Hutchinson
673877
GOLIAD FAMILY PRACTICE
139 WEST FRANKLIN STREET
GOLIAD, TX 77963
(361)645-8235
Goliad
458883
402 N KAUFMAN
LINDEN, TX 75563
(903)756-5581
Cass
458916
GOOD SHEPHERD GLENN GARRETT CLINIC
LINDEN
GRACE AND MERCY HEALTH CLINIC
100 S E 4TH STREET
KERENS, TX 75144
(903)396-7217
Navarro
673854
GROVETON FAMILY MEDICAL CLINIC
110 MAGEE ST
GROVETON, TX 75845
(936)642-0841
Trinity
673424
HAMLIN MEDICAL CLINIC
350 NORTHWEST AVENUE F
HAMLIN, TX 79520
(325)597-3611
Jones
458893
HARDEMAN COUNTY CLINIC
404 MERCER STREET
QUANAH, TX 79252
(940)663-6651
Hardeman
458831
HEREFORD HEALTH CLINIC
540 W 15TH ST
HEREFORD, TX 79045
(806)364-7512
Deaf Smith
458878
HICO CLINIC
104 WALNUT STREET
HICO, TX 76457
(254)796-4224
Hamilton
673409
201 TEXAS BLVD
DALHART, TX 79022
(806)249-8324
Dallam
453859
HIGH COUNTRY COMMUNITY RURAL HEALTH
CLINIC
HOOD MEDICAL CLINIC
207 TILDEN STREET
COTULLA, TX 78014
(830)879-2358
La Salle
453860
HOOD MEDICAL CLINIC OF DILLEY
111 E MILLER
DILLEY, TX 78017
(830)965-1684
Frio
458978
HOOD MEDICAL CLINICS-PEARSALL
325 N CHERRY STR
PEARSALL, TX 78061
(830)334-8703
Frio
673976
HUNTSVILLE MEMORIAL HOSPITAL
125 MEDICAL PARK LANE, SUITE C
HUNTSVILLE, TX 77340
(936)291-3219
Walker
458899
HUNTSVILLE MEMORIAL HOSPITAL
1613 EAST MAIN STREET
MADISONVILLE, TX 77864
(936)349-0359
Madison
453888
INTERNAL MEDICINE CLINIC OF UVALDE
214 RIVERSIDE DRIVE
UVALDE, TX 78801
(830)278-6681
Uvalde
673425
IOWA PARK CLINIC
405 SE ACCESS ROAD
IOWA PARK, TX 76367
(940)495-3981
Wichita
673404
JACK COUNTY MEDICAL CLINIC
717 MAGNOLIA ST
JACKSBORO, TX 76458
(940)567-6633
Jack
458736
JACKSON COUNTY MEDICAL CLINIC OF EDNA
1013 A SOUTH WELLS STREET
EDNA, TX 77957
(361)782-7820
Jackson
Run Date: 10/08/2015
Job # 41303463
Last Update: 10/07/2015
Page 5 of 9
CASPER Report 0006D
Name and Address Listing
For Rural Health Clinic
Based on Current Survey
Texas
CCN
Provider Name
Address
City, State and ZIP
Telephone # County Name
673923
JASPER FAMILY HEALTH & WELLNESS RURAL
CLINIC
JOURDANTON FAMILY HEALTH CENTE
492 SPRINGHILL STREET, SUITE B
JASPER, TX 75951
(409)381-5751
Jasper
1540 WEST GOODWIN
PLEASANTON, TX 78064
(830)569-6340
Atascosa
458965
458531
JUNCTION MEDICAL CLINIC
399 REID ROAD
JUNCTION, TX 76849
(325)446-3305
Kimble
458833
KNOX COUNTY HOSPITAL CLINIC
712 SOUTH 5TH STREET
KNOX CITY, TX 79529
(940)657-3535
Knox
673994
LAVACA FAMILY HEALTH CLINIC
1406 N TEXANA STREET
HALLETTSVILLE, TX 77964
(361)798-1200
Lavaca
453825
LAVERNIA FAMILY MEDICAL CENTER
402 W CHIHUAHUA STREET
LA VERNIA, TX 78121
(830)779-3800
Wilson
673988
LEVELLAND CLINIC
1804 SOUTH COLLEGE AVENUE
LEVELLAND, TX 79336
(806)894-3141
Hockley
458815
LEVELLAND CLINIC NORTH
103 JOHN DUPREE
LEVELLAND, TX 79336
(806)894-2465
Hockley
458836
LHC FAMILY MEDICINE
1600 SOUTH SUNSET
LITTLEFIELD, TX 79339
(806)385-6424
Lamb
453892
LIBERTY MEDICAL RHC
720 TRAVIS ST
LIBERTY, TX 77575
(936)336-6439
Liberty
458889
LITTLE RIVER HEALTHCARE CAMERON CLINIC
708 N CROCKETT
CAMERON, TX 76520
(254)697-6554
Milam
458590
LITTLE RIVER HEALTHCARE ROCKDALE CLINIC
602 NORTH MAIN
ROCKDALE, TX 76567
(512)446-4555
Milam
453918
LIVE OAK PROFESSIONAL CENTER
1705 LIVE OAK
COMMERCE, TX 75428
(903)886-8818
Hunt
458934
LOS FRESNOS MEDICINE
725 OCEAN STREET
LOS FRESNOS, TX 78566
(956)233-3443
Cameron
458863
LOVETT MEREDITH RURAL HEALTH CLINIC
306 WEST MAIN STREET
OLNEY, TX 76374
(940)564-3546
Young
673421
LYNN COUNTY HOSPITAL DISTRIC FAMILY
WELLNESS RURAL
MARATHON HEALTH CENTER
1809 LOCKWOOD ST
TAHOKA, TX 79373
(806)998-4533
Lynn
101 SOUTH FIRST
MARATHON, TX 79842
(432)386-4316
Brewster
673808
673412
MARATHON RURAL HEALTH CENTER
101 SOUTH POST ROAD
MARATHON, TX 79842
(432)336-4200
Brewster
453496
MARSHALL HEALTH CLINIC
805 LINDSEY
MARSHALL, TX 75670
(903)927-6140
Harrison
458824
MARSHALL PEDIATRIC CLINIC
707 S GROVE ST
MARSHALL, TX 75670
(903)927-6620
Harrison
458868
MARTIN COUNTY FAMILY CLINIC
207 N LAMESA HWY
STANTON, TX 79782
(432)756-3345
Martin
673928
MATHIS MEDICAL CENTER PA
304 E PATRICIO AVENUE
MATHIS, TX 78368
(361)547-2203
San Patricio
458681
MCCAMEY HOSPITAL RURAL HEALTH
2500 HWY 305 SOUTH
MCCAMEY, TX 79752
(432)652-8626
Upton
453466
MEDICAL ARTS CLINIC
2202 N BRYAN AVENUE
LAMESA, TX 79331
(806)872-7494
Dawson
458679
MEDICAL CENTER OF DIMMITT
300 W HALSELL
DIMMITT, TX 79027
(806)647-2194
Castro
458872
MEDICAL CLINIC OF CASTROVILLE
1028 COUNTRY LANE
CASTROVILLE, TX 78009
(830)538-3035
Medina
453982
MEDICAL CLINIC OF DEVINE
1250 STATE HIGHWAY 173 NORTH
DEVINE, TX 78016
(830)665-2876
Medina
453981
MEDICAL CLINIC OF HONDO
3200 AVENUE E
HONDO, TX 78861
(830)426-7444
Medina
453963
MEMORIAL CLINIC
105 MEDICAL PLAZA
SULPHUR SPRINGS, TX 75482
(903)885-3181
Hopkins
673811
MEMORIAL CLINIC
650 E LENNON
EMORY, TX 75440
(903)473-7234
Rains
458611
MEMORIAL HEALTH CLINIC
1303 MABEE DRIVE
STAMFORD, TX 79553
(915)773-5733
Jones
673411
MEMORIAL HOSPITAL
110 SOUTH BLISS AVE
DUMAS, TX 79029
(806)935-6599
Moore
673422
MEMORIAL MEDICAL CLINIC
815 N VIRGINIA STREET
PORT LAVACA, TX 77979
(361)552-0325
Calhoun
453463
MID COAST MEDICAL CLINIC
305 SANDY CORNER ROAD, SUITE 120
EL CAMPO, TX 77437
(409)543-5510
Wharton
Run Date: 10/08/2015
Job # 41303463
Last Update: 10/07/2015
Page 6 of 9
CASPER Report 0006D
Name and Address Listing
For Rural Health Clinic
Based on Current Survey
Texas
CCN
Provider Name
Address
City, State and ZIP
Telephone # County Name
458530
MILLS COUNTY MEDICAL CLINIC
1510 HANNAH VALLEY ROAD
GOLDTHWAITE, TX 76844
(325)648-2263
Mills
458784
MMH FAMILY HEALTH CLINIC
509 N MAPLE ST
MUENSTER, TX 76252
(940)759-2226
Cooke
458809
MORTON RURAL HEALTH CLINIC
210 EAST GRANT
MORTON, TX 79346
(806)266-5565
Cochran
458897
MOTHER FRANCES HOSPITAL WINNSBORO RHC 719 W COKE RD MOB 4
WINNSBORO, TX 75494
(903)342-0407
Wood
458898
MOTLEY COUNTY CLINIC
1224 MAIN STREET, PO BOX 136
MATADOR, TX 79244
(806)347-2641
Motley
458968
MOULTON CLINIC
100 SOUTH PECAN
MOULTON, TX 77975
(361)596-4675
Lavaca
458652
MULESHOE AREA MEDICAL CLINIC
701 SOUTH 1ST STREET
MULESHOE, TX 79347
(806)272-4524
Bailey
458835
MUNDAY CLINIC
120 EAST D STREET
MUNDAY, TX 76371
(940)422-5271
Knox
458970
NEW BRAUNFELS PEDIATRIC ASSOCI
1535 E COMMON
NEW BRAUNFELS, TX 78130
(830)625-9153
Comal
458999
NEW BRAUNFELS RURAL HEALTH CLI
189 E AUSTIN STREET SUITE 106
NEW BRAUNFELS, TX 78130
(830)629-3614
Comal
673840
NEWTON FAMILY RURAL HEALTH CLINIC
207 EAST COURT
NEWTON, TX 75966
(409)379-2647
Newton
673918
561 STATE STREET
JASPER, TX 75951
(409)384-8990
Jasper
104 EAST LAVIELLE ST
KIRBYVILLE, TX 75956
(409)423-4414
Jasper
453876
NEWTON FAMILY RURAL HEALTH CLINIC AT
JASPER
NEWTON FAMILY RURAL HEALTH CLINIC AT
KIRBYVILLE
NOCONA MEDICAL CLINIC PA
90 PARK RD
NOCONA, TX 76255
(940)825-3333
Montague
453460
NORTHEAST TEXAS RURAL HEALTH CLINIC
108 SIXTH ST
WINFIELD, TX 75493
(903)524-4700
Titus
458865
NRH CLINIC
7571 STATE HWY 153 / PO BOX 185
WINTERS, TX 79567
(325)754-4553
Runnels
673405
NTMC PEDIATRICS
801 N GRAND AVE STE 4
GAINESVILLE, TX 76240
(940)665-0683
Cooke
673895
ONE SOURCE HEALTH CENTER, EARL
2005 HWY 183 N
EARLY, TX 76802
(915)646-8541
Brown
673900
ONE SOURCE HEALTH CENTER-SAN SABA
403 WEST WALLACE
SAN SABA, TX 76877
(915)372-5701
San Saba
673826
P I MEDICAL DAY AND NIGHT CLIN
1200 HIGHWAY 100 SUITE 5
PORT ISABEL, TX 78578
(956)943-6675
Cameron
458830
PADUCAH RURAL HEALTH CLINIC
917 GOBER, PO DRAWER A
PADUCAH, TX 79248
(806)492-3581
Cottle
458820
PALACIOS MEDICAL CLINIC
1519 4TH STREET
PALACIOS, TX 77465
(361)972-2511
Matagorda
673834
PALMER MEDICAL CLINIC
110 NORTH MAIN STREET
PALMER, TX 75152
(972)449-3555
Ellis
458548
PALO PINTO RHC
118 S MAIN
GORDON, TX 76453
(254)693-5211
Palo Pinto
458639
PARIS HEALTH CLINIC
2224 BONHAM
PARIS, TX 75460
(903)139-2299
Lamar
673423
PARKSIDE FAMILY CLINIC
1109 E BROADWAY
CUERO, TX 77954
(361)275-2800
De Witt
673999
PARKVIEW REGIONAL HEALTH CLINI
514 S BONHAM STE G H
MEXIA, TX 76667
(254)562-9699
Limestone
673802
PCA GUN BARREL
801 WEST MAIN STREET
GUN BARREL CITY, TX 75147
(903)877-6252
Anderson
453871
PCA ELLINGTON
4803 WESLEY STREET
GREENVILLE, TX 75401
(903)454-2246
Hunt
453870
PCA GREENVILLE
4211 JOE RAMSEY BLVD, SUITE 100
GREENVILLE, TX 75401
(903)408-7700
Hunt
458946
PCA QUINLAN
734 E QUINLAN PARKWAY
QUINLAN, TX 75474
(903)408-4848
Hunt
458972
PCA- PARIS
3150 CLARKSVILLE SUITE 100
PARIS, TX 75460
(903)782-9206
Lamar
453883
PCA-LEONARD
700 E HWY 78
LEONARD, TX 75452
(903)587-3331
Fannin
458579
PECOS VALLEY RURAL HEALTH CLIN
2323 TEXAS STREET
PECOS, TX 79772
(432)447-3551
Reeves
673879
Run Date: 10/08/2015
Job # 41303463
Last Update: 10/07/2015
Page 7 of 9
CASPER Report 0006D
Name and Address Listing
For Rural Health Clinic
Based on Current Survey
Texas
CCN
Provider Name
Address
City, State and ZIP
Telephone # County Name
673915
PEDIATRIC PRACTICE ASSOCIATION
1609 US HWY 83
ZAPATA, TX 78076
(956)765-0770
Zapata
673891
201 EAST 2ND ST
RIO GRANDE CITY, TX 78582
(956)488-1200
Starr
673893
PEDIATRIC PRACTICE ASSOCIATION - RIO
GRANDE CITY
PEDIATRIC PRACTICE ASSOCIATION - ROMA
1408 GRANT STREET
ROMA, TX 78584
(956)849-4700
Starr
458750
PERRYTON HEALTH CENTER
3101 GARRETT DR
PERRYTON, TX 79070
(806)435-7224
Ochiltree
458810
PLAINS CLINIC
602 HWY 214
PLAINS, TX 79355
(806)456-6365
Yoakum
458956
PLAINVIEW CHILDREN'S RURAL HEALTH
2202 EDGEMERE
PLAINVIEW, TX 79072
(806)293-1555
Hale
458923
PORT ISABEL HEALTH CLINIC
202 2ND STREET
PORT ISABEL, TX 78578
(956)943-1774
Cameron
453957
PORT LAVACA CLINIC ASSOCIATES
1200 N VIRGINIA
PORT LAVACA, TX 77979
(361)552-6721
Calhoun
458653
PPGH FAMILY HEALTH CLINIC
400 S W 25TH AVE
MINERAL WELLS, TX 76067
(940)328-7500
Palo Pinto
673912
PRESIDIO MEDICAL CENTER
101 NORTH ERMA
PRESIDIO, TX 79845
(432)229-4246
Presidio
673919
PUCKETT FAMILY CLINIC, PC
1301 EAST MAIN STREET
HONEY GROVE, TX 75446
(903)378-3444
Fannin
673892
REDMAN FAMILY PRACTICE CLINIC LTD
107 N WINFREE
DAYTON, TX 77535
(936)258-7664
Liberty
453441
REFUGIO RHC
107 SWIFT ST
REFUGIO, TX 78377
(361)526-2321
Refugio
458804
RICE MEDICAL ASSOCIATES
610 SOUTH AUSTIN ROAD
EAGLE LAKE, TX 77434
(409)234-2551
Colorado
458871
RICE MEDICAL ASSOCIATES - EAST BERNARD
703 MORRIS
EAST BERNARD, TX 77435
(979)234-5571
Wharton
673871
RICHARD A LANKES MD
400 S 8TH STREET
CARRIZO SPRINGS, TX 78834
(830)876-5257
Dimmit
453962
RIO HONDO HEALTH CLINIC
29099 HWY 106
RIO HONDO, TX 78583
(956)748-2381
Cameron
673857
ROBSTOWN HEALTH CENTER
327 W AVE J
ROBSTOWN, TX 78380
(361)387-9233
Nueces
458780
ROBY RURAL HEALTH CLINIC
117 NORTH 1ST
ROBY, TX 79543
(325)776-2500
Fisher
458812
ROMA FAMILY HEALTH CLINIC
128 N FM 3167
ROMA, TX 78584
(956)849-0674
Starr
453921
ROMA MEDICAL CLINIC
640 E BRAVO BLVD
ROMA, TX 78584
(956)849-2176
Starr
458862
ROSEBUD RURAL HEALTH CLINIC
320 E AVENUE I
ROSEBUD, TX 76570
(254)583-0331
Falls
673865
RURAL FAMILY HEALTHCARE
1304 WEST COURT STREET
NEWTON, TX 75966
(409)379-2177
Newton
458885
SABINE FAMILY MEDICAL CENTER
1111 WORTH ST
HEMPHILL, TX 75948
(409)787-1707
Sabine
673801
SAINT JO HEALTHCARE CENTER
108 E BOGGESS
SAINT JO, TX 76265
(940)995-2410
Montague
673406
SANDERSON RURAL HEALTH CENTER
213 PERSIMMONS STREET
SANDERSON, TX 79848
(432)345-2508
Terrell
458684
SANDHILLS FAMILY CLINIC
813 E 4TH STREET
MONAHANS, TX 79756
(432)943-2068
Ward
458823
SCHLEICHER COUNTY FAMILY CLINIC
100 NORTH US HIGHWAY 277
ELDORADO, TX 76936
(325)853-2507
Schleicher
673417
SCOTT & WHITE CLINIC - JOHNSON CITY
208 HALEY RD
JOHNSON CITY, TX 78636
(830)868-4033
Blanco
673419
SCOTT & WHITE CLINIC BURNET
101 E JACKSON ST
BURNET, TX 78611
(830)201-7100
Burnet
458839
SCOTT & WHITE CLINIC-HORSESHOE BAY
100 PECAN CROSSING
HORSESHOE BAY, TX 78657
(830)598-4405
Burnet
458686
SCOTT & WHITE CLINIC-KINGSLAND
105 FM 2342
KINGSLAND, TX 78639
(325)388-3515
Llano
458693
SCOTT & WHITE CLINIC-MARBLE FALLS
706 AVENUE G
MARBLE FALLS, TX 78654
(830)593-8234
Burnet
458799
SCOTT & WHITE CLINIC-SAN SABA
2005 W WALLACE SUITE 200
SAN SABA, TX 76877
(325)372-5163
San Saba
NORTH CONCHO BOX 66
Run Date: 10/08/2015
Job # 41303463
Last Update: 10/07/2015
Page 8 of 9
CASPER Report 0006D
Name and Address Listing
For Rural Health Clinic
Based on Current Survey
Texas
CCN
Provider Name
Address
City, State and ZIP
Telephone # County Name
458738
SCOTT & WHITE FAMILY PRACTICE- BRENHAM
539 MEDICAL PARKWAY
BRENHAM, TX 77833
(979)836-1883
Washington
453413
SCOTT & WHITE HOERSTER CLINIC-LLANO
102 E YOUNG
LLANO, TX 78643
(325)247-4131
Llano
453922
SEARS MEDICAL ASSOCIATES
836 E CALIFORNIA ST
GAINESVILLE, TX 76240
(940)665-5566
Cooke
458845
SEBD CHILDREN'S CARE-A-VAN
300 S COLORADO
LOCKHART, TX 78644
(512)376-9690
Caldwell
458876
SETON BERTRAM HEALTHCARE CENTER
160 NORTH LAMPASAS ST
BERTRAM, TX 78605
(512)355-2678
Burnet
458825
SETON BURNET HEALTHCARE CENTER
200 COUNTY RD 340 A SUITE 2
BURNET, TX 78611
(512)715-3009
Burnet
458843
700 HIGHWAY 281
MARBLE FALLS, TX 78654
(830)693-2500
Burnet
458887
SETON HIGHLAND LAKES MARBLE FALLS
HEALTH CENTER
SETON LAMPASAS HEALTHCARE CENTER
1205 CENTRAL TEXAS EXPRESSWAY
LAMPASAS, TX 76550
(512)556-5362
Lampasas
458819
SETON LOCKHART FAMILY HEALTH CENTER
300 SOUTH COLORADO SUITE A&D
LOCKHART, TX 78644
(830)875-7000
Caldwell
458573
SEYMOUR HOSPITAL RHC
201 STADIUM DRIVE
SEYMOUR, TX 76380
(940)889-5572
Baylor
673925
SHANNON CLINIC
201 E ARIZONA AVE
SWEETWATER, TX 79556
(325)235-8641
Nolan
458844
SHL CARE-A-VAN
3201 S WATER STREET
BURNET, TX 78611
(830)693-2600
Burnet
453456
SIEVERS MEDICAL CLINIC
1110 N SARAH DEWITT DRIVE
GONZALES, TX 78629
(830)672-8502
Gonzales
453953
SINTON PEDIATRIC CENTER
301 S SAN PATRICIO
SINTON, TX 78387
(361)364-3355
San Patricio
673911
SLATON FAMILY MEDICAL CLINIC
235 W GARZA
SLATON, TX 79364
(806)828-1600
Lubbock
458877
SONORA MEDICAL CLINIC
301 HUDSPETH SUITE B
SONORA, TX 76950
(325)387-7911
Sutton
458986
SOUTH PADRE ISLAND PEDS CNTR M
220E ST MARY STREET
MATHIS, TX 78368
(361)547-5700
San Patricio
458966
SOUTH TEXAS FAMILY CARE
8555 NORTH STATE HIGHWAY 16
POTEET, TX 78065
(830)742-3637
Atascosa
673426
SPUR CLINIC
907 E HILL ST
SPUR, TX 79370
(806)271-3306
Dickens
458713
STARR COUNTY MEMORIAL HOSPITAL RURAL
HEALTH CLINIC
STEVE AHMED, MD, PA
128 N FARM ROAD 3167
RIO GRANDE CITY, TX 78582
(210)487-5561
Starr
1700 W FM 700
BIG SPRING, TX 79720
(432)264-1900
Howard
673887
453826
STOCKDALE FAMILY MEDICAL CENTE
601 PERSON ST
STOCKDALE, TX 78160
(830)996-3701
Wilson
458789
STONEWALL MEMORIAL HOSPITAL
1447 MAIN STREET
JAYTON, TX 79528
(806)237-3405
Kent
453986
STONEWALL RURAL HEALTH CLINIC
821 N BROADWAY ST
ASPERMONT, TX 79502
(940)989-2875
Stonewall
673858
TAFT HEALTH CENTER
1210 GREGORY SUITE 2
TAFT, TX 78390
(361)528-2595
San Patricio
458705
TCH FAMILY MEDICAL CLINIC
104 N BEECH STREET
WOODVILLE, TX 75979
(409)283-2822
Tyler
458974
TEARE MEMORIAL CLINIC
146 PIONEER DRIVE
BOOKER, TX 79005
(806)658-4531
Lipscomb
673908
CRYSTAL CITY, TX 78839
(830)374-3118
Zavala
673922
THE CHILDRENS CLINIC OF DIMMIT AND ZAVALA 523 WEST ZAVALA
PA
THE PEDIATRIC CARE CENTER
4857 W HWY 83
ROMA, TX 78584
(956)849-0104
Starr
458683
THROCKMORTON RURAL HEALTH CLINIC
802 NORTH MINTER AVE, SUITE B
THROCKMORTON, TX 76483
(940)849-2471
Throckmorton
673401
TOLEDO BEND FAMILY MEDICINE
2421 WORTH ST
HEMPHILL, TX 75948
(409)787-1416
Sabine
673822
TRINITY CLINIC - CANTON
18780 INTERSTATE 20
CANTON, TX 75103
(903)567-4841
Van Zandt
673823
TRINITY CLINIC - QUITMAN
502 EGOODE ST, STE 1E
QUITMAN, TX 75783
(903)763-5402
Wood
673883
TRINITY CLINIC HENDERSON
511 N HIGH
HENDERSON, TX 75652
(903)657-7583
Rusk
Run Date: 10/08/2015
Job # 41303463
Last Update: 10/07/2015
Page 9 of 9
CASPER Report 0006D
Name and Address Listing
For Rural Health Clinic
Based on Current Survey
Texas
CCN
Provider Name
Address
City, State and ZIP
Telephone # County Name
673886
TRINITY CLINIC HOLLY LAKE
5321 FM 14/2869
HAWKINS, TX 75765
(903)769-2990
Wood
673825
TRINITY CLINIC MINEOLA
1302 NORTH PACIFIC
MINEOLA, TX 75773
(903)531-4965
Wood
458694
TULIA RURAL HEALTH CLINIC
105 HOSPITAL AVE
TULIA, TX 79088
(806)995-4122
Swisher
453929
UNITED CLINICS OF NORTH TEXAS
1010 NORTH MILL STREET
BOWIE, TX 76230
(940)872-1121
Montague
458619
UNIVERSITY MEDICAL CENTER-FABENS
101 POTASIO, PO BOX 3940
FABENS, TX 79838
(915)764-5000
El Paso
453835
UVALDE FAMILY PRACTICE ASSN
1800 GARNER FIELD ROAD
UVALDE, TX 78801
(830)278-4453
Uvalde
453462
VAN HORN RHC
FM 2185 & EISENHOWER ROAD
VAN HORN, TX 79855
(432)283-2760
Culberson
453451
VAN RURAL HEALTH CLINIC
113 W MAIN ST
VAN, TX 75790
(903)863-8303
Van Zandt
458932
VIDOR COMMUNITY HEALTH CLINIC
1290 HWY 12
VIDOR, TX 77662
(409)769-7795
Orange
453481
WAELDER MEDICAL CLINIC
401 NORTH AVENUE G# APT9
WAELDER, TX 78959
(830)788-7280
Gonzales
458912
WAGNER MEDICAL CLINIC, LLP
124 E WOLTERS/2ND STREET
SHINER, TX 77984
(361)594-3824
Lavaca
458811
WEST TEXAS MEDICAL CENTER
415 NORTH AVENUE F
DENVER CITY, TX 79323
(806)592-9501
Yoakum
458973
WESTLAKE MEDICAL CENTER LLC
1607 E QUINLAN PARKWAY
QUINLAN, TX 75474
(903)356-2144
Hunt
458557
WINKLER COUNTY RURAL HEALTH CLINIC
828 MYER LANE
KERMIT, TX 79745
(432)586-2040
Winkler
458874
WINNIE COMMUNITY CLINIC
538 BROADWAY
WINNIE, TX 77665
(409)296-6337
Chambers
673982
WOODSBORO MEDICAL CLINIC
120 WOOD AVE
WOODSBORO, TX 78393
(361)543-5414
Refugio
458987
YELED SHALOM PEDIATRIC CLINIC
1975 VETERANS BLVD SUITE 5
EAGLE PASS, TX 78852
(830)773-9449
Maverick
458851
YOUNG COUNTY FAMILY CLINIC
820 MONTGOMERY ROAD SUITE 202
GRAHAM, TX 76450
(940)549-7741
Young
Total Providers for this State = 291
Run Date: 10/08/2015
Job # 41303463
Last Update: 10/07/2015
Page 1 of 5
CASPER Report 0006D
Name and Address Listing
For Rural Health Clinic
Based on Current Survey
Iowa
CCN
Provider Name
Address
City, State and ZIP
Telephone # County Name
168501
ADAIR COUNTY MEDICAL CLINIC
406 FIFTH STREET
FONTANELLE, IA 50846
(641)745-4300
Adair
168500
ADAIR COUNTY MEDICAL CLINIC-GREENFIELD
609 SOUTHEAST KENT
GREENFIELD, IA 50849
(641)743-6189
Adair
163830
AKRON FAMILY PRACTICE CLINIC
321 MILL STREET
AKRON, IA 51001
(712)568-2411
Plymouth
163476
707 IOWA AVENUE
DUNLAP, IA 51529
(712)643-2298
Harrison
168526
ALEGENT HEALTH DUNLAP RURAL HEALTH
CLINIC
ANITA MEDICAL CENTER
720 MAIN
ANITA, IA 50020
(712)762-4462
Cass
168945
ANTHON MERCY MEDICAL CLINIC
307 MAIN STREET
ANTHON, IA 51004
(712)373-5711
Woodbury
168556
ATKINS FAMILY MEDICAL CLINIC
401 CARDINAL AVENUE
ATKINS, IA 52206
(319)446-7800
Benton
168523
ATLANTIC MEDICAL CENTER
1501 EAST 10TH, PO BOX 429
ATLANTIC, IA 50022
(712)243-2850
Cass
168546
AUDUBON FAMILY HEALTH CARE
515 PACIFIC STREET, SUITE 2
AUDUBON, IA 50025
(712)563-4611
Audubon
163853
AUDUBON MEDICAL CLINIC
222 BROADWAY
AUDUBON, IA 50026
(712)563-4206
Audubon
168557
BELMOND CLINIC
403 FIRST STREET SE
BELMOND, IA 50421
(641)444-3500
Wright
163997
BIRMINGHAM MEDICAL CLINIC
735 N HIGHWAY 1
BIRMINGHAM, IA 52535
(319)498-4370
Van Buren
163451
BONAPARTE MEDICAL CLINIC
624 FIRST STREET
BONAPARTE, IA 52620
(319)592-3168
Van Buren
163470
BURGESS FAMILY CLINC - DUNLAP
612 IOWA AVENUE
DUNLAP, IA 51529
(712)643-5880
Harrison
168538
BURGESS FAMILY CLINIC - MAPLE VALLEY
513 SOUTH MUCKEY STREET
MAPLETON, IA 51034
(712)882-2234
Monona
163483
BURGESS FAMILY CLINIC - SLOAN
409 EVANS
SLOAN, IA 51055
(712)428-4100
Woodbury
168535
C C M H MEDICAL CLINIC
100 MEDICAL PARKWAY, SUITE A
DENISON, IA 51442
(712)262-2700
Crawford
163487
CHEROKEE REGIONAL CLINIC
300 SIOUX VALLEY DRIVE
CHEROKEE, IA 51012
(712)225-6265
Cherokee
163441
CHEROKEE REGIONAL CLINIC-HOLSTEIN
112 NORTH KIEL STREET
HOLSTEIN, IA 51025
(712)368-4730
Ida
163479
CHI HEALTH BEDFORD CLINIC
1502 MADISON STREET
BEDFORD, IA 50833
(712)523-2196
Taylor
163480
CHI HEALTH CORNING CLINIC
601 ROSARY DRIVE
CORNING, IA 50841
(641)322-3121
Adams
163478
CHI HEALTH LENOX CLINIC
210 SOUTH MAIN
LENOX, IA 50851
(641)333-2266
Taylor
163431
CHI HEALTH LOGAN CLINIC
122 WEST EIGHTH STREET
LOGAN, IA 51546
(712)642-3612
Harrison
163433
CHI HEALTH MISSOURI VALLEY CLINIC
809 EAST ELM STREET
MISSOURI VALLEY, IA 51555
(712)642-2794
Harrison
163477
CHI HEALTH WOODBINE CLINIC
518 LINCOLN WAY
WOODBINE, IA 51579
(712)647-2566
Harrison
168539
CHRISTOPHEL CLINIC
312 9TH STREET SW, SUITE 2300
WAVERLY, IA 50677
(319)483-1390
Bremer
163495
CLARION CLINIC
215 13TH AVENUE SW
CLARION, IA 50525
(515)532-2836
Wright
168553
CORNERSTONE FAMILY PRACTICE
101 SOUTH WASHINGTON
EDGEWOOD, IA 52042
(563)928-6435
Delaware
168552
CORNERSTONE FAMILY PRACTICE
200 MAIN STREET
GUTTENBERG, IA 52052
(563)252-2141
Clayton
168550
CORNERSTONE FAMILY PRACTICE
104 SOUTH MAIN STREET
GARNAVILLO, IA 52049
(563)964-2608
Clayton
168934
CORRECTIONVILLE MERCY MEDICAL CLINIC
1120 EAST HIGHWAY 20
CORRECTIONVILLE, IA 51016
(712)372-4145
Woodbury
163438
COVENANT CLINIC - ARLINGTON
751 MAIN STREET
ARLINGTON, IA 50606
(319)633-6965
Fayette
163493
CRESCO MEDICAL CLINIC
321 EIGHTH AVENUE WEST
CRESCO, IA 52136
(563)547-2022
Howard
163878
DALLAS CENTER MEDICAL ASSOCIATES
507 14TH STREET
DALLAS CENTER, IA 50063
(515)992-3711
Dallas
Run Date: 10/08/2015
Job # 41303463
Last Update: 10/07/2015
Page 2 of 5
CASPER Report 0006D
Name and Address Listing
For Rural Health Clinic
Based on Current Survey
Iowa
CCN
Provider Name
Address
City, State and ZIP
Telephone # County Name
168566
DAVIS COUNTY MEDICAL ASSOCIATES
509 N MADISON STREET, SUITE 100
BLOOMFIELD, IA 52537
(641)664-3832
Davis
168922
DEER CREEK FAMILY CARE
401 FIRST AVENUE
TOLEDO, IA 52342
(641)484-2602
Tama
163998
DOUDS MEDICAL CLINIC
14204 HIGHWAY 98
DOUDS, IA 52551
(641)936-7107
Van Buren
163486
EARLHAM MEDICAL CLINIC
125 WEST FIRST STREET
EARLHAM, IA 50072
(515)758-2907
Madison
168534
EXIRA MEDICAL CLINIC
107 SOUTH JEFFERSON STREET
EXIRA, IA 50076
(712)268-5348
Audubon
163890
FAMILY HEALTH CARE OF SIOUXLAND
410 MAIN STREET
MOVILLE, IA 51039
(712)873-5225
Woodbury
163464
FAMILY HEALTH CENTER
309 SOUTH FIFTH AVENUE
VILLISCA, IA 50864
(712)826-3003
Montgomery
163831
FAMILY MEDICINE CLINIC
1614 DIAMOND STREET PLACE
ONAWA, IA 51040
(712)423-1525
Monona
163482
FAMILY PRACTICE CLINIC EMMETSBURG
3201 FIRST STREET
EMMETSBURG, IA 50536
(712)852-5555
Palo Alto
163472
FAMILY PRACTICE CLINIC GRAETTINGER
109 WEST ROBBINS STREET
GRAETTINGER, IA 51342
(712)859-3131
Palo Alto
163417
FAMILY PRACTICE CLINIC WEST BEND
107 DIVISION STREET
WEST BEND, IA 50597
(515)887-7881
Palo Alto
163452
FARMINGTON MEDICAL CLINIC
206 SOUTH FOURTH STREET
FARMINGTON, IA 52626
(319)878-4232
Van Buren
163498
1501 SOUTH MAIN STREET, SUITE 6
CHARLES CITY, IA 50616
(641)257-1184
Floyd
163996
FLOYD COUNTY AREA FAMILY PRACTICE
CENTER
FOX RIVER MEDICAL CLINIC
14983 275TH STREET
CANTRIL, IA 52542
(319)397-2300
Van Buren
168913
FRANCISCAN HEALTHCARE - WAUKON
105 EAST MAIN STREET
WAUKON, IA 52172
(563)568-3449
Allamakee
163987
FRANKLIN MEDICAL CENTER-DOWS
103 EAST ELLSWORTH STREET
DOWS, IA 50071
(515)852-4113
Wright
163979
FRANKLIN MEDICAL CENTER-DUMONT
606 SOUTH SECOND STREET
DUMONT, IA 50625
(641)857-6696
Butler
163420
FRANKLIN MEDICAL CENTER-HAMPTON
1720 CENTRAL AVENUE EAST
HAMPTON, IA 50441
(641)456-5050
Franklin
163463
FRANKLIN MEDICAL CENTER-LATIMER
109 SOUTH AKIR STREET
LATIMER, IA 50452
(641)579-6340
Franklin
163849
GREAT RIVER CLINIC AT WAPELLO
220 MULBERRY, SUITE A
WAPELLO, IA 52653
(319)523-3421
Louisa
168525
GRISWOLD MEDICAL CENTER
1109 MORNINGSIDE DRIVE
GRISWOLD, IA 51535
(712)778-5140
Cass
163818
GUNDERSEN FAYETTE CLINIC
110 KING STREET
FAYETTE, IA 52142
(563)425-3381
Fayette
163892
GUNDERSEN LANSING CLINIC
50 NORTH 4TH STREET
LANSING, IA 52151
(563)538-4874
Allamakee
163882
GUNDERSEN POSTVILLE CLINIC
111 SOUTH REYNOLDS
POSTVILLE, IA 52162
(563)864-7512
Allamakee
163881
GUNDERSEN WEST UNION CLINIC
110 JEFFERSON STREET
WEST UNION, IA 52175
(563)422-3817
Fayette
168559
HAMPTON CLINIC
700 SECOND STREET SE
HAMPTON, IA 50441
(641)444-3223
Franklin
163456
HARDIN MEDICAL CLINIC
400 SOUTH DODGE STREET
BEDFORD, IA 50833
(712)523-2738
Taylor
163492
HARTLEY MERCY MEDICAL CLINIC
231 NORTH EIGHTH AVENUE WEST
HARTLEY, IA 51346
(712)728-2820
O Brien
168503
1122 AVENUE L
HAWARDEN, IA 51023
(712)551-2522
Sioux
163410
HAWARDEN REGIONAL HEALTHCARE CLINICS,
LLC
HEALTH TRUST PHYSICIANS CLINIC
300 WEST HUTCHINS STREET
WINTERSET, IA 50273
(515)462-2950
Madison
168537
HORN PHYSICIANS CLINIC
700 EAST 2ND STREET, SUITE 2
IDA GROVE, IA 51445
(712)364-2514
Ida
168558
HORN PHYSICIANS CLINIC MAPLETON
412 MAIN STREET
MAPLETON, IA 51034
(712)881-4676
Monona
168565
HORN PHYSICIANS CLINIC ODEBOLT
300 S MAPLE STREET
ODEBOLT, IA 51458
(712)668-2232
Sac
168548
HUMESTON FAMILY MEDICAL CLINIC
109 BROAD STREET
HUMESTON, IA 50123
(641)877-6108
Wayne
Run Date: 10/08/2015
Job # 41303463
Last Update: 10/07/2015
Page 3 of 5
CASPER Report 0006D
Name and Address Listing
For Rural Health Clinic
Based on Current Survey
Iowa
CCN
Provider Name
Address
City, State and ZIP
Telephone # County Name
168520
HUMESTON MEDICAL CLINIC
123 BROAD STREET
HUMESTON, IA 50123
(641)877-8502
Wayne
163453
KEOSAUQUA MEDICAL CLINIC
304 FRANKLIN ST
KEOSAUQUA, IA 52565
(319)293-3171
Van Buren
163846
KINGSLEY MERCY MEDICAL CLINIC
111 MAIN STREET
KINGSLEY, IA 51028
(712)378-2921
Plymouth
163437
KOSSUTH FAMILY HEALTH CENTER
1519 SOUTH PHILLIPS STREET
ALGONA, IA 50511
(515)295-2451
Kossuth
163976
KOSSUTH REGIONAL HEALTH CENTER
122 WEST RAMSEY STREET
BANCROFT, IA 50517
(515)885-2336
Kossuth
163469
LENOX MEDICAL CLINIC
100 S MAIN STREET
LENOX, IA 50851
(641)333-4545
Taylor
163494
LIME SPRINGS MEDICAL CLINIC
101 WEST MAIN STREET
LIME SPRINGS, IA 52155
(563)566-2243
Howard
163435
LINEVILLE MEDICAL CLINIC
101 MAIN STREET
LINEVILLE, IA 50147
(641)876-2070
Wayne
168560
1200 N 7TH STREET
CHARITON, IA 50049
(641)774-3000
Lucas
168511
LUCAS COUNTY HEALTH CENTER MEDICAL
CLINIC
LYNNVILLE MEDICAL CLINIC
303 EAST STREET
LYNNVILLE, IA 50153
(641)527-2929
Jasper
168947
MANSON FAMILY HEALTH
1303 11TH AVENUE
MANSON, IA 50563
(712)469-3307
Calhoun
168563
MARENGO FAMILY MEDICAL CLINIC
255 W LUCAS STREET
MARENGO, IA 52301
(319)741-6789
Iowa
168524
MASSENA MEDICAL CENTER
92 SOUTH MAIN STREET
MASSENA, IA 50853
(712)779-3626
Cass
163475
MCCRARY ROST CLINIC
1800 MAIN STREET
GOWRIE, IA 50543
(515)352-3891
Webster
168516
MCCRARY ROST CLINIC
1160 3RD STREET
LAKE VIEW, IA 51450
(712)657-8555
Sac
168522
MCCRARY-ROST CLINIC
1351 WEST MAIN STREET
LAKE CITY, IA 51449
(712)464-3194
Calhoun
168545
MCCRARY-ROST CLINIC
505 EAST LAKE STREET
ROCKWELL CITY, IA 50579
(712)297-8989
Calhoun
168951
MEDIAPOLIS MEDICAL CLINIC
401 N ORCHARD
MEDIAPOLIS, IA 52637
(319)394-3177
Des Moines
163833
MEDICAL CLINIC
313 MAIN STREET
SIDNEY, IA 51652
(712)374-2649
Fremont
163834
MEDICAL CLINIC
1219 MAIN STREET
HAMBURG, IA 51640
(712)382-2626
Fremont
163836
MEDICAL CLINIC
710 CENTER STREET
TABOR, IA 51653
(712)629-2975
Fremont
168950
MERCY CARE MONTICELLO
619 SOUTH MAIN STREET
MONTICELLO, IA 52310
(319)465-5937
Jones
168949
MERCY CARE TAMA
402 SIEGAL STREET
TAMA, IA 52339
(641)484-3333
Tama
168948
MERCY FAMILY CLINIC
115 NORTH MAIN STREET
BUFFALO CENTER, IA 50424
(641)562-2424
Winnebago
168533
MERCY MEDICAL CLINIC
19876 ST JOSEPH'S DRIVE
CENTERVILLE, IA 52544
(641)856-8684
Appanoose
163462
MILL CREEK FAMILY PRACTICE
5616 460TH STREET
PAULLINA, IA 51046
(712)448-2000
O Brien
168536
MONROE COUNTY HOSPITAL CLINIC
6580 165TH STREET
ALBIA, IA 52531
(641)932-2134
Monroe
163449
MONROE FAMILY HEALTH CENTER
100 E SHERMAN
MONROE, IA 50170
(641)259-2155
Jasper
168570
MOUNT AYR MEDICAL CLINIC
504 N CLEVELAND STREET, SUITE M
MOUNT AYR, IA 50854
(641)464-4470
Ringgold
168517
MYRTUE MEDICAL CENTER - AVOCA CLINIC
510 NORTH ELM STREET
AVOCA, IA 51521
(712)343-6455
Pottawattamie
168518
4022 MAIN STREET
ELK HORN, IA 51531
(712)764-4642
Shelby
168509
MYRTUE MEDICAL CENTER - G E LARSON ELK
HORN/KIMBAL
MYRTUE MEDICAL CENTER - HARLAN CLINIC
1220 CHATBURN AVENUE
HARLAN, IA 51537
(712)755-5130
Shelby
168519
MYRTUE MEDICAL CENTER - SHELBY CLINIC
105 EAST STREET
SHELBY, IA 51570
(712)544-2511
Shelby
168527
NASHUA CLINIC
80 AMHEARST BLVD, SUITE 400
NASHUA, IA 50658
(641)435-4133
Chickasaw
Run Date: 10/08/2015
Job # 41303463
Last Update: 10/07/2015
Page 4 of 5
CASPER Report 0006D
Name and Address Listing
For Rural Health Clinic
Based on Current Survey
Iowa
CCN
Provider Name
Address
City, State and ZIP
Telephone # County Name
163454
OSAGE CLINIC
620 NORTH EIGHTH STREET
OSAGE, IA 50461
(641)732-6100
Mitchell
168562
OTTUMWA MEDICAL
920 N QUINCY AVENUE
OTTUMWA, IA 52501
(641)455-5200
Wapello
163488
PAULLINA MERCY MEDICAL CLINIC
108 EAST GROESBECK AVENUE
PAULLINA, IA 51046
(712)448-2126
O Brien
163490
PRIMGHAR MERCY MEDICAL CLINIC
240 NORTH RERICK AVENUE
PRIMGHAR, IA 51245
(712)957-2310
O Brien
163827
REDFIELD MEDICAL CLINIC
1013 FIRST STREET
REDFIELD, IA 50233
(515)833-2301
Dallas
168530
REGIONAL FAMILY HEALTH - MANCHESTER
709 WEST MAIN STREET
MANCHESTER, IA 52057
(563)927-3232
Delaware
168554
REGIONAL FAMILY HEALTH WINTHROP
345 1ST STREET SOUTH
WINTHROP, IA 50682
(319)935-3343
Buchanan
168531
REGIONAL FAMILY HEALTH, EDGEWOOD
702 WEST UNION STREET
EDGEWOOD, IA 52042
(563)928-7191
Clayton
168529
REGIONAL FAMILY HEALTH, HOPKINTON
122 FIRST STREET SW
HOPKINTON, IA 52237
(563)926-2922
Delaware
168528
111 EAST MISSION STREET
STRAWBERRY POINT, IA 52076
(563)933-6277
Clayton
163497
REGIONAL FAMILY HEALTH, STRAWBERRY
POINT
RICEVILLE CLINIC
109 WESTWARD DRIVE
RICEVILLE, IA 50466
(641)985-2122
Howard
168508
SANFORD CLINIC LAKE PARK
204 MARKET STREET
LAKE PARK, IA 51347
(712)382-9559
Dickinson
168507
SANFORD CLINIC ROCK RAPIDS
803 SOUTH GREEN STREET
ROCK RAPIDS, IA 51246
(712)472-3716
Lyon
168505
SANFORD CLINIC SANBORN
321 MAIN STREET
SANBORN, IA 51248
(712)729-3545
O Brien
168506
SANFORD CLINIC SHELDON
800 OAK STREET, PO BOX 10
SHELDON, IA 51201
(712)324-5356
O Brien
168561
SANFORD ROCK RAPIDS GEORGE CLINIC
101 N MAIN STREET
GEORGE, IA 51237
(712)475-3393
Lyon
168541
SEYMOUR MEDICAL CLINIC
515 W WALL
SEYMOUR, IA 52590
(641)898-2898
Wayne
168555
SHELL ROCK CLINIC
1001 MASON WAY
SHELL ROCK, IA 50670
(319)885-6530
Butler
168549
SHENANDOAH PHYSICIANS CLINIC
1 JACK FOSTER DRIVE
SHENANDOAH, IA 51601
(712)246-7240
Page
168569
SHENANDOAH PHYSICIANS CLINIC - SIDNEY
802 ILLINOIS STREET
SIDNEY, IA 51652
(712)374-6005
Fremont
168547
SOUTH CENTRAL IOWA MEDICAL CLINIC
417 S EAST STREET, SUITE 100
CORYDON, IA 50060
(641)872-2063
Wayne
163445
ST ANSGAR CLINIC
140 WEST FOURTH STREET, SUITE 1
SAINT ANSGAR, IA 50472
(641)736-4401
Mitchell
163467
STACYVILLE CLINIC
411 SOUTH BROAD STREET
STACYVILLE, IA 50476
(641)737-2406
Mitchell
168943
STUART MEDICAL CLINIC
106 NE SECOND STREET
STUART, IA 50250
(515)523-2283
Adair
163455
SULLY FAMILY HEALTH CENTER
704 THIRD STREET
SULLY, IA 50251
(641)594-3150
Jasper
163489
SUTHERLAND MERCY MEDICAL CLINIC
108 WEST SECOND STREET
SUTHERLAND, IA 51058
(712)446-2567
O Brien
168958
UI FAMILY CARE - SIGOURNEY
1314 S STUART STREET
SIGOURNEY, IA 52591
(641)622-3840
Keokuk
168959
UI HEALTH CARE - RIVER CROSSING
3056 RIVER CROSSING COURT
RIVERSIDE, IA 52327
(319)467-8355
Washington
168955
312 9TH STREET SW, SUITE 1200
WAVERLY, IA 50677
(319)352-4340
Bremer
168918
UNITYPOINT CLINC FAMILY MEDICINE ROHLF
MEMORIAL
UNITYPOINT CLINIC
301 HIGHLAND AVENUE
SAC CITY, IA 50583
(712)662-7119
Sac
168925
UNITYPOINT CLINIC
608 NW SEVENTH STREET
POCAHONTAS, IA 50574
(712)335-5632
Pocahontas
168919
UNITYPOINT CLINIC
208 MAIN STREET
LAKE VIEW, IA 51450
(712)657-8513
Sac
168917
UNITYPOINT CLINIC
1010 NORTH 15TH STREET
HUMBOLDT, IA 50548
(515)332-2015
Humboldt
168926
UNITYPOINT CLINIC
307 WEST HIGHWAY 10
LAURENS, IA 50554
(712)841-4516
Pocahontas
Run Date: 10/08/2015
Job # 41303463
Last Update: 10/07/2015
Page 5 of 5
CASPER Report 0006D
Name and Address Listing
For Rural Health Clinic
Based on Current Survey
Iowa
CCN
Provider Name
Address
City, State and ZIP
Telephone # County Name
168916
UNITYPOINT CLINIC
115 SOUTH PARK
EAGLE GROVE, IA 50533
(515)448-5185
Wright
168944
UNITYPOINT CLINIC
101 N MAIN
FONDA, IA 50540
(712)288-4426
Pocahontas
168905
UNITYPOINT CLINIC FAMILY MEDICINE ALLISON 502 LOCUST STREET
ALLISON, IA 50602
(319)267-2759
Butler
163894
UNITYPOINT CLINIC FAMILY MEDICINE
ANAMOSA
UNITYPOINT CLINIC FAMILY MEDICINE BELLE
PLAINE
UNITYPOINT CLINIC FAMILY MEDICINE
CLARENCE
UNITYPOINT CLINIC FAMILY MEDICINE DENVER
1791 HIGHWAY 64 EAST
ANAMOSA, IA 52205
(563)462-3571
Jones
105 9TH AVENUE
BELLE PLAINE, IA 52208
(319)444-2840
Benton
411 FIRST AVENUE
CLARENCE, IA 52216
(563)452-3211
Cedar
168952
163898
168907
DENVER, IA 50622
(319)984-5645
Bremer
UNITYPOINT CLINIC FAMILY MEDICINE GRUNDY 101 EAST J AVENUE, SUITE 120
CENTER
UNITYPOINT CLINIC FAMILY MEDICINE OELWEIN 124 1ST AVENUE SE
GRUNDY CENTER, IA 50638
(319)824-6945
Grundy
OELWEIN, IA 50662
(563)283-2651
Fayette
502 THIRD STREET
PARKERSBURG, IA 50665
(319)346-2331
Butler
400 CANTON STREET NW
SHELLSBURG, IA 52332
(319)436-2040
Benton
168900
UNITYPOINT CLINIC FAMILY MEDICINE
PARKERSBURG
UNITYPOINT CLINIC FAMILY MEDICINE
SHELLSBURG
UNITYPOINT CLINIC FAMILY MEDICINE TIPTON
1412 CEDAR STREET
TIPTON, IA 52772
(563)886-2182
Cedar
163896
UNITYPOINT CLINIC FAMILY MEDICINE VINTON
1803 C AVENUE
VINTON, IA 52349
(319)472-2304
Benton
163485
URBANA FAMILY MEDICAL CLINIC
1002 WEST MAIN STREET
URBANA, IA 52345
(319)472-6318
Benton
163468
VAN HORNE FAMILY MEDICAL CLINIC
205 MAIN STREET
VAN HORNE, IA 52346
(319)228-8240
Benton
168510
VICTOR HEALTH CENTER
709 2ND STREET
VICTOR, IA 52347
(319)647-7511
Iowa
163461
VINTON FAMILY MEDICAL CLINIC
504 NORTH NINTH AVENUE
VINTON, IA 52349
(319)472-6300
Benton
163400
WALL LAKE MEDICAL CLINIC
311 WEST FIRST STREET
WALL LAKE, IA 51466
(712)664-2800
Sac
168567
1230 SOUTH IOWA AVENUE, BOX 909
WASHINGTON, IA 52353
(319)653-7291
Washington
444 EAST POLK STREET
WASHINGTON, IA 52353
(319)653-6601
Washington
168564
WASHINGTON CO HOSP AND CLINICS FAMILY
MEDICINE
WASHINGTON CO HOSP AND CLINICS FAMILY
MEDICINE
WILLIAMSBURG FAMILY MEDICAL CLINIC
498 N HIGHLAND STREET
WILLIAMSBURG, IA 52361
(319)668-6789
Iowa
168540
WOMEN'S CLINIC
312 9TH STREET SW, SUITE 2200
WAVERLY, IA 50677
(319)483-4074
Bremer
163460
ZEARING MEDICAL CLINIC
112 WEST MAIN STREET
ZEARING, IA 50278
(641)487-7779
Story
168953
168904
168903
168908
168568
Total Providers for this State = 159
160 EAST MAIN STREET
Run Date: 10/08/2015
Job # 41303463
Last Update: 10/07/2015
Page 1 of 5
CASPER Report 0006D
Name and Address Listing
For Rural Health Clinic
Based on Current Survey
Kansas
CCN
Provider Name
Address
City, State and ZIP
Telephone # County Name
178578
ALLEN COUNTY REGIONAL CLINIC
401 SOUTH WASHINGTON
IOLA, KS 66749
(620)365-6933
Allen
173438
ANDERSON CO HOSP FAM CARE CTR
536 W FOURTH PO BOX 309
GARNETT, KS 66032
(785)448-2674
Anderson
173403
ANTHONY PRIMARY CARE CENTER
1101 E SPRING ST
ANTHONY, KS 67003
(620)842-5144
Harper
178913
ARK CITY CLINIC PA
510 WEST RADIO LANE
ARKANSAS CITY, KS 67005
(620)442-2100
Cowley
173476
ASHLAND HEALTH CENTER
529 W 7TH
ASHLAND, KS 67831
(620)635-2222
Clark
178923
ASHLEY CLINIC
505 S PLUMMER
CHANUTE, KS 66720
(620)431-2500
Neosho
178924
ASHLEY CLINIC - HUMBOLDT
202 S 9TH STREET
HUMBOLDT, KS 66748
(620)473-2275
Allen
178997
ASSOCIATES IN FAMILY CARE, OSAWATOMIE
100 EAST MAIN STREET
OSAWATOMIE, KS 66064
(913)755-3044
Miami
178994
ASSOCIATES IN FAMILY CARE-PAOLA
2102 BAPTISTE DRIVE STE A
PAOLA, KS 66071
(913)557-5678
Miami
178521
810 RAVEN HILL DRIVE
ATCHISON, KS 66002
(913)367-7300
Atchison
178533
ATCHISON INTERNAL MEDICINE & FAMILY
PRACTICE
ATTICA RURAL HEALTH CLINIC
302 N BOTKIN
ATTICA, KS 67009
(620)254-7878
Harper
703805
AUGUSTA FAMILY PRACTICE
1230 E 6TH SUITE 2C
WINFIELD, KS 67156
(620)402-6699
Cowley
178951
AUGUSTA FAMILY PRACTICE
1306 STATE STREET
AUGUSTA, KS 67010
(316)775-9191
Butler
173416
BLUE RAPIDS MEDICAL CLINIC
607 LINCOLN ST
BLUE RAPIDS, KS 66411
(785)363-7202
Marshall
178537
BUCKLIN COMMUNITY CLINIC
101 N FORD AVENUE, BOX 625
BUCKLIN, KS 67834
(620)826-3266
Ford
178973
CALDWELL FAMILY CLINIC
415 S OSAGE
CALDWELL, KS 67022
(620)845-2516
Sumner
173414
CEDAR VALE RURAL HEALTH CLINIC
508 WASHINGTON STREET
CEDAR VALE, KS 67024
(620)758-2221
Chautauqua
178576
CENTRAL KANSAS FAMILY PRACTICE PA
1309 POLK STREET
GREAT BEND, KS 67530
(620)792-5341
Barton
173483
CENTRALIA MEDICAL CLINIC
606 FIRST STREET
CENTRALIA, KS 66415
(785)857-3334
Nemaha
178585
CHASE COUNTY FAMILY HEALTH CTR
411 WALNUT
COTTONWOOD FALLS, KS 66845
(620)273-6131
Chase
178566
CHETOPA COMMUNITY CLINIC
429 MAPLE
CHETOPA, KS 67336
(620)236-7351
Labette
173478
CHEYENNE COUNTY CLINIC
221 W 4TH STREET
BIRD CITY, KS 67731
(785)734-2306
Cheyenne
173477
CHEYENNE COUNTY CLINIC-ST FRANCIS
221 W FIRST STREET
SAINT FRANCIS, KS 67756
(785)332-2682
Cheyenne
173466
CLARA BARTON RURAL HEALTH CLINIC
252 W 9TH
HOISINGTON, KS 67544
(620)653-2386
Barton
173858
CLAY CENTER FAMILY PHYSICIANS
609 LIBERTY
CLAY CENTER, KS 67432
(785)632-2181
Clay
173856
CLYDE CLINIC
815 W CAMPBELL
LINN, KS 66953
(785)446-2226
Washington
173982
COFFEY COUNTY MEDICAL CLINIC
309 SANDERS ST
BURLINGTON, KS 66839
(620)364-5395
Coffey
178577
COLBY MEDICAL SERVICES
1005 S RANGE AVENUE STE 200
COLBY, KS 67701
(785)462-2122
Thomas
173404
COMMUNITY PHYSICIANS CLINIC
1902 MAY STREET
MARYSVILLE, KS 66508
(785)562-3942
Marshall
178549
CONWAY SPRINGS RHC
111 W SPRING AVENUE
CONWAY SPRINGS, KS 67031
(620)456-2411
Sumner
178968
DANIEL J SANCHEZ MD PA
1210 N WASHINGTON
PLAINVILLE, KS 67663
(785)434-2622
Rooks
178564
OBERLIN, KS 67749
(785)475-2015
Decatur
173433
DECATUR HEALTH SYSTEMS FAMILY PRACTICE 902 W COLUMBIA
CLINIC
DEXTER COMMUNITY RHC
204 N MAIN
DEXTER, KS 67038
(620)876-5863
Cowley
178958
DONLEY MEMORIAL CLINIC LLC
KINGMAN, KS 67068
(620)532-3101
Kingman
437 NORTH CEDAR STREET
Run Date: 10/08/2015
Job # 41303463
Last Update: 10/07/2015
Page 2 of 5
CASPER Report 0006D
Name and Address Listing
For Rural Health Clinic
Based on Current Survey
Kansas
CCN
Provider Name
Address
City, State and ZIP
Telephone # County Name
173485
DOWNTOWN MEDICAL CLINIC
112 E 2ND STREET
FRANKFORT, KS 66427
(785)292-4451
Marshall
178999
DRS MORRIS & HILL MEDICAL CLINIC LLC
1525 MADISON ST SUITE 2
FREDONIA, KS 66736
(620)378-2068
Wilson
173498
ECMC RURAL HEALTH CLINIC - LUCAS
216 S MAIN
LUCAS, KS 67648
(785)525-7788
Russell
178925
EL DORADO CLINIC PA
700 W CENTRAL SUITE 205
EL DORADO, KS 67042
(316)321-2010
Butler
173402
ELLINWOOD HOSPITAL CLINIC
611 N MAIN
ELLINWOOD, KS 67526
(620)564-3771
Barton
178538
ELLIS FAMILY CARE CENTER
1000 WASHINGTON STREET
ELLIS, KS 67637
(785)726-4956
Ellis
173497
ELLSWORTH MEDICAL CLINIC
1602 AYLWARD
ELLSWORTH, KS 67439
(785)810-1177
Ellsworth
178544
EUREKA CLINIC
100 WEST 16TH
EUREKA, KS 67045
(620)583-7436
Greenwood
178917
F ALLEN MOORHEAD JR MD
709 MAIN STREET
NEODESHA, KS 66757
(620)325-2200
Wilson
173469
FAMILY CARE CENTER
1100 HIGHLAND DRIVE
CONCORDIA, KS 66901
(785)243-4272
Cloud
178586
FAMILY CARE CENTER SOUTH
309 N PINE
COLONY, KS 66015
(620)852-3600
Anderson
178508
FAMILY CENTER FOR HEALTH CARE
310 E COLLEGE DRIVE
COLBY, KS 67701
(785)462-6184
Thomas
178580
FAMILY HEALTH CENTER
506 THORPE ST
LAKIN, KS 67860
(620)355-7550
Kearny
178579
FAMILY HEALTH CENTER
521 MAIN
DEERFIELD, KS 67838
(620)426-2990
Kearny
178966
FAMILY PRAC ASSOC OF WSTRN KS
120 WEST ROSS BLVD
DODGE CITY, KS 67801
(620)225-1650
Ford
178511
FAMILY PRACTICE ASSOCIATES
1100 COLUMBINE DRIVE
HOLTON, KS 66436
(785)364-2126
Jackson
178575
FAMILY PRACTICE ASSOCIATES (WETMORE)
323 SECOND STREET
WETMORE, KS 66550
(785)364-2116
Nemaha
178523
FAMILY PRACTICE ASSOCIATES HOYT CLINIC
207 HIGHLAND AVE
HOYT, KS 66440
(785)986-6630
Jackson
178513
FARMER CLINIC
802 W BROADWAY
STAFFORD, KS 67578
(620)234-6826
Stafford
178536
FOWLER COMMUNITY CLINIC
404 MAIN ST PO BOX 462
FOWLER, KS 67844
(620)646-5446
Meade
173452
GCH RURAL HEALTH CLINIC
1110 SAINT MARY'S RD
JUNCTION CITY, KS 66441
(785)762-2585
Geary
178520
GIRARD MEDICAL CENTER OF CHEROKEE
120 NW HIGHWAY 400
CHEROKEE, KS 66724
(620)457-8100
Crawford
178532
GIRARD MEDICAL CENTER OF FRONTENAC
1011 N 69 HWY
FRONTENAC, KS 66763
(620)235-1377
Crawford
178552
GIRARD RURAL HEALTH CLINIC
307 N HOSPITAL DRIVE STE 1, 4, 5
GIRARD, KS 66743
(620)724-4659
Crawford
178569
GOAD MEDICAL CLINIC
431 W NEW HAMPSHIRE
OSBORNE, KS 67473
(785)346-2510
Osborne
178515
GOODLAND FAMILY HEALTH CENTER
106 WILLOW STREET
GOODLAND, KS 67735
(785)890-6075
Sherman
178550
GRAHAM COUNTY HOSPITAL CLINIC
114 E WALNUT ST
HILL CITY, KS 67642
(785)421-2191
Graham
173805
GREAT BEND CHILDREN'S CLINIC PA
1021 EISENHOWER
GREAT BEND, KS 67530
(620)792-5437
Barton
178522
GREELEY CO FAMILY PRACTICE CLINIC
321 E HARPER
TRIBUNE, KS 67879
(620)376-4251
Greeley
173494
GREENSBURG FAMILY PRACTICE
721 W KANSAS
GREENSBURG, KS 67054
(620)723-2127
Kiowa
173480
GRISELL MEMORIAL HOSPITAL RHC
206 S VERMONT AVE
RANSOM, KS 67572
(785)731-2295
Ness
173481
GRISELL MEMORIAL HOSPITAL SATELLITE RHC 114 E MAIN
NESS CITY, KS 67560
(785)798-2955
Ness
178547
HAMILTON COUNTY FAMILY PRACTICE CLINIC
700 N HUSER
SYRACUSE, KS 67878
(620)384-7350
Hamilton
173407
HARPER HOSP MED CLINIC
700 W 13TH STREET
HARPER, KS 67058
(620)896-7306
Harper
178540
HAVILAND CLINIC
106 N MAIN
HAVILAND, KS 67059
(620)862-5431
Kiowa
Run Date: 10/08/2015
Job # 41303463
Last Update: 10/07/2015
Page 3 of 5
CASPER Report 0006D
Name and Address Listing
For Rural Health Clinic
Based on Current Survey
Kansas
CCN
Provider Name
Address
City, State and ZIP
Telephone # County Name
173464
HCH FAMILY PRACTICE
300 UTAH 2ND FLOOR
HIAWATHA, KS 66434
(785)742-2161
Brown
178574
HEALTH PROFESSIONALS OF WINFIELD
1230 E 6TH AVE STE 1B
WINFIELD, KS 67156
(620)221-4000
Cowley
178563
HEARTLAND HEALTH CARE CENTER
511 NE 10TH
ABILENE, KS 67410
(785)263-4131
Dickinson
178557
HEARTLAND REGIONAL HEALTH CLINIC
514 CLEVELAND STREET
GREAT BEND, KS 67530
(620)793-7520
Barton
178517
HERINGTON AREA HEALTH CLINIC
1005 NORTH B STREET
HERINGTON, KS 67449
(785)258-5130
Dickinson
173491
HIAWATHA COMM HOSPITAL HIGHLAND CLINIC
415 WEST MAIN
HIGHLAND, KS 66035
(785)442-3312
Doniphan
178567
HILLSBORO CLINIC
704 S MAIN STREET
HILLSBORO, KS 67063
(620)947-1421
Marion
173458
HMC PEDIATRIC CENTER
2214 CANTERBURY DRIVE SUITE 204
HAYS, KS 67601
(785)623-2360
Ellis
173482
HOLTON FAMILY HEALTH CLINIC
1603 W 4TH STREET
HOLTON, KS 66436
(785)364-3205
Jackson
173499
HOLYROOD MEDICAL CLINIC
101 S MAIN
HOLYROOD, KS 67450
(785)252-3565
Ellsworth
173489
HORTON RURAL HEALTH CLINIC
1903 EUCLID AVE
HORTON, KS 66439
(785)486-2998
Brown
178542
HOWARD CLINIC
118 S WABASH
HOWARD, KS 67349
(620)374-2650
Elk
173437
HOXIE MEDICAL CLINIC
826 EIGHTEENTH ST
HOXIE, KS 67740
(785)675-3018
Sheridan
178908
HUTCHINSON CLINIC
2101 N WALDRON
HUTCHINSON, KS 67502
(620)669-2500
Reno
173882
HUTCHINSON CLINIC PA INC
1100 N MAIN
HUTCHINSON, KS 67501
(620)669-6690
Reno
703804
HUTCHINSON CLINIC WALK-IN CARE
24 SOUTH MAIN STREET
SOUTH HUTCHINSON, KS 67505
(620)669-2500
Reno
178582
INDEPENDENCE FAMILY MEDICINE
209 N 6TH STREET SUITE 103
INDEPENDENCE, KS 67301
(620)331-2400
Montgomery
173479
JEWELL COUNTY RURAL HEALTH CLINIC
102 S CENTER
MANKATO, KS 66956
(785)378-3511
Jewell
178965
KINGMAN HEALTH CLINIC
701 E A AVENUE
KINGMAN, KS 67068
(620)532-5145
Kingman
173449
KINSLEY RURAL HEALTH CLINIC
807 E 4TH
KINSLEY, KS 67547
(620)659-3639
Edwards
178506
KIOWA DISTRICT HOSP - CLINIC
1002 S 4TH STREET
KIOWA, KS 67070
(620)825-4121
Barber
178995
LA CYGNE FAMILY CARE
1017 E MARKET STREET
LA CYGNE, KS 66040
(913)757-4575
Linn
178570
LABETTE HEALTH CHERRYVALE CLINIC
116 N MAPLE
CHERRYVALE, KS 67335
(620)336-3255
Montgomery
178571
LABETTE HEALTH FAMILY PRACTICE CLINIC
1902 S HWY 59 BLDG E STE 101
PARSONS, KS 67357
(620)820-5800
Labette
173475
LANE COUNTY MEDICAL CLINIC
444 W LONG
DIGHTON, KS 67839
(620)397-5316
Lane
173984
LEROY MEDICAL CLINIC
538 S C ST PO BOX 212
LE ROY, KS 66857
(620)964-2264
Coffey
173405
LINCOLN COUNTY MEDICAL CLINIC
313 E FRANKLIN
LINCOLN, KS 67455
(785)524-4474
Lincoln
173855
LINN CLINIC
706 W 3RD ST
LINN, KS 66953
(785)348-5503
Washington
178501
LOGAN MEDICAL CLINIC
214 WEST MAIN
LOGAN, KS 67646
(785)689-4220
Phillips
178996
LOUISBURG FAMILY CARE
102 WEST CRESTVIEW CIRCLE SUITE 200
LOUISBURG, KS 66053
(913)837-4299
Miami
178568
LYONS MEDICAL CENTER
1221 W NOBLE
LYONS, KS 67554
(620)257-5124
Rice
173417
MARYSVILLE CLINIC
808 N 19TH STREET
MARYSVILLE, KS 66508
(785)562-2303
Marshall
178529
MEADE RURAL HEALTH CLINIC
119 N HART
MEADE, KS 67864
(620)873-2112
Meade
178545
MEDICINE LODGE MEMORIAL HOSPITAL
PHYSICIANS CLINIC
710 NORTH WALNUT STREET
MEDICINE LODGE, KS 67104
(620)930-3704
Barber
Run Date: 10/08/2015
Job # 41303463
Last Update: 10/07/2015
Page 4 of 5
CASPER Report 0006D
Name and Address Listing
For Rural Health Clinic
Based on Current Survey
Kansas
CCN
Provider Name
Address
City, State and ZIP
Telephone # County Name
178982
MERCY CLINIC - COLUMBUS FAMILY MEDICINE
101 W SYCAMORE
COLUMBUS, KS 66725
(620)429-3636
Cherokee
173422
601 E WASHINGTON
ARMA, KS 66712
(620)347-4033
Crawford
11155 TUCKER ROAD
PLEASANTON, KS 66075
(913)352-8379
Linn
203 WEST MAIN STREET
CHERRYVALE, KS 67335
(620)336-2131
Montgomery
173495
MERCY HOSPITAL FORT SCOTT - ARMA FAMILY
MEDICINE
MERCY HOSPITAL FORT SCOTT-LINN COUNTY
FAMILY MEDIC
MERCY HOSPITAL INDEPENDENCECHERRYVALE FAMILY MED
MIDWAY CLINIC
604 W 8TH
KINSLEY, KS 67547
(620)659-2732
Edwards
178535
MINNEOLA COMMUNITY CLINIC
222 MAIN ST PO BOX 127
MINNEOLA, KS 67865
(620)885-4202
Clark
173425
MOLINE COMM RURAL HEALTH CLINIC
200 N PLUM ST
MOLINE, KS 67353
(620)647-8109
Elk
178998
MOUND CITY FAMILY CARE
302 N 1ST STREET
MOUND CITY, KS 66056
(913)795-2203
Linn
173420
173421
173822
MULVANE FAMILY CARE CENTER
102 E MAIN
MULVANE, KS 67110
(316)777-0106
Sumner
178560
NESS CITY MEDICAL CLINIC
316 CUSTER ST
NESS CITY, KS 67560
(785)798-2233
Ness
178562
NEW FRONTIERS HEALTH SERVICES
212 MAPLE AVE
OAKLEY, KS 67748
(785)672-3261
Logan
178584
NMRMC ERIE FAMILY CARE CLINIC
13920 HIGHWAY 59
ERIE, KS 66733
(620)244-5105
Neosho
178518
NORTON MEDICAL CLINIC
807 N STATE STREET
NORTON, KS 67654
(785)877-3305
Norton
173992
O'SHEA MEMORIAL CLINIC
810 WEST BRAMLEY
JETMORE, KS 67854
(620)357-8354
Hodgeman
173486
ONAGA CLINIC
114 W 8TH STREET
ONAGA, KS 66521
(785)889-4241
Pottawatomie
178561
OSWEGO COMMUNITY CLINIC
800 BARKER DRIVE SUITE B
OSWEGO, KS 67356
(620)795-2921
Labette
173876
OTTAWA FAMILY PHYSICIANS, CHARTERED
1418 S MAIN SUITE 5
OTTAWA, KS 66067
(785)242-1620
Franklin
178977
PANACEA FAMILY MEDICINE PA
629 S PLUMMER
CHANUTE, KS 66720
(620)431-2273
Neosho
178581
PAWNEE VALLEY MEDICAL ASSOCIATES
713 W 11TH
LARNED, KS 67550
(620)804-6007
Pawnee
178502
PHILLIPS COUNTY MEDICAL CLINIC
1719 HIGHWAY 183
PHILLIPSBURG, KS 67661
(785)543-5211
Phillips
178528
PLAINS RURAL HEALTH CLINIC
402 GRAND AVE
PLAINS, KS 67869
(620)563-9313
Meade
178987
PRATT FAMILY PRACTICE
203 WATSON SUITE 200
PRATT, KS 67124
(620)672-7422
Pratt
178583
PRATT INTERNAL MEDICINE GROUP
420 COUNTRY CLUB RD
PRATT, KS 67124
(620)672-7415
Pratt
173487
RAWLINS CLINIC/ATWOOD
707 GRANT ST
ATWOOD, KS 67730
(785)626-3241
Rawlins
173493
RAWLINS CLINIC/MCDONALD
504 OTTAWA STREET
MCDONALD, KS 67745
(785)538-2559
Rawlins
178504
RRH PHYSICIAN'S CLINIC
222 S MAIN
RUSSELL, KS 67665
(785)483-3333
Russell
178541
RUSH COUNTY MEDICAL CLINIC
801 LOCUST STREET
LA CROSSE, KS 67548
(785)222-2545
Rush
178519
RUSSELL FAMILY MEDICAL CLINIC
410 N MAIN ST
RUSSELL, KS 67665
(785)483-3811
Russell
173455
SATANTA HOSP CLINIC-SATANTA BRANCH
410 S CHEYENNE ST PO BOX 9
SATANTA, KS 67870
(620)649-2771
Haskell
173454
SATANTA HOSP CLINIC-SUBLETTE BRANCH
301 SOUTH DERBY
SUBLETTE, KS 67877
(620)675-2686
Haskell
173492
SCOTT CITY CLINIC
201 ALBERT AVENUE
SCOTT CITY, KS 67871
(620)872-2187
Scott
173843
SENECA FAMILY PACTICE PA
201 NORTH SIXTH
SENECA, KS 66538
(785)336-6107
Nemaha
178507
SENECA FAMILY PRACTICE PA
1600 COMMUNITY DRIVE
SENECA, KS 66538
(785)336-6107
Nemaha
178505
SMITH COUNTY FAMILY PRACTICE
119 E PARLIAMENT
SMITH CENTER, KS 66967
(785)282-6834
Smith
Run Date: 10/08/2015
Job # 41303463
Last Update: 10/07/2015
Page 5 of 5
CASPER Report 0006D
Name and Address Listing
For Rural Health Clinic
Based on Current Survey
Kansas
CCN
Provider Name
Address
City, State and ZIP
Telephone # County Name
178539
SPEARVILLE MEDICAL CLINIC
205 HALL STREET
SPEARVILLE, KS 67876
(620)385-2963
Ford
703806
SPRING RIVER MEDICAL CLINIC
6524 SE QUAKERVALE RD
RIVERTON, KS 66770
(620)848-2380
Cherokee
178934
ST JOHN CLINIC
1505 W 11TH
COFFEYVILLE, KS 67337
(620)251-5400
Montgomery
178512
ST JOHN CLINIC
609 E FIRST AVE
SAINT JOHN, KS 67576
(620)549-3251
Stafford
173893
ST JOHN CLINIC (CANEY)
218 WEST 4TH STREET
CANEY, KS 67333
(620)879-2182
Montgomery
178983
ST JOHN'S CLINIC-OSWEGO-FAMILY MEDICINE
805 BARKER DRIVE
OSWEGO, KS 67356
(620)795-2525
Labette
178551
ST LUKE MEDICAL CLINIC
537 S FREEBORN STREET
MARION, KS 66861
(620)382-2033
Marion
173484
ST MARYS CLINIC
206 GRAND AVENUE
SAINT MARYS, KS 66536
(785)437-3734
Pottawatomie
173432
ST PAUL RURAL HEALTH CLINIC
200 CARROLL
SAINT PAUL, KS 66771
(620)449-2582
Neosho
178572
STANTON COUNTY FAMILY PRACTICE
404 N CHESTNUT STREET
JOHNSON, KS 67855
(620)492-1400
Stanton
178565
STERLING MEDICAL CENTER
239 N BROADWAY
STERLING, KS 67579
(620)278-2123
Rice
173446
STEVENS COUNTY RURAL HEALTH CLINIC
1006 S JACKSON PO BOX 10
HUGOTON, KS 67951
(620)544-8563
Stevens
173819
SUMNER COUNTY FAMILY CARE CENTER
507 E 16TH STREET SUITE 1
WELLINGTON, KS 67152
(620)326-3301
Sumner
173408
SYLVAN MEDICAL CLINIC
219 N MAIN STREET
SYLVAN GROVE, KS 67481
(785)526-7474
Lincoln
178526
SYLVIA HEALTH CARE CLINIC
200 S MAIN ST
SYLVIA, KS 67581
(620)486-2985
Reno
173423
TALLGRASS RURAL HEALTH CLINIC
300 NORTH STREET
SEDAN, KS 67361
(620)725-3818
Chautauqua
178969
THE FAMILY PHYSICIANS
1408 EAST STREET
IOLA, KS 66749
(620)365-3115
Allen
173991
TROY MEDICAL CLINIC
311 WEST LOCUST
TROY, KS 66087
(785)985-3504
Doniphan
173465
ULYSSES FAMILY PHYSICIANS
505 N MAIN STREET
ULYSSES, KS 67880
(620)356-1261
Grant
178530
WAKEENEY FAMILY CARE CENTER
333 N 14TH STREET
WA KEENEY, KS 67672
(785)743-2124
Trego
178525
WALLACE CO FAMILY PRACTICE CLINIC
504 EAST 6TH STREET
SHARON SPGS, KS 67758
(785)852-4230
Wallace
178510
WAMEGO FAMILY CLINIC
711 GENN DRIVE
WAMEGO, KS 66547
(785)458-7420
Pottawatomie
173983
WAVERLY MEDICAL CLINIC
302 PEARSON PO BOX 65
WAVERLY, KS 66871
(785)733-2667
Coffey
173488
WICHITA COUNTY HEALTH CENTER CLINIC
211 E EARL
LEOTI, KS 67861
(620)375-2222
Wichita
178500
WILSON MEDICAL CLINIC
2509 N AVE E
WILSON, KS 67490
(785)658-3688
Ellsworth
178964
WINFIELD MEDICAL ARTS PA
3625 QUAIL RIDGE DRIVE
WINFIELD, KS 67156
(620)221-6100
Cowley
178559
YATES CENTER MEDICAL CENTER RURAL
HEALTH CLINIC
1004 E MADISON
YATES CENTER, KS 66783
(620)625-2312
Woodson
Total Providers for this State = 164
Run Date: 10/08/2015
Job # 41303463
Last Update: 10/07/2015
Page 1 of 12
CASPER Report 0006D
Name and Address Listing
For Rural Health Clinic
Based on Current Survey
Missouri
CCN
Provider Name
Address
City, State and ZIP
Telephone # County Name
268593
A C RURAL HEALTH CLINIC
408 E 7TH, PO BOX 97
APPLETON CITY, MO 64724
(660)476-2121
St. Clair
268921
A PLUS FAMILY CLINIC
203 EAST 3RD STREET
PORTAGEVILLE, MO 63873
(573)379-2100
New Madrid
268988
ADVANCE MEDICAL CLINIC
103 SOUTH OAK STREET
ADVANCE, MO 63730
(573)722-3467
Stoddard
268671
AKEMAN MCBURNEY HEALTH CLINIC
420 WEST FRONT STREET
SLATER, MO 65349
(660)529-2251
Saline
263827
ANDERSON RURAL HEALTH CLINIC
104 EAST MAIN, PO BOX 750
ANDERSON, MO 64831
(417)845-6984
Mcdonald
268945
APOLLO HEALTHCARE, LLC
1031 E KARSCH
FARMINGTON, MO 63640
(573)756-7880
St. Francois
268622
APPLE-KIDS PEDIATRICS
590 PINE STREET
SAINTE GENEVIEVE, MO 63670
(573)883-4455
Ste. Genevieve
268669
APPLEGATE MEDICAL GROUP
125 E LOCKLING
BROOKFIELD, MO 64628
(660)258-8237
Linn
268572
ARCADIA VALLEY FAMILY CLINIC
200 ST MARY, BOX 523
PILOT KNOB, MO 63663
(573)546-7000
Iron
268522
ARCHIE MEDICAL CLINIC
709 E PINE ST, PO BOX 48
ARCHIE, MO 64725
(816)430-5777
Cass
263471
ASH GROVE FAMILY MEDICAL CENTER
500 NORTH MEDICAL DRIVE
ASH GROVE, MO 65604
(417)672-2794
Greene
263449
ASSOCIATED MEDICAL ARTS
504 NORTH STURGEON ST
MONTGOMERY CITY, MO 63361
(314)564-2486
Montgomery
268505
AUSTIN PLAZA PRIMARY CARE
108 FRIZZELL STREET, SUITE 5
POTOSI, MO 63664
(573)438-8500
Washington
793825
BEST MEDICAL LLC
112 UNION STREET
LEADINGTON, MO 63601
(573)431-2253
St. Francois
268649
BETHANY MEDICAL CLINIC
3202 MILLER ST
BETHANY, MO 64424
(660)425-3154
Harrison
268942
BEYER MEDICAL GROUP
735 WEST MAIN STREET
FREDERICKTOWN, MO 63645
(573)783-8875
Madison
263486
BLOOMFIELD MEDICAL CLINIC
101 SOUTH PRAIRIE
BLOOMFIELD, MO 63825
(573)568-3838
Stoddard
268647
BLOOMSDALE FAMILY HEALTH CENTER
255 BODERMAN LANE
BLOOMSDALE, MO 63627
(573)483-9492
Ste. Genevieve
268694
BOLIVAR FAMILY CARE CENTER, LLC
1240 N BUTTERFIELD RD
BOLIVAR, MO 65613
(417)326-6012
Polk
268957
BOLIVAR MEDICAL CENTER, INC
714 N POMME DE TERRE AVENUE
BOLIVAR, MO 65613
(417)326-4000
Polk
268681
BONNE TERRE MEDICAL GROUP
527 BENHAM STREET
BONNE TERRE, MO 63628
(573)358-5577
St. Francois
793809
BOOTHEEL COUNSELING SERVICES
760 PLANTATION BLVD
SIKESTON, MO 63801
(573)471-0800
New Madrid
268626
1502 WARD AVE
CARUTHERSVILLE, MO 63830
(573)333-4244
Pemiscot
268627
BOOTHEEL PRIMARY CARE CLINIC
CARUTHERSVILLE
BOOTHEEL PRIMARY CARE CLINIC HAYTI
310 E MAIN STREET
HAYTI, MO 63851
(573)359-2019
Pemiscot
268628
BOOTHEEL PRIMARY CARE CLINIC-STEELE
213 SOUTH WALNUT STREET
STEELE, MO 63877
(573)575-4416
Pemiscot
268598
BOTHWELL HEALTH CENTER - TRUMAN LAKE
1765 COMMERCIAL STREET
WARSAW, MO 65355
(660)438-6800
Benton
268527
BOURBON MEDICAL CLINIC
240 COLLEGE ROAD, PO BOX 100
BOURBON, MO 65441
(573)732-5140
Crawford
268917
BRANSON WALK-IN CLINIC
1440 STATE HIGHWAY 248, STE J
BRANSON, MO 65616
(417)239-0706
Taney
263925
BRIDGES MEDICAL SERVICES PC
PO BOX 1240
FORSYTH, MO 65653
(417)546-4200
Taney
268904
BURTON CREEK MEDICAL CLINIC
805 KENTUCKY AVE
WEST PLAINS, MO 65775
(417)256-2111
Howell
268553
BUTTERFIELD PARK MEDICAL CENTER
1125 NORTH BUTTERFIELD ROAD
BOLIVAR, MO 65613
(417)326-7676
Polk
268554
BUTTERFIELD PARK PEDIATRICS
1165 NORTH BUTTERFIELD ROAD
BOLIVAR, MO 65613
(417)777-2121
Polk
268937
BYRNES MILL MEDICAL CENTER - RICHWOODS
10649 STATE HIGHWAY A, PO BOX 280
RICHWOODS, MO 63071
(573)678-2444
Washington
793830
C&S FAMILY MEDICAL
2480 THREE RIVERS BLVD
POPLAR BLUFF, MO 63901
(573)785-4600
Butler
Run Date: 10/08/2015
Job # 41303463
Last Update: 10/07/2015
Page 2 of 12
CASPER Report 0006D
Name and Address Listing
For Rural Health Clinic
Based on Current Survey
Missouri
CCN
Provider Name
Address
City, State and ZIP
Telephone # County Name
263405
CAMPBELL MEDICAL CLINIC
413 WEST GRAND
CAMPBELL, MO 63933
(314)246-3220
Dunklin
263984
CANTON-LAGRANGE FAMILY PRACTICE
1802 ELM STREET
CANTON, MO 63435
(573)288-5360
Lewis
263972
CAPE FAMILY MEDICAL CLINIC, LLC
24 N SPRIGG ST SUITE 1
CAPE GIRARDEAU, MO 63701
(573)332-7992
Cape Girardeau
263862
1121 LINDEN STREET
CAPE GIRARDEAU, MO 63703
(573)335-7846
Cape Girardeau
793828
CAPE GIRARDEAU COUNTY RURAL HEALTH
CLINIC
CAROL TIMMONS CLINIC
101 N CENTER STREET
CLARENCE, MO 63437
(660)699-2240
Shelby
793800
CARUTHERSVILLE CLINIC
412 WARD AVENUE
CARUTHERSVILLE, MO 63830
(573)333-0033
Pemiscot
268510
CASSVILLE MEDICAL CARE ASSOCIATES
75 SMITHSON DR, SUITE A, PO BOX 568
CASSVILLE, MO 65625
(417)269-2414
Barry
263474
CCMH MEDICAL MALL CLINIC
1317 SOUTH 32 HIGHWAY
EL DORADO SPRINGS, MO 64744
(417)876-3333
Cedar
268983
CENTRALIA FAMILY HEALTH CLINIC
1021 E HWY 22
CENTRALIA, MO 65240
(573)682-5588
Boone
263891
CHAFFEE MEDICAL CLINIC
537 WEST YOAKUM
CHAFFEE, MO 63740
(573)887-3010
Scott
268715
CHARITON VALLEY FAMILY MEDICINE
413 W 2ND STREET
SALISBURY, MO 65281
(660)388-7084
Chariton
268927
CHARLESTON FAMILY CARE
400 SOUTH MAIN ST
CHARLESTON, MO 63834
(573)331-5510
Mississippi
268727
CMH OSCEOLA MEDICAL CENTER
855 ARDUSER DRIVE
OSCEOLA, MO 64776
(417)646-5075
St. Clair
268640
CMH WALK-IN-CLINIC
2230 S SPRINGFIELD AVE STE H-J
BOLIVAR, MO 65613
(417)326-6000
Polk
268977
COMMUNITY HEALTH PARTNERS LLP
510 E GAY STREET, SUITE A
WARRENSBURG, MO 64093
(660)747-1111
Johnson
268563
COMMUNITY MEDICAL ASSOCIATES
130 EAST LOCKLING
BROOKFIELD, MO 64628
(660)258-8237
Linn
793824
COMPASS HEALTH WELLNESS
530 ARDUSER DR
OSCEOLA, MO 64776
(417)646-8157
St. Clair
793837
COMPLETE FAMILY MEDICINE - LA PLATA
29934 JULY ROAD
LA PLATA, MO 63549
(660)332-7576
Macon
793838
COMPLETE FAMILY MEDICINE LLC
1611 S BALTIMORE STREET
KIRKSVILLE, MO 63501
(660)665-7575
Adair
268980
COMPREHENSIVE FAMILY HEALTH CARE LLC
32 W MISSOURI
BENTON, MO 63736
(573)355-1779
Scott
263874
CONWAY FAMILY CLINIC
301 SOUTH NEWPORT AVE, PO BOX 9
CONWAY, MO 65632
(417)589-2050
Laclede
263470
COOPER CO RURAL HEALTH CLINIC
17601 HIGHWAY B, PO BOX 88
BOONVILLE, MO 65233
(660)882-7461
Cooper
263964
COX FAMILY MEDICINE OF MONETT
307 WEST BENTON
MONETT, MO 65708
(417)236-2410
Barry
268565
COX HEALTH CENTER - AURORA
106 COMMERCE, PO BOX 71
AURORA, MO 65605
(417)269-2400
Lawrence
268531
COX HEALTH CENTER BUFFALO
119 NORTH ASH
BUFFALO, MO 65622
(417)345-2231
Dallas
263962
COX HEALTH CENTER LEBANON
510 E HIGHWAY 32
LEBANON, MO 65536
(417)532-8700
Laclede
263472
COX HEALTH CENTER MARSHFIELD
941 HUBBLE DR, PO BOX 589
MARSHFIELD, MO 65706
(417)859-2339
Webster
268617
COX HEALTH CENTER MT VERNON
10763 HIGHWAY 39, SUITE 200
MOUNT VERNON, MO 65712
(417)269-2460
Lawrence
268564
COX HEALTH CENTER ROGERSVILLE
151 JOHNSTOWN DRIVE
ROGERSVILLE, MO 65742
(417)269-2252
Webster
263966
COX HEALTH CENTER SHELL KNOB
25376 STATE HWY 39, SUITE 301
SHELL KNOB, MO 65747
(417)858-6845
Barry
268692
COXHEALTH CENTER BRANSON
890 HWY 248
BRANSON, MO 65616
(417)269-3721
Taney
263480
COXHEALTH CENTER BRANSON WEST
18452 BUSINESS 13
BRANSON WEST, MO 65737
(417)272-8911
Stone
268543
COXHEALTH CENTER CRANE
102 CORTNEY LANE
CRANE, MO 65633
(417)723-8537
Stone
268501
COXHEALTH CENTER KIMBERLING CITY
2 KIMBERLING BVLD
KIMBERLING CITY, MO 65686
(417)739-2520
Stone
Run Date: 10/08/2015
Job # 41303463
Last Update: 10/07/2015
Page 3 of 12
CASPER Report 0006D
Name and Address Listing
For Rural Health Clinic
Based on Current Survey
Missouri
CCN
Provider Name
Address
City, State and ZIP
Telephone # County Name
268571
COXHEALTH CENTER MOUNTAIN GROVE
1602 A NORTH MAIN ST
MOUNTAIN GROVE, MO 65711
(417)926-5572
Wright
268684
COXHEALTH CENTER REPUBLIC
820 SOUTH ILLINOIS
REPUBLIC, MO 65738
(417)269-1910
Greene
263451
COXHEALTH CENTER SEYMOUR
202 N COMMERCIAL ST
SEYMOUR, MO 65746
(417)935-2213
Webster
263496
COXHEALTH FAMILY MEDICINE & OBSTETRICS
545 N BRANSON LANDING BLVD, SUITE 508
BRANSON, MO 65616
(417)335-7540
Taney
268595
1150 STATE HWY 248, STE 202
BRANSON, MO 65616
(417)348-8964
Taney
263407
COXHEALTH FAMILY MEDICINE BRANSON HWY
248
CUBA MEDICAL OFFICE
102 OZARK STREET, SUITE B
CUBA, MO 65453
(573)885-3499
Crawford
263411
DADE COUNTY FAMILY MEDICAL CENTER
PO BOX 367
GREENFIELD, MO 65661
(417)637-5133
Dade
263482
DALLAS CO COMM MEDICAL CEN
102 N ASH ST, PO BOX 1730
BUFFALO, MO 65662
(417)345-6100
Dallas
263805
DEKALB HEALTH SERVICES
1007 SOUTH POLK
MAYSVILLE, MO 64469
(816)449-2123
De Kalb
263824
DENT MEDICAL CLINIC
1010 E SCENIC RIVERS BLVD
SALEM, MO 65560
(573)729-5533
Dent
263849
DESOTO FAMILY PRACTICE
12 JEFFERSON SQUARE
DE SOTO, MO 63020
(636)586-6685
Jefferson
263440
DEXTER MEDICAL CENTER
610 NORTH ONE MILE ROAD, PO BOX 399
DEXTER, MO 63841
(314)624-3600
Stoddard
263875
206 WEST SECOND, PO BOX 235
DIXON, MO 65459
(573)759-3030
Pulaski
106 WEST 12TH STREET
268537
DIXON FAMILY PRACTICE AND INTERNAL
MEDICINE LLC
DOCTOR'S CLINIC
CARUTHERSVILLE, MO 63830
(573)333-1782
Pemiscot
268911
DOCTORS URGENT CARE OF WEST PLAINS, LLC 314 NORTH KENTUCKY AVENUE
WEST PLAINS, MO 65775
(417)256-1006
Howell
268700
EAGLEVILLE MEDICAL CLINIC
12050 12TH STREET
EAGLEVILLE, MO 64442
(816)632-2101
Harrison
263460
EASTERN MO HEALTH SERVICES
2305 WEST GEORGIA STREET
LOUISIANA, MO 63353
(314)754-4584
Pike
263468
EASTERN MO HEALTH SERVICES
1015 WEST ADAMS STREET
BOWLING GREEN, MO 63334
(314)324-5300
Pike
263885
ELK RIVER HEALTH SERVICES, INC, GOODMAN
FAMILY CLI
FAMILIES 1ST OF DESOTO LLC
125 E MAIN STREET, PO BOX 97
GOODMAN, MO 64843
(417)364-8300
Mcdonald
127 W PRATT
DE SOTO, MO 63020
(636)337-7800
Jefferson
2200 E CLEVELAND AVE
MONETT, MO 65708
(417)236-2600
Barry
268606
FAMILY AND OCCUPATIONAL MEDICINE OF
MONETT
FAMILY CARE CLINIC - NURSERY STREET
617 W NURSERY ST
BUTLER, MO 64730
(660)200-2004
Bates
268667
FAMILY CARE CLINIC ADRIAN
102 E MAIN STREET
ADRIAN, MO 64720
(816)297-2640
Bates
268639
FAMILY CARE CLINIC CHESTNUT
200 W CHESTNUT ST
BUTLER, MO 64730
(660)679-3149
Bates
268646
FAMILY CARE CLINIC HIGH STREET
706 SOUTH HIGH
BUTLER, MO 64730
(660)679-3118
Bates
263837
FAMILY HEALTH ASSOCIATES
341 HOSPITAL DRIVE
LEBANON, MO 65536
(417)532-7850
Laclede
268580
FAMILY HEALTH CARE - POINTE BASSE
753 POINTE BASSE DR
SAINTE GENEVIEVE, MO 63670
(314)883-2782
Ste. Genevieve
263418
FAMILY HEALTH CENTER OF EDINA
205 SOUTH FIFTH ST, PO BOX 8
EDINA, MO 63537
(816)397-2400
Knox
793802
FAMILY MEDICAL CENTER OF CARTHAGE
1632 MISSOURI AVENUE
CARTHAGE, MO 64836
(417)358-1500
Jasper
263948
FAMILY PRACTICE & OBSTETRICS OF MONETT
813 NORTH LINCOLN, SUITE B
MONETT, MO 65708
(417)354-1500
Barry
268928
FAMILY PRACTICE OF RAY COUNTY
916 WOLLARD BLVD
RICHMOND, MO 64085
(816)776-6933
Ray
268944
FAMILY PREFERENCE HEALTH CARE CLINIC
201 W MAIN
MATTHEWS, MO 63867
(573)471-1514
New Madrid
263939
FAMILY WALK IN CLINIC OF MOUNTAIN GROVE,
INC
205 W 3RD, SUITE 3
MOUNTAIN GROVE, MO 65711
(417)926-7625
Wright
793834
268952
Run Date: 10/08/2015
Job # 41303463
Last Update: 10/07/2015
Page 4 of 12
CASPER Report 0006D
Name and Address Listing
For Rural Health Clinic
Based on Current Survey
Missouri
CCN
Provider Name
Address
City, State and ZIP
Telephone # County Name
268973
FARMINGTON PRIMARY CARE
1101 WEBER RD, SUITE 302
FARMINGTON, MO 63640
(573)756-5787
St. Francois
263931
FERGUSON MEDICAL GROUP
1012 NORTH MAIN
SIKESTON, MO 63801
(573)471-0330
New Madrid
263930
FERGUSON MEDICAL GROUP
320 NORTH LINCOLN STREET
EAST PRAIRIE, MO 63845
(573)649-3026
Mississippi
268978
FERGUSON MEDICAL GROUP
1516 W BUSINESS HWY 60
DEXTER, MO 63841
(573)614-5007
Stoddard
263830
FERGUSON MEDICAL GROUP
105 NORTH MAIN STREET
CHARLESTON, MO 63834
(573)683-4010
Mississippi
268577
FITZGIBBON PROFESSIONAL BUILDING
2305 S HIGHWAY 65 BUILDING A
MARSHALL, MO 65340
(660)886-7800
Saline
263904
FOREST CITY FAMILY PRACTICE
1000 NORTH JEFFERSON
SAINT JAMES, MO 65559
(573)265-8840
Phelps
268722
FREEMAN NEOSHO PHYSICIAN GROUP
336 S JEFFERSON STREET
NEOSHO, MO 64850
(417)455-4200
Newton
268532
FULTON MEDICAL CLINIC
850 WEST HOSPITAL DRIVE, SUITE F
FULTON, MO 65251
(573)642-5338
Callaway
263981
GAINESVILLE CLINIC
404 W STATE HWY 160, PO BOX 426
GAINESVILLE, MO 65655
(417)679-4613
Ozark
268632
GALLATIN FAMILY MEDICINE
502 SOUTH MAIN
GALLATIN, MO 64640
(660)663-3751
Daviess
263458
GARDEN CITY FAMILY CLINIC
101 OLD HWY 7, PO BOX 46
GARDEN CITY, MO 64747
(816)862-6203
Cass
268958
GIDEON MEDICAL CLINIC
100 MAIN STREET
GIDEON, MO 63848
(573)448-3165
New Madrid
268691
GILMAN CITY MEDICAL CLINIC
427 MAIN ST
GILMAN CITY, MO 64642
(660)876-5533
Daviess
263974
GLENNON CARE PEDIATRICS
511 ASHLAND, SUITE A
WARRENTON, MO 63383
(636)456-0543
Warren
268625
GOLDEN CITY CLINIC
407 MAIN STREET
GOLDEN CITY, MO 64748
(417)537-4311
Barton
268584
GOLDEN VALLEY MEDICAL - CLINTON
1602 N 2ND STREET
CLINTON, MO 64735
(660)885-8171
Henry
268725
GOLDEN VALLEY MEDICAL - OSCEOLA
286 CHESTNUT STREET
OSCEOLA, MO 64776
(417)646-2231
St. Clair
268588
GOLDEN VALLEY MEDICAL - WARSAW
1771 COMMERCIAL
WARSAW, MO 65355
(660)438-5193
Benton
268583
GOLDEN VALLEY MEDICAL - WINDSOR
100 S TEBO
WINDSOR, MO 65360
(660)647-2147
Henry
263498
GRAND RIVER MEDICAL CLINIC
815 EAST BROADWAY
BRUNSWICK, MO 65236
(660)548-3161
Chariton
268991
HALLSVILLE AREA FAMILY CLINIC
501 N ROUTE B
HALLSVILLE, MO 65255
(573)696-0500
Boone
263404
HAMILTON FAMILY HEALTH CENTER
103 NORTH DAVIS
HAMILTON, MO 64644
(816)583-7839
Caldwell
263852
HANNIBAL CLINIC
100 MEDICAL DRIVE
HANNIBAL, MO 63401
(573)221-5250
Ralls
793816
HANNIBAL CLINIC AT CENTER
401 E HWY 19
CENTER, MO 63436
(573)267-3318
Ralls
793804
HANNIBAL CLINIC AT PALMYRA
1811 S MAIN STREET
PALMYRA, MO 63461
(573)769-2231
Marion
793815
HANNIBAL CLINIC BOWLING GREEN
710 BUSINESS 61 SOUTH
BOWLING GREEN, MO 63334
(573)324-2063
Pike
268696
HARRISON COUNTY FAMILY HEALTH CENTER
2703 MILLER ST, PO BOX 233
BETHANY, MO 64424
(660)425-7443
Harrison
268515
HARRISONVILLE MEDICAL CLINIC
2820 E ROCK HAVEN ROAD, STE 210
HARRISONVILLE, MO 64701
(816)884-3244
Cass
263869
HARTVILLE MEDICAL CLINIC
275 SOUTH SCHOOL AVENUE
HARTVILLE, MO 65667
(417)741-7484
Wright
268934
HAVEN HEALTH CARE MEDICAL CLINIC
502 WEST STURDIVANT, PO BOX 137
ADVANCE, MO 63730
(573)722-9191
Stoddard
263410
HEALTH WAY PRIMARY CARE
200 HEALTH WAY
POTOSI, MO 63664
(573)438-2240
Washington
268539
HEDRICK MEDICAL CENTER
2791 NORTH WASHINGTON STREET
CHILLICOTHE, MO 64601
(660)646-2682
Livingston
268947
HERITAGE MEDICAL CLINIC
101-1 MAIN STREET
CASSVILLE, MO 65625
(417)846-2277
Barry
268602
HERMANN MEDICAL ARTS
134 WEST SIXTH STREET
HERMANN, MO 65041
(573)486-5711
Gasconade
Run Date: 10/08/2015
Job # 41303463
Last Update: 10/07/2015
Page 5 of 12
CASPER Report 0006D
Name and Address Listing
For Rural Health Clinic
Based on Current Survey
Missouri
CCN
Provider Name
Address
City, State and ZIP
Telephone # County Name
263978
HERMITAGE FAMILY MEDICAL CEN
HWY 254 & DALLAS, PO BOX 125
HERMITAGE, MO 65668
(417)745-2121
Hickory
268548
HIGGINSVILLE MEDICAL CLINIC
3401 PINE STREET
HIGGINSVILLE, MO 64037
(660)584-2192
Lafayette
263919
HIGGINSVILLE RURAL HEALTH CLIN
1200 WEST 22ND STREET
HIGGINSVILLE, MO 64037
(660)584-7751
Lafayette
268933
HIGH POINTE HEALTHCARE
100 EAST OUTER ROAD
SCOTT CITY, MO 63780
(573)264-2211
Scott
793811
HOLDEN FAMILY CARE, LLC
612 E 10TH STREET
HOLDEN, MO 64040
(816)732-6010
Johnson
263976
HUMANSVILLE FAMILY CARE CENTER
201 SOUTH ARTHUR
HUMANSVILLE, MO 65674
(417)754-2223
Polk
268599
I-70 MEDICAL CLINIC
105 HOSPITAL DRIVE, BUILDING B
SWEET SPRINGS, MO 65351
(660)335-4700
Saline
263897
IMMEDIATE CONVENIENT CARE
1702 NORTH KINGSHIGHWAY
CAPE GIRARDEAU, MO 63701
(573)339-2000
Cape Girardeau
268642
IRON COUNTY HOSPITAL FAMILY CARE CLINIC
600 NORTH MAIN
PILOT KNOB, MO 63663
(573)546-0184
Iron
263912
JACKSON FAMILY CARE
545 BROADRIDGE DRIVE SUITE 200
JACKSON, MO 63755
(573)243-8408
Cape Girardeau
263914
JACKSON PHYSICIAN ASSOCIATES
2130 E JACKSON BLVD
JACKSON, MO 63755
(573)243-2154
Cape Girardeau
793807
JACKSON PRIMARY CARE, LLC
2685 EAST MAIN STREET, SUITE A
JACKSON, MO 63755
(573)204-1400
Cape Girardeau
263988
JAMESPORT OUTREACH CLINIC
409 W AUBERRY GROVE
JAMESPORT, MO 64648
(816)684-6252
Daviess
268666
JEFFERSON MEDICAL GROUP
1403 N JEFFERSON STREET
CARROLLTON, MO 64633
(660)542-9998
Carroll
268665
JEFFERSON MEDICAL GROUP HALE CLINIC
221 ELM STREET
HALE, MO 64643
(660)565-2602
Carroll
268664
105 E 2ND STREET
NORBORNE, MO 64668
(660)593-3623
Carroll
263895
JEFFERSON MEDICAL GROUP NORBORNE
CLINIC
JOSEPH E PEHLMAN FAMILY CLINIC, LLC
1207 NORTH DOUGLAS
MALDEN, MO 63863
(573)276-3884
Dunklin
268918
JOSEPH WILLIAM STAFFORD, JR
312 KENTUCKY AVE
WEST PLAINS, MO 65775
(417)757-7076
Howell
263960
KENNETT PEDIATRICS AND ADOLESC
211 TEACO ROAD PO BOX 908
KENNETT, MO 63857
(583)888-0001
Dunklin
268659
KINGSVILLE MEDICAL CLINIC
305 EAST PACIFIC STREET
KINGSVILLE, MO 64061
(816)597-3500
Johnson
263935
KNEIBERT CLINIC LLC
686 LESTER STREET
POPLAR BLUFF, MO 63902
(573)778-7210
Butler
268615
LAKE AREA PRIMARY CARE CLINIC
HWY 54 EAST, PO BOX 38
WHEATLAND, MO 65779
(417)282-5882
Hickory
268705
LAKE REGIONAL - ELDON
304-A EAST 4TH ST
ELDON, MO 65026
(573)392-5654
Miller
268707
LAKE REGIONAL CLINIC - CAMDENTON
1930 N BUSINESS ROUTE 5, UNIT 1A
CAMDENTON, MO 65020
(573)346-5624
Camden
268710
LAKE REGIONAL CLINIC - IBERIA
2333 HIGHWAY 17
IBERIA, MO 65486
(573)793-6900
Miller
268711
LAKE REGIONAL CLINIC - LAKE OZARK
1870 BAGNELL DAM BLVD
LAKE OZARK, MO 65049
(573)365-2318
Camden
268706
LAKE REGIONAL CLINIC - MACKS CREEK
14298 W US HIGHWAY 54
MACKS CREEK, MO 65786
(573)363-5304
Camden
268709
LAKE REGIONAL CLINIC - OSAGE BEACH
1057 MEDICAL PARK DRIVE, STE A
OSAGE BEACH, MO 65065
(573)302-3100
Camden
268708
LAKE REGIONAL CLINIC-LAURIE
156 MISSOURI BLVD, SUITE B
LAURIE, MO 65038
(573)374-5263
Morgan
268999
LAKES AREA MEDICAL CLINIC
BRANSON WEST, MO 65737
(417)272-0400
Stone
263857
LANCASTER CLINIC
11016 E STATE HWY 76, CLAYBROUGH PLAZA
MALL STE 26
PO BOX 295, HWY 136
LANCASTER, MO 63548
(660)457-3772
Schuyler
268530
LANCASTER MEDICAL SERVICES
HWY 63 NORTH
LANCASTER, MO 63548
(660)457-3655
Schuyler
263831
LEBANON INTERNAL MEDICINE/PEDS
120 HOSPITAL DRIVE, SUITE 300
LEBANON, MO 65536
(417)533-6746
Laclede
263833
LEWISTOWN RURAL HEALTH CLINIC
105 EAST QUINCY STREET, PO BOX 98
LEWISTOWN, MO 63452
(573)215-2715
Lewis
Run Date: 10/08/2015
Job # 41303463
Last Update: 10/07/2015
Page 6 of 12
CASPER Report 0006D
Name and Address Listing
For Rural Health Clinic
Based on Current Survey
Missouri
CCN
Provider Name
Address
City, State and ZIP
Telephone # County Name
268551
LEXINGTON MEDICAL CLINIC
1026 STATE STREET
LEXINGTON, MO 64067
(660)259-2216
Lafayette
268624
LOCKWOOD CLINIC
723 S MAIN
LOCKWOOD, MO 65682
(417)232-5200
Dade
268568
MADISON MEDICAL CENTER RHC
611 WEST MAIN PO BOX 431
FREDERICKTOWN, MO 63645
(573)783-3341
Madison
263996
MALDEN MEDICAL CENTER
806 NORTH DOUGLAS
MALDEN, MO 63863
(314)276-3873
Dunklin
268965
MANAGED CARE, INC
808 HUNTER, SUITE 4
SIKESTON, MO 63801
(557)347-5911
Scott
263940
MANSFIELD CLINIC
304 WEST COMMERICAL
MANSFIELD, MO 65704
(417)924-3066
Wright
268961
MANSFIELD CLINIC DBA PRIME CARE OF AVA
120 SW 2ND AVE
AVA, MO 65608
(417)683-6790
Douglas
793835
MARBLE HILL MEDICAL CLINIC, LLC
307 BROADWAY STREET
MARBLE HILL, MO 63764
(573)238-0038
Bollinger
268908
MARIES MEDICAL CLINIC
606 HIGHWAY 63 SOUTH
VIENNA, MO 65582
(573)422-3636
Maries
263823
MARSHFIELD FAMILY CLINIC
487 POMME DE TERRE DRIVE, PO BOX 736
MARSHFIELD, MO 65706
(417)468-7875
Webster
268616
MCVICKER FAMILY CLINIC
2588 N WESTWOOD
MOUNTAIN VIEW, MO 65548
(417)111-1111
Howell
268682
MEADVILLE MEDICAL CLINIC
101 E HAYWARD
MEADVILLE, MO 64659
(660)258-1041
Linn
263947
MEDICAL ARTS CLINIC
1103 WEST LIBERTY
FARMINGTON, MO 63640
(573)756-6751
St. Francois
268536
MEDICAL CLINIC OF OWENSVILLE
708 EAST HWY 28
OWENSVILLE, MO 65066
(573)437-4481
Gasconade
263967
MEDICAL CLINIC OF WILLOW SPRINGS
816 E MAIN
WILLOW SPRINGS, MO 65793
(417)469-3116
Howell
268648
MEDICAL ONE CLINIC
29 NW 1ST LANE
LAMAR, MO 64759
(417)681-5284
Barton
263889
MEDSTOP ONE
3065 WILLIAMS STREET, SUITE 209
CAPE GIRARDEAU, MO 63703
(573)335-4100
Cape Girardeau
268518
MEMPHIS MEDICAL SERVICES
450 E SIGLER AVE SUITE A
MEMPHIS, MO 63555
(660)465-2828
Scotland
268689
MERCY CARTHAGE PEDIATRICS
1911 BUENA VISTA AVENUE
CARTHAGE, MO 64836
(417)358-8121
Jasper
263900
MERCY CLINIC - EL DORADO SPRINGS
309 EAST HOSPITAL ROAD
EL DORADO SPRINGS, MO 64744
(417)876-5851
Cedar
263839
MERCY CLINIC - HOUSTON
1422 SOUTH SAM HOUSTON BLVD
HOUSTON, MO 65483
(417)967-4445
Texas
263870
MERCY CLINIC - SALEM
404 W ROLLA ROAD
SALEM, MO 65560
(573)729-6225
Dent
268979
MERCY CLINIC EAST COMMUNITIES
1326 S SERVICE RD W STE. 200
SULLIVAN, MO 63080
(573)468-3555
Crawford
268984
MERCY CLINIC EAST COMMUNITIES-BOURBON
125 N OLD HWY 66
BOURBON, MO 65441
(573)679-2006
Crawford
268986
MERCY CLINIC EAST COMMUNITIES-CUBA
301 THERESA STREET
CUBA, MO 65453
(573)677-2006
Crawford
263809
MERCY CLINIC FAMILY MEDICINE - CUBA
114 DOWNEY PLACE
CUBA, MO 65453
(573)885-3358
Crawford
263945
MERCY CLINIC FAMILY MEDICINE - LEBANON
331 HOSPITAL DR STE C
LEBANON, MO 65536
(417)533-6500
Laclede
263921
MERCY CLINIC FAMILY MEDICINE- BUFFALO
118 W DALLAS
BUFFALO, MO 65622
(417)345-6101
Dallas
263814
MERCY CLINIC FAMILY MEDICINE- LEBANON
120 HOSPITAL DRIVE, SUITE 100
LEBANON, MO 65536
(417)533-6751
Laclede
263806
MERCY CLINIC FAMILY MEDICINE-BIRCH TREE
BIRCH TREE, MO 65438
(573)292-3214
Shannon
263909
MERCY CLINIC FAMILY MEDICINE-CASSVILLE
STATE HIGHWAY 99 & OBANION STREET, PO BOX
229
92 MAIN STREET
CASSVILLE, MO 65625
(417)847-5225
Barry
268900
MERCY CLINIC FAMILY MEDICINE-MONETT
315 E CLEVELAND
MONETT, MO 65708
(417)235-0196
Barry
263840
MERCY CLINIC FAMILY MEDICINE-MOUNTAIN
GROVE
MERCY CLINIC FAMILY MEDICINE-MOUNTAIN
VIEW
120 W 16TH STREET
MOUNTAIN GROVE, MO 65711
(417)926-6111
Wright
104 E HIGHWAY 60
MOUNTAIN VIEW, MO 65548
(417)934-2251
Howell
263819
Run Date: 10/08/2015
Job # 41303463
Last Update: 10/07/2015
Page 7 of 12
CASPER Report 0006D
Name and Address Listing
For Rural Health Clinic
Based on Current Survey
Missouri
CCN
Provider Name
Address
City, State and ZIP
Telephone # County Name
263946
MERCY CLINIC FAMILY MEDICINE-REPUBLIC
332 S MAIN AVENUE
REPUBLIC, MO 65738
(417)732-5050
Greene
793805
MERCY CLINIC FAMILY MEDICINE-SHELL KNOB
22361 OAK RIDGE DRIVE
SHELL KNOB, MO 65747
(417)858-3731
Barry
263813
MERCY CLINIC FAMILY MEDICINE-ST ROBERT
608 CITY ROUTE 66, PO BOX 914
ST ROBERT, MO 65584
(573)336-5100
Pulaski
263920
149 ROGERS AVENUE
SUMMERSVILLE, MO 65571
(417)932-4119
Texas
1202 EAST MAIN
WILLOW SPRINGS, MO 65793
(417)469-1820
Howell
268924
MERCY CLINIC FAMILY MEDICINESUMMERSVILLE
MERCY CLINIC FAMILY MEDICINE-WILLOW
SPRINGS
MERCY CLINIC OB/GYN- LEBANON
120 HOSPITAL DRIVE, SUITE 225
LEBANON, MO 65536
(417)533-6710
Laclede
268935
MERCY CLINIC PEDIATRICS-ROLLA
1605 MARTIN SPRINGS DRIVE, STE 250
ROLLA, MO 65401
(573)341-9163
Phelps
263934
MERCY CLINIC RICHLAND
904 SOUTH PINE STREET
RICHLAND, MO 65556
(573)765-2956
Pulaski
263918
MERCY CLINIC-BRANSON WEST
18598 STATE HIGHWAY 13, PO BOX 2067
BRANSON WEST, MO 65737
(417)272-8497
Stone
263850
MERCY CLINIC-STEELVILLE
518 PINE STREET
263457
MERCY HOSP LINCOLN FAMILY MEDICINE AND 900 EAST CHERRY ST
PSYCHIATRY
MERCY HOSPITAL JOPLIN NEOSHO
2550 LUSK DR
268990
268506
268663
STEELVILLE, MO 65565
(573)775-5838
Crawford
TROY, MO 63379
(636)528-8585
Lincoln
NEOSHO, MO 64850
(417)451-2060
Newton
106 BROADWAY, SUITE 3C
ELSBERRY, MO 63343
(573)898-9100
Lincoln
1003 E CHERRY ST
TROY, MO 63379
(636)528-6755
Lincoln
35 WINFIELD PLAZA
WINFIELD, MO 63389
(636)668-6824
Lincoln
1165 EAST CHERRY STREET
TROY, MO 63379
(636)528-7745
Lincoln
851 E 5TH STREET SUITE 200
WASHINGTON, MO 63090
(636)239-8585
Franklin
268687
MERCY HOSPITAL LINCOLN FAMILY MEDICINE
ELSBERRY
MERCY HOSPITAL LINCOLN FAMILY MEDICINE
TROY
MERCY HOSPITAL LINCOLN FAMILY MEDICINE
WINFIELD
MERCY HOSPITAL LINCOLN-FAMILY MEDICINE
268545
MERCY MCAULEY CLINIC
268688
MERCY PHYSICIANS FOR WOMEN'S HEALTH
1515 HAZEL ST, SUITE 101
CARTHAGE, MO 64836
(417)358-8121
Jasper
268690
MERCY PRIMARY CARE
1515 HAZEL ST
CARTHAGE, MO 64836
(417)358-8121
Jasper
793812
MERCY URGENT CARE-BRANSON
1065 STATE HIGHWAY 248, STE 200
BRANSON, MO 65616
(417)337-5000
Taney
268582
MID-SOUTH HEALTH CLINIC
3100 WARRIOR LANE
POPLAR BLUFF, MO 63901
(573)785-0851
Butler
263479
268701
793829
MIDWEST FAMILY CARE
404 S HOPE
JACKSON, MO 63755
(573)204-3900
Cape Girardeau
793823
MIDWEST FAMILY CARE LLC
36 DOCTORS PARK
CAPE GIRARDEAU, MO 63703
(573)803-1771
Cape Girardeau
263834
MILAN FAMILY PRACTICE CLINIC
210 N MARKET STREET, PO BOX 176
MILAN, MO 63556
(660)265-4456
Sullivan
263487
MISSOURI BAPTIST SULLIVAN MEDICAL OFFICE 965 MATTOX DR
SULLIVAN, MO 63080
(573)860-6000
Crawford
268591
MISSOURI DELTA EXPRESS CLINIC
1008 NORTH MAIN
SIKESTON, MO 63801
(573)471-1600
New Madrid
268660
MISSOURI DELTA PRIMARY CARE
135 PLAZA DRIVE, STE 102
SIKESTON, MO 63801
(573)472-6010
Scott
268528
MO BAPTIST-STEELVILLE OFFICE
510 WEST MAIN, PO BOX AH
STEELVILLE, MO 65565
(573)775-4600
Crawford
263492
MO DELTA MED CTR COMM CARE CTR
1200 EAST MARSHALL
CHARLESTON, MO 63834
(573)683-2191
Mississippi
268611
MOBERLY RHC
1501 UNION AVENUE, SUITE A & B
MOBERLY, MO 65270
(660)263-9095
Randolph
268513
MONROE CITY FAMILY PRACTICE
821 BUSINESS HIGHWAY 24 & 36, PO BOX 305
MONROE CITY, MO 63456
(573)735-2506
Monroe
268594
MONTROSE RURAL HEALTH CLINIC
100 W 4TH
MONTROSE, MO 64770
(660)693-8885
Henry
793813
MORTON VAN ZANTEN CLINIC
101 GIESLER DRIVE
OSCEOLA, MO 64776
(417)646-8123
St. Clair
Run Date: 10/08/2015
Job # 41303463
Last Update: 10/07/2015
Page 8 of 12
CASPER Report 0006D
Name and Address Listing
For Rural Health Clinic
Based on Current Survey
Missouri
CCN
Provider Name
Address
City, State and ZIP
Telephone # County Name
268579
MOUNTAIN GROVE MEDICAL COMPLEX
500 N 19TH ST STE A
MOUNTAIN GROVE, MO 65711
(417)926-6955
Wright
268946
MT VERNON CLINIC
1011 SOUTH EAST ST
MOUNT VERNON, MO 65712
(417)466-7191
Lawrence
263901
NEVADA MEDICAL CLINIC
900 SOUTH ADAMS
NEVADA, MO 64772
(417)667-6015
Vernon
268699
NEW MADRID COMMUNITY CARE CENTER
615 N MAIN STREET
NEW MADRID, MO 63869
(573)748-2546
New Madrid
263911
NIXA FAMILY MEDICAL WALK IN CL
103 OLD WOLDERNESS ROAD
NIXA, MO 65714
(417)724-0308
Christian
268702
NMC - NEW HAMPTON RURAL HEALTH CLINIC
304 E LINCOLN WAY
NEW HAMPTON, MO 64471
(660)439-2060
Harrison
263420
NMC - STANBERRY RURAL HEALTH CLINIC
202 EAST MAIN PO BOX 99
STANBERRY, MO 64489
(816)783-2192
Gentry
268714
NORTH HARRISON MEDICAL CLINIC
16027 LOCUST STREET
EAGLEVILLE, MO 64442
(660)867-5111
Harrison
268675
NORTHEAST REGIONAL MEDICAL GROUP
1607 S BALTIMORE
KIRKSVILLE, MO 63501
(660)785-1122
Adair
268645
NRMC NOWCARE CLINIC
345 S BARRETT LANE, STE 2
NEVADA, MO 64772
(417)448-2439
Vernon
268533
OB/GYN SPECIALTY SERVICES
415-A BURKARTH ROAD
WARRENSBURG, MO 64093
(660)429-2992
Johnson
268728
327 EAST AIRPORT DRIVE
CARTHAGE, MO 64836
(417)237-0604
Jasper
268597
OCH JASPER COUNTY CLINIC CARTHAGE
CAMPUS
OCH LAWRENCE COUNTY CLINIC
108 S HICKORY
MOUNT VERNON, MO 65712
(417)466-4110
Lawrence
268695
OCH MCDONALD COUNTY CLINIC
125 MAIN ST
NOEL, MO 64854
(417)837-4004
Mcdonald
268697
OCH POLK COUNTY CLINIC
910 E SAN MARTIN ST, BOLIVAR, MO 65613-2893
BOLIVAR, MO 65613
(417)777-4749
Polk
268726
OCH SPARTA CLINIC
155 VILLAGE DRIVE, PO BOX 183
SPARTA, MO 65753
(417)634-4203
Christian
268609
OCH WEBSTER COUNTY CLINIC
101 S MAIN
ROGERSVILLE, MO 65742
(417)753-9404
Greene
268672
OCH WELLPOINTE FAMILY MEDICAL CLINIC
543 WEST HUBBLE DRIVE
MARSHFIELD, MO 65706
(417)859-7746
Webster
268550
ODESSA MEDICAL GROUP
1280 WEST OLD HWY 40
ODESSA, MO 64076
(660)633-5774
Lafayette
263484
OMC URGENT CARE CLINIC
181 KENTUCKY AVE, SUITE 100
WEST PLAINS, MO 65775
(417)257-5911
Howell
793808
OZARK OB-GYN, LLC
225 PHYSICIANS, SUITE 300
POPLAR BLUFF, MO 63901
(573)785-0313
Butler
268523
OZARKS MED CLINIC OF ALTON
100 MEDICAL DRIVE, PO BOX 468
ALTON, MO 65606
(417)778-7227
Oregon
268902
PALMYRA CLINIC
6996 COUNTY ROAD 326
PALMYRA, MO 63461
(573)769-3710
Marion
268910
PARIS FAMILY MEDICAL CLINIC
102 E MARION
PARIS, MO 65275
(660)327-4911
Monroe
263402
PATTONSBURG MED CLINIC
110 N CENTRAL AVE
PATTONSBURG, MO 64670
(660)367-4304
Daviess
263495
PCMH RURAL HEALTH CLINIC
1926 OAK STREET, PO BOX 389
UNIONVILLE, MO 63565
(660)947-7373
Putnam
268987
PCRMC MEDICAL GROUP INC
1050 WEST TENTH STREET
ROLLA, MO 65401
(573)458-3510
Phelps
263434
PEMISCOT PRIMARY CARE CLINIC
907 EAST REED AVE
HAYTI, MO 63851
(573)359-3660
Pemiscot
268614
PERRY COUNTY PHYSICIANS SERVICES
206 HOSPITAL LANE, SUITE 201
PERRYVILLE, MO 63775
(573)547-4899
Perry
268909
PERRY KIDS PEDIATRICS
210 HOSPITAL LN, SUITE 202
PERRYVILLE, MO 63775
(573)517-0999
Perry
268592
PERRYVILLE FAMILY CARE CLINIC
212 HOSPITAL LANE, SUITE 101
PERRYVILLE, MO 63775
(314)547-7888
Perry
268717
PFCC WEST
1508 EDGEMONT BLVD
PERRYVILLE, MO 63775
(573)339-2000
Perry
263968
PHYSICIANS PARK PRIMARY CARE
225 PHYSICIANS PARK DRIVE, SUITE 400
POPLAR BLUFF, MO 63901
(573)727-5500
Butler
263435
PIEDMONT FAMILY CLINIC
#1 HAL'S PLAZA
PIEDMONT, MO 63957
(573)223-4800
Wayne
Run Date: 10/08/2015
Job # 41303463
Last Update: 10/07/2015
Page 9 of 12
CASPER Report 0006D
Name and Address Listing
For Rural Health Clinic
Based on Current Survey
Missouri
CCN
Provider Name
Address
City, State and ZIP
Telephone # County Name
263933
PIEDMONT PHYSICIAN ASSOCIATES
CANYON RD & HWY 34, RT 4 BOX 4515
PIEDMONT, MO 63957
(573)223-4233
Wayne
268723
PIKE MEDICAL CLINIC INC
211 SOUTH THIRD ST
LOUISIANA, MO 63353
(573)754-5555
Pike
268724
PIKE MEDICAL CLINIC INC
905 HWY 161
BOWLING GREEN, MO 63334
(573)324-2241
Pike
268939
PILOT GROVE RURAL HEALTH CLINIC
212 COLLEGE STREET
PILOT GROVE, MO 65276
(660)834-5100
Cooper
263893
PINEVILLE MED CLINIC
412 S HIGHWAY 71, SUITE J, PO BOX 265
PINEVILLE, MO 64856
(417)223-4290
Mcdonald
268586
PLATTSBURG FAMILY MEDICINE
214 N MAIN
PLATTSBURG, MO 64477
(816)930-2041
Clinton
263929
PLATTSBURG MEDICAL CLINIC
214 N MAIN
PLATTSBURG, MO 64477
(816)539-2117
Clinton
263485
PLEASANT HILL MEDICAL CENTER
1601 N HIGHWAY 7
PLEASANT HILL, MO 64080
(816)540-2111
Cass
268552
PLEASANT HOPE FAMILY MED CTR
209 SOUTH MAIN STREET
PLEASANT HOPE, MO 65725
(417)267-2001
Polk
268581
PMHS CONVENIENT CARE CLINIC
946 E REED STREET
HAYTI, MO 63851
(573)359-6162
Pemiscot
263446
POLO FAMILY HEALTH CTR
198 N MAIN STREET
POLO, MO 64671
(660)354-2550
Caldwell
268676
POPLAR BLUFF MEDICAL CLINIC
2588 N WESTWOOD
POPLAR BLUFF, MO 63901
(573)778-1277
Butler
268919
POPLAR BLUFF PEDIATRIC ASSOCIATES, LLC
2210 BARRON ROAD, STE, 120
POPLAR BLUFF, MO 63901
(573)785-2002
Butler
268685
POPLAR BLUFF PRIMARY CARE
2360 KATY LANE
POPLAR BLUFF, MO 63901
(573)712-2546
Butler
268698
PORTAGEVILLE COMMUNITY CARE CENTER
204 E 3RD STREET
PORTAGEVILLE, MO 63873
(573)379-5467
New Madrid
263421
PORTAGEVILLE PRIMARY CARE
314 E MAIN STREET
PORTAGEVILLE, MO 63873
(314)379-3777
New Madrid
793836
POTOSI PAIN SOLUTIONS
24 SOUTHTOWNE DRIVE
POTOSI, MO 63664
(573)438-3733
Washington
268651
POTOSI RURAL HEALTH CLINIC
#1 KWAN PLAZA
POTOSI, MO 63664
(573)438-1899
Washington
268713
PRINCETON MEDICAL CLINIC
400 N FULLERTON STREET
PRINCETON, MO 64673
(660)748-4040
Mercer
268996
624 OLD ST MARYS RD, SUITE A
PERRYVILLE, MO 63775
(573)547-3232
Perry
263826
PROFESSIONAL CLINICS DBA CONVENIENT
HEALTHCARE
PULASKI MEDICAL CLINIC
1000 GW LANE
WAYNESVILLE, MO 65583
(573)774-2715
Pulaski
263473
PUXICO CLINIC
130 E HARBIN PO BOX 7
PUXICO, MO 63960
(573)222-3556
Stoddard
268995
LA BELLE, MO 63447
(660)462-3266
Lewis
263836
QUINCY MEDICAL GR, LABELLE RURAL HEALTH 1000 CENTRAL STREET
AFFILIATE
QUINCY MEDICAL GROUP - CANTON
1100 EAST OUTER ROAD SOUTH
CANTON, MO 63435
(573)288-5949
Lewis
268959
RANDOLPH COUNTY HEALTH DEPARTMENT
423 E LOGAN
MOBERLY, MO 65270
(660)263-6643
Randolph
268670
REID MEDICAL CLINIC
1401 N JEFFERSON ST
CARROLLTON, MO 64633
(660)542-3900
Carroll
268941
REPUBLIC FAMILY MEDICAL WALK-IN CLINIC
281 US HWY 60 WEST
REPUBLIC, MO 65738
(417)732-6277
Greene
263425
RICH HILL FAMILY MED CLINIC
320 NORTH 14TH ST
RICH HILL, MO 64779
(417)395-2150
Bates
263892
RIVER CITY HLTH CLINIC INC
224 NORTH FREDERICK ST
CAPE GIRARDEAU, MO 63701
(573)332-0121
Cape Girardeau
268956
ROLLA FAMILY CLINIC
1060 SOUTH BISHOP AVENUE
ROLLA, MO 65401
(573)647-1869
Phelps
268556
SAC-OSAGE HOSPITAL TRI-COUNTY CLINIC
855 ARDUSER DRIVE
OSCEOLA, MO 64776
(417)646-8153
St. Clair
268960
SCHEIDLER RURAL HEALTH CLINIC
301 SOUTH BYP
KENNETT, MO 63857
(573)888-0900
Dunklin
263942
SCOTT CITY MEDICAL CLINIC
2102 MAIN STREET
SCOTT CITY, MO 63780
(573)264-0087
Scott
263450
SE HEALTH CENTER OF RIPLEY COUNTY RURAL 109 LEROUX DR
HEALTH
DONIPHAN, MO 63935
(573)996-2136
Ripley
Run Date: 10/08/2015
Job # 41303463
Last Update: 10/07/2015
Page 10 of 12
CASPER Report 0006D
Name and Address Listing
For Rural Health Clinic
Based on Current Survey
Missouri
CCN
Provider Name
Address
City, State and ZIP
Telephone # County Name
263979
SHANNON CO MEDICAL CLINIC
1008 HWY 19 NORTH PO BOX 28
WINONA, MO 65588
(314)325-4711
Shannon
268512
SHELBINA FAMILY PRACTICE
400 SOUTH CENTER
SHELBINA, MO 63468
(573)588-4131
Shelby
268538
SHELDON FAMILY MEDICAL CLINIC
810 W MAIN STREET
SHELDON, MO 64784
(417)884-5006
Vernon
268993
SIKESTON FAMILY MEDICAL
1226 LINN STREET, SUITE F
SIKESTON, MO 63801
(573)481-0700
Scott
268920
SIKESTON URGENT CARE, PC
918 S KINGSHIGHWAY
SIKESTON, MO 63801
(573)471-8500
New Madrid
793831
SIMMONS FAMILY PRACTICE
1000 WEBSTER ST, SUITE 101
MEXICO, MO 65265
(573)581-2348
Audrain
268704
SMDH CENTER FOR FAMILY HEALTH
35629 HIGHWAY 72 , BLDG 1, PO BOX 774
SALEM, MO 65560
(573)729-2050
Dent
268634
SMDH FAMILY MEDICINE
35629 HWY 72, PHYSICIANS OFFICE BLDG 3
SALEM, MO 65560
(573)729-6626
Dent
268635
SMITH STREET MEDICAL CLINIC
117 SMITH AVE
SIKESTON, MO 63801
(573)471-0200
New Madrid
268683
SOUTHEAST HEALTH BERNIE CLINIC
810 N WALNUT
BERNIE, MO 63822
(573)283-5336
Stoddard
268587
SOUTHEAST HEALTH BLOOMFIELD CLINIC
1003 HIGHWAY 25 NORTH
BLOOMFIELD, MO 63825
(573)568-3686
Stoddard
268546
1300 NORTH ONE MILE RD, STE 2
DEXTER, MO 63841
(573)624-7662
Stoddard
1 HOSPITAL DRIVE
DONIPHAN, MO 63935
(573)996-7148
Ripley
350 E WALNUT STREET SUITE 1
ELLINGTON, MO 63638
(573)663-2571
Reynolds
1009 HWY BUSINESS 60
VAN BUREN, MO 63965
(573)323-4812
Carter
1300 N ONE MILE RD STE 1
DEXTER, MO 63841
(573)624-7788
Stoddard
268661
SOUTHEAST HEALTH CHILDREN'S CLINIC OF
DEXTER
SOUTHEAST HEALTH FAMILY MEDICINE OF
DONIPHAN
SOUTHEAST HEALTH FAMILY MEDICINE OF
ELLINGTON
SOUTHEAST HEALTH FAMILY MEDICINE OF VAN
BUREN
SOUTHEAST HEALTH INTERNAL MEDICINE OF
DEXTER
SOUTHEAST HEALTH MALDEN CLINIC
500 N DOUGLAS
MALDEN, MO 63863
(573)276-2221
Dunklin
268674
SOUTHEAST PEDIATRICS
25 DOCTORS PARK
CAPE GIRARDEAU, MO 63703
(573)519-4600
Cape Girardeau
268657
SOUTHEAST PRIMARY CARE-MT AUBURN
817 S MT AUBURN, SUITE 100
CAPE GIRARDEAU, MO 63703
(573)519-4500
Cape Girardeau
268570
SOUTHEASTHEALTH FAMILY MEDICINE OF
DEXTER
SOUTHSIDE MEDICAL CENTER
1200 N ONE MILE RD DEXTER MO 63841-1000
DEXTER, MO 63841
(573)624-7575
Stoddard
1120 SOUTH SPRINGFIELD AVENUE
BOLIVAR, MO 65613
(417)328-6653
Polk
268721
268720
268719
268547
268668
263821
SOUTHWEST CITY COMM CLINIC
109 NORTH BROADWAY, PO BOX 160
SOUTH WEST CITY, MO 64863
(417)762-3287
Mcdonald
268590
SOUTHWEST MEDICAL ASSOCIATES
1714 WEIN STREET
HERMANN, MO 65041
(573)486-2118
Gasconade
263886
SPARTA HEALTH CLINIC
515 HUGH AVENUE, PO BOX 449
SPARTA, MO 65753
(417)634-3000
Christian
263906
SSM GLENNON CARE PEDIATRICS-TROY
164 PROFESSIONAL PARKWAY
TROY, MO 63379
(636)462-5437
Lincoln
268680
SSM HEALTH MEDICAL GROUP
2265 BADNELL DAM BLVD SUITE 103
LAKE OZARK, MO 65049
(573)964-5599
Camden
268559
SSM HEALTH MEDICAL GROUP - FAMILY
MEDICINE
SSM HEALTH MEDICAL GROUP FAMILY
MEDICINE
SSM HEALTH MEDICAL GROUP FAMILY
MEDICINE
SSM HEALTH MEDICAL GROUP FAMILY
MEDICINE
SSM HEALTH MEDICAL GROUP FAMILY
MEDICINE
240 PICKERING STREET
MONTGOMERY CITY, MO 63361
(573)564-2101
Montgomery
204 WEST WASHINGTON STREET
VANDALIA, MO 63382
(573)594-3800
Audrain
809 MEDICAL PARK DRIVE, STE 101
MEXICO, MO 65265
(573)581-8590
Audrain
100 HIGHWAY 28 W
BELLE, MO 65013
(573)859-3775
Maries
626 E SUMMIT STREET, SUITE L
MEXICO, MO 65265
(573)581-6266
Audrain
268562
268631
268678
268560
Run Date: 10/08/2015
Job # 41303463
Last Update: 10/07/2015
Page 11 of 12
CASPER Report 0006D
Name and Address Listing
For Rural Health Clinic
Based on Current Survey
Missouri
CCN
Provider Name
Address
City, State and ZIP
Telephone # County Name
268677
SSM HEALTH MEDICAL GROUP FAMILY
MEDICINE
SSM HEALTH MEDICAL GROUP FAMILY
MEDICINE
SSM HEALTH MEDICAL GROUP FAMILY
MEDICINE
SSM HEALTH MEDICAL GROUP FAMILY
MEDICINE
SSM HEALTH MEDICAL GROUP FAMILY
MEDICINE
SSM HEALTH MEDICAL GROUP FAMILY
MEDICINE
SSM HEALTH MEDICAL GROUP INTERNAL
MEDICINE
SSM HEALTH MEDICAL GROUP PEDIATRICS
221 N MAIN STREET
PARIS, MO 65275
(660)327-4000
Monroe
801 KIDWELL DR
VERSAILLES, MO 65084
(573)378-5454
Morgan
201 S MAIN STREET
AUXVASSE, MO 65231
(573)386-5959
Callaway
875 STATE ROUTE 5
TIPTON, MO 65081
(660)433-5541
Moniteau
111 W BATES STREET
WELLSVILLE, MO 63384
(573)684-2208
Montgomery
1223 MAIN STREET
PERRY, MO 63462
(573)565-2213
Ralls
600 MEDICAL PARK DRIVE
MEXICO, MO 65265
(573)581-1040
Audrain
3626 S CLARK STREET, STE A
MEXICO, MO 65265
(573)581-5011
Audrain
2016 SOUTH MAIN
MARYVILLE, MO 64468
(660)562-2525
Nodaway
301 E PRICE AVE STE A
SAVANNAH, MO 64485
(816)432-0006
Andrew
114 E SOUTH HILLS DRIVE
MARYVILLE, MO 64468
(660)562-2525
Nodaway
268686
268716
268703
268557
268558
268555
268589
268540
263915
SSM HEALTH ST FRANCIS HOSPITAL MEDICAL
GROUP
SSM HEALTH ST FRANCIS HOSPITAL MEDICAL
GROUP
SSM HEALTH ST FRANCIS HOSPITAL MEDICAL
GROUP
ST JOHN'S CLINIC - ROLLA FAMILY MEDICINE
263943
ST JOHN'S CLINIC - ST JAMES
263851
263439
268693
268542
1605 MARTIN SPRINGS DRIVE, STE 230
ROLLA, MO 65401
(573)341-9106
Phelps
107 W ELDON ST
SAINT JAMES, MO 65559
(573)265-1818
Phelps
ST LUKE'S GREEN HILLS MEDICAL CLINIC
3300 E 10TH ST
TRENTON, MO 64683
(660)359-3939
Grundy
STE GENEVIEVE FAMILY HEALTH CLINIC
930 PARK DRIVE
SAINTE GENEVIEVE, MO 63670
(573)883-2782
Ste. Genevieve
263896
STEELE FAMILY RURAL HEALTH CLINIC, LLC
216 WEST MAIN STREET, SUITE A
STEELE, MO 63877
(573)695-2181
Pemiscot
263983
STEWARTSVILLE MED CLINIC
106 E FOURTH
STEWARTSVILLE, MO 64490
(816)669-3225
De Kalb
263977
STOCKTON FAMILY MEDICAL CENTER
810 SOUTH ST
STOCKTON, MO 65785
(417)276-5131
Cedar
268520
SULLIVAN CO MEM HOSP PHYS CLIN
630 WEST THIRD ST
MILAN, MO 63556
(660)265-5204
Sullivan
268718
18 WEST 3RD STREET
GREEN CITY, MO 63545
(660)874-5887
Sullivan
268603
SULLIVAN COUNTY MEMORIAL HOSP GREEN
CITY CLINIC
TCMH - CABOOL MEDICAL CLINIC
500 MAIN STREET, PO BOX 380
CABOOL, MO 65689
(417)962-3121
Texas
268630
TCMH FAMILY CLINIC-LICKING
233 S MAIN
LICKING, MO 65542
(573)674-3011
Texas
268535
TCMH INTERNAL MEDICINE ASSOC
1337 S SAM HOUSTON BLVD
HOUSTON, MO 65483
(417)967-3311
Texas
268653
TCMH MOUNTAIN GROVE CLINIC
1905 WEST 19TH STREET
MOUNTAIN GROVE, MO 65711
(417)926-1770
Wright
263438
THAYER MEDICAL CLINIC
HWY 63 & EASTWOOD CTR
THAYER, MO 65791
(417)257-6752
Oregon
268658
2025 W BUSINESS HIGHWAY 60
DEXTER, MO 63841
(573)614-4600
Stoddard
268930
THE CLINIC AT WALMART OPERATED BY
SOUTHEASTHEALTH
THE MEDICAL CENTER RURAL HEALTH CLINIC
902 WOLLARD BLVD
RICHMOND, MO 64085
(816)776-2201
Ray
793833
THEODOSIA FAMILY MEDICAL CLINIC LLC
4900 ST HWY 160 STE 2
THEODOSIA, MO 65761
(417)273-2300
Ozark
263970
TINSLEY MEDICAL CLINIC
2400 LUCY LEE PARKWAY SUITE A
POPLAR BLUFF, MO 63901
(573)686-1144
Butler
268567
TOTAL FAMILY HEALTH CARE
1201 NORTH RUTHERFORD
MACON, MO 63552
(660)385-5880
Macon
Run Date: 10/08/2015
Job # 41303463
Last Update: 10/07/2015
Page 12 of 12
CASPER Report 0006D
Name and Address Listing
For Rural Health Clinic
Based on Current Survey
Missouri
CCN
Provider Name
Address
City, State and ZIP
Telephone # County Name
268679
TWIN RIVERS FAMILY PRACTICE
1231 FIRST STREET SUITE 5
KENNETT, MO 63857
(573)888-8690
Dunklin
268655
TWIN RIVERS PEDIATRICS
1312 FIRST STREET
KENNETT, MO 63857
(573)717-1080
Dunklin
268644
TWIN RIVERS WOMEN'S CENTER
501 TEACO RD
KENNETT, MO 63857
(573)888-0444
Dunklin
263871
VALLEY MEDICAL CLINIC
308 SOUTH HARRIS
WILLOW SPRINGS, MO 65793
(417)469-3175
Howell
263820
WARRENSBURG RURAL HLTH CLINIC
513 BURKARTH RD
WARRENSBURG, MO 64093
(660)747-7751
Johnson
268650
WCMH URGENT CARE
300 HEALTHWAY
POTOSI, MO 63664
(573)438-0751
Washington
263414
WESTWOOD RURAL HLTH CLINIC
2642 STATE ROUTE 76
WILLOW SPRINGS, MO 65793
(417)469-5124
Howell
263969
WILBERS FAMILY CARE CLINIC
111 EAST FIRST ST
MONTGOMERY CITY, MO 63361
(573)564-3214
Montgomery
268652
WOMEN'S CARE CENTER
1013 NORTH MAIN STREET, STE 101
SIKESTON, MO 63801
(573)472-7535
Scott
263488
WOMEN'S PRIMARY CARE CLINIC
701 EAST LINCOLN ST
HAYTI, MO 63851
(573)359-1372
Pemiscot
268623
WOMENS HEALTH CENTER
800 STE GENEVIEVE DRIVE
SAINTE GENEVIEVE, MO 63670
(573)883-5715
Ste. Genevieve
793827
WOMENS HEALTH SPECIALISTS, PC
2340 KATY LANE
POPLAR BLUFF, MO 63901
(573)776-7393
Butler
263926
WOODS MEDICAL CLINIC LLC
250 SOUTH HICKMAN
PUXICO, MO 63960
(573)222-2292
Stoddard
268643
WRIGHT MEMORIAL JAMESPORT CLINIC
103 2ND STREET
JAMESPORT, MO 64648
(660)684-6244
Daviess
268637
WRIGHT MEMORIAL PHYSICIANS GROUP
189 IOWA BLVD
TRENTON, MO 64683
(660)359-3899
Grundy
268519
WYACONDA MEDICAL SERVICES
124 WEST JEFFERSON
WYACONDA, MO 63474
(660)479-5553
Clark
Total Providers for this State = 382
Run Date: 10/08/2015
Job # 41303463
Last Update: 10/07/2015
Page 1 of 5
CASPER Report 0006D
Name and Address Listing
For Rural Health Clinic
Based on Current Survey
Nebraska
CCN
Provider Name
Address
City, State and ZIP
Telephone # County Name
283499
ADAMS PRIMARY CARE
PO BOX 963, 620 MAIN STREET, SUITE A
ADAMS, NE 68301
(402)988-2188
Gage
288520
AINSWORTH FAMILY CLINIC
913 EAST ZERO STREET
AINSWORTH, NE 69210
(402)387-1900
Brown
283473
AMH CLEARWATER CLINIC
401 HIGHWAY 275
CLEARWATER, NE 68726
(402)485-2277
Antelope
283472
AMH ELGIN CLINIC
101 WEST CEDAR STREET
ELGIN, NE 68636
(402)843-5444
Antelope
283438
AMH FAMILY PRACTICE
P O BOX 109, 109 WEST 11TH
NELIGH, NE 68756
(402)887-5440
Antelope
283474
AMH-TILDEN CLINIC
104 SOUTH CENTER
TILDEN, NE 68781
(402)368-5520
Antelope
283976
ARAPAHOE MEDICAL CLINIC
P.O. BOX 389, 305 NEBRASKA AVENUE
ARAPAHOE, NE 68922
(308)962-8495
Furnas
283475
ARNOLD MEDICAL CLINIC
104 NORTH BROADWAY STREET
ARNOLD, NE 69120
(308)848-3259
Custer
288539
ASHLAND FAMILY CLINIC
705 N 17TH AVENUE
ASHLAND, NE 68003
(402)944-2201
Saunders
283814
AVERA MEDICAL GROUP BUTTE
730 WILSON
BUTTE, NE 68722
(402)775-2508
Boyd
283427
AVERA MEDICAL GROUP CROFTON
203 WEST MAIN STREET
CROFTON, NE 68730
(402)388-2343
Knox
283428
AVERA MEDICAL GROUP HARTINGTON
405 WEST DARLENE STREET
HARTINGTON, NE 68739
(402)254-3935
Cedar
288521
AVERA MEDICAL GROUP LAFLAN
804 CHASE AVENUE
CREIGHTON, NE 68729
(402)358-5335
Knox
283460
AVERA MEDICAL GROUP NIOBRARA
254-10 PARK AVE APT E, PO BOX 254
NIOBRARA, NE 68760
(402)857-3398
Knox
288507
AVERA MEDICAL GROUP O'NEILL
300 NORTH 2ND STREET
O' NEILL, NE 68763
(402)336-2900
Holt
288509
AVERA MEDICAL GROUP PIERCE
503 N 6TH STREET
PIERCE, NE 68767
(402)329-6780
Pierce
283466
AVERA MEDICAL GROUP VERDIGRE
401 JAMES STREET
VERDIGRE, NE 68783
(402)668-2216
Knox
288528
BANCROFT MEDICAL CLINIC
219 MAIN STREET
BANCROFT, NE 68004
(402)648-7606
Cuming
288524
BEATRICE INTERNAL MEDICINE
1201 NORTH 10TH STREET
BEATRICE, NE 68310
(402)228-3545
Gage
288523
BEATRICE MEDICAL CENTER
805 WEST COURT
BEATRICE, NE 68310
(402)228-3366
Gage
288527
BEEMER MEDICAL CLINIC
212 MAIN STREET
BEEMER, NE 68716
(402)528-3288
Cuming
283498
BLUE HILL MEDICAL CLINIC
102 NORTH PINE
BLUE HILL, NE 68930
(402)756-2141
Webster
283480
BOONE COUNTY MEDICAL CLINIC
1019 SOUTH 8TH STREET
ALBION, NE 68620
(402)395-5013
Boone
283832
BRADY RURAL HEALTH CLINIC
114 NORTH MAIN STREET
BRADY, NE 69123
(308)584-3770
Lincoln
288538
BURGESS FAMILY CLINIC-DECATUR
823 S BROADWAY, SUITE 120
DECATUR, NE 68020
(402)349-5592
Burt
283836
BURWELL FAMILY PRACTICE CLINIC
410 SOUTH 8TH AVENUE, PO BOX 906
BURWELL, NE 68823
(308)346-5544
Garfield
283476
CALLAWAY MEDICAL CLINIC
213 EAST KIMBALL STREET
CALLAWAY, NE 68825
(308)836-2294
Custer
283977
CAMBRIDGE MEDICAL CENTER
P.O. BOX 488, 1305 WEST HIGHWAY 6/34
CAMBRIDGE, NE 69022
(308)697-3317
Furnas
283864
CEDAR RAPIDS MEDICAL CLINIC
106 S 3RD STREET
CEDAR RAPIDS, NE 68627
(308)358-0615
Boone
283489
CHASE COUNTY CLINIC
308 NORTH TECUMSEH STREET
WAUNETA, NE 69045
(308)394-5593
Chase
283490
CHASE COUNTY CLINIC
600 WEST 12TH STREET
IMPERIAL, NE 69033
(308)882-7299
Chase
283477
CHERRY COUNTY CLINIC
512 NORTH GREEN STREET
VALENTINE, NE 69201
(402)376-3770
Cherry
283435
CHESTER MEDICAL CLINIC
116 HURON STREET
CHESTER, NE 68327
(402)324-7101
Thayer
283461
CHI HEALTH CLARKSON CLINIC
322 PINE STREET
CLARKSON, NE 68629
(402)892-3466
Colfax
283403
CHI HEALTH HOWELLS CLINIC
P O BOX 98, 121 S 6TH STREET
HOWELLS, NE 68641
(402)986-1115
Colfax
Run Date: 10/08/2015
Job # 41303463
Last Update: 10/07/2015
Page 2 of 5
CASPER Report 0006D
Name and Address Listing
For Rural Health Clinic
Based on Current Survey
Nebraska
CCN
Provider Name
Address
City, State and ZIP
Telephone # County Name
283402
CHI HEALTH PLAINVIEW CLINIC
704 NORTH 3RD STREET
PLAINVIEW, NE 68769
(402)582-3434
Pierce
283418
CHI HEALTH SCHUYLER CLINIC
1721 COLFAX STREET
SCHUYLER, NE 68661
(402)352-3745
Colfax
283997
CHIMNEY ROCK MEDICAL CENTER
320 MAIN
BAYARD, NE 69334
(308)586-1717
Morrill
283426
COMMUNITY PHYSICIAN'S CLINIC
100 NORTH 7TH
WYMORE, NE 68466
(402)645-3733
Gage
283404
COTTONWOOD RURAL HEALTH CLINIC
120 S. 9TH ST.
TEKAMAH, NE 68061
(402)374-1585
Burt
288512
COZAD COMMUNITY MEDICAL CLINIC
P O BOX 86, 1803 PAPIO LANE
COZAD, NE 69130
(308)784-3039
Dawson
283468
CRETE AREA MEDICAL CENTER
2910 BETTEN DRIVE
CRETE, NE 68333
(402)826-2102
Saline
283980
CURTIS MEDICAL CENTER
302 EAST 6TH STREET
CURTIS, NE 69025
(308)367-4162
Frontier
283436
DAVENPORT MEDICAL CLINIC
102 NORTH A STREET
DAVENPORT, NE 68335
(402)364-2105
Thayer
283482
DINKLAGE MEDICAL CLINIC
500 EAST DECATUR
WEST POINT, NE 68788
(402)372-2477
Cuming
283496
EDGAR MEDICAL CLINIC
315 NORTH C STREET, BOX 406
EDGAR, NE 68935
(402)224-3344
Clay
283879
ELKHORN VALLEY FAMILY MEDICINE PC
304 E DOUGLAS STREET
O' NEILL, NE 68763
(402)336-4222
Holt
288525
EMERSON MEDICAL CLINIC
1012 S MAIN ST
EMERSON, NE 68733
(402)695-2453
Dakota
283449
FAMILY MEDICINE
3307 N BARADA STREET
FALLS CITY, NE 68355
(402)245-4475
Richardson
283400
FCMH CAMPBELL MEDICAL CLINIC
148 SOUTH TAYLOR
CAMPBELL, NE 68932
(402)756-8080
Franklin
283998
FCMH HILDRETH MEDICAL CLINIC
511 HUBBARD
HILDRETH, NE 68947
(308)938-4885
Franklin
283999
FCMH POOL MEDICAL CLINIC
P O BOX 315, 121 15TH AVE
FRANKLIN, NE 68939
(308)425-6249
Franklin
283844
FILLMORE COUNTY MEDICAL CENTER, PC
1840 F STREET
GENEVA, NE 68361
(402)759-4485
Fillmore
288506
FORT CALHOUN CLINIC
4929 COUNTY ROAD P43
FORT CALHOUN, NE 68023
(402)468-4655
Washington
283846
FRIEND MEDICAL CENTER, PC
1210 SECOND STREET, PO BOX 227
FRIEND, NE 68359
(402)947-2021
Saline
288518
GAGE COUNTY MEDICAL CLINIC
1101 NORTH 10TH STREET
BEATRICE, NE 68310
(402)228-3436
Gage
283448
GORDON CLINIC
807 N ASH
GORDON, NE 69343
(308)282-1442
Sheridan
288536
GOTHENBURG CLINIC
918 20TH STREET
GOTHENBURG, NE 69138
(308)537-4066
Dawson
283876
GOTHENBURG MEDICAL ARTS RURAL HEALTH
CLINIC
GRANT MEDICAL CLINIC
619 10TH STREET, P O BOX 389
GOTHENBURG, NE 69138
(308)537-3673
Dawson
283989
288502
912 CENTRAL AVENUE
GRANT, NE 69140
(308)352-7100
Perkins
2091 BOX BUTTE AVENUE, SUITE 200 & SUITE 700
ALLIANCE, NE 69301
(308)762-4300
Box Butte
812 LARAMIE AVENUE
HEMINGFORD, NE 69348
(308)487-3322
Box Butte
111 NORTH MAIN STREET
HYANNIS, NE 69350
(308)458-2436
Grant
P O BOX 146, 101 E SOUTH STREET
283866
GREATER NEBRASKA MEDICAL & SURGICAL
SERV-ALLIANCE
GREATER NEBRASKA MEDICAL & SURGICAL
SERV-HEMINGFOR
GREATER NEBRASKA MEDICAL & SURGICAL
SERV-HYANNIS
GREATER SANDHILLS FAMILY HEALTHCARE PC
BASSETT, NE 68714
(402)684-2285
Rock
283867
GREATER SANDHILLS FAMILY HEALTHCARE PC 418 E 5TH STREET
ATKINSON, NE 68713
(402)925-2994
Holt
283865
GREATER SANDHILLS FAMILY HEALTHCARE PC 110 W 2ND STREET
STUART, NE 68780
(402)924-3777
Holt
283454
283467
288511
GREELEY MEDICAL CLINIC
109 WEST OCONNOR AVENUE
GREELEY, NE 68842
(308)428-3018
Greeley
288516
HEARTLAND FAMILY MEDICINE
715 BROWN STREET
ALMA, NE 68920
(308)928-2103
Harlan
Run Date: 10/08/2015
Job # 41303463
Last Update: 10/07/2015
Page 3 of 5
CASPER Report 0006D
Name and Address Listing
For Rural Health Clinic
Based on Current Survey
Nebraska
CCN
Provider Name
Address
City, State and ZIP
Telephone # County Name
288515
HEARTLAND FAMILY MEDICINE
811 HOWELL STREET
OXFORD, NE 68967
(308)824-3288
Furnas
283421
HENDERSON FAMILY CARE
1621 FRONT STREET
HENDERSON, NE 68371
(402)723-4512
York
288537
HOOPER MEDICAL CLINIC
600 E FULTON STREET, SUITE A
HOOPER, NE 68031
(402)654-2221
Dodge
283455
HOWARD COUNTY MEDICAL CLINIC
1113 SHERMAN STREET
ST PAUL, NE 68873
(308)754-5447
Howard
283483
HOWELLS FAMILY PRACTICE
119 SOUTH 3RD STREET
HOWELLS, NE 68641
(402)986-0830
Colfax
283493
HUMBOLDT FAMILY MEDICINE
1120 GRAND AVENUE
HUMBOLDT, NE 68376
(402)862-3280
Richardson
288519
HUMPHREY MEDICAL CLINIC
303 MAIN STREET
HUMPHREY, NE 68642
(402)923-0412
Platte
283985
INDIANOLA MEDICAL CLINIC
119 SOUTH FOURTH
INDIANOLA, NE 69034
(308)364-9290
Red Willow
283416
KEARNEY COUNTY HEALTH SERVICES
727 EAST FIRST STREET
MINDEN, NE 68959
(308)832-1440
Kearney
288532
KHS POTTER CLINIC
922 1/2 SHERMAN STREET
POTTER, NE 69156
(308)879-0155
Cheyenne
283437
KIMBALL COUNTY HOSPITAL CLINIC
505 SOUTH BURG STREET
KIMBALL, NE 69145
(308)235-1966
Kimball
283405
LEGEND BUTTES HEALTH SERVICES-
P.O. BOX 272, 11 PADDOCK ST.
CRAWFORD, NE 69339
(308)665-1770
Dawes
288531
LONE TREE MEDICAL CLINIC
2510 18TH AVENUE
CENTRAL CITY, NE 68826
(308)946-3845
Merrick
288530
LONE TREE MEDICAL CLINIC
901 BROADWAY STREET
FULLERTON, NE 68638
(308)536-2458
Nance
283401
LYONS MERCY MEDICAL CLINIC
220 MAIN, BOX 229
LYONS, NE 68038
(402)687-2171
Burt
283813
MAIN STREET MEDICAL CLINIC
313 NORTH WEBSTER, P O BOX 467
RED CLOUD, NE 68970
(402)746-2282
Webster
283462
MCH PHYSICIANS BLAIR CLINIC
812 NORTH 22ND STREET
BLAIR, NE 68008
(402)426-4611
Washington
283994
MEMORIAL CLINIC-UTICA
100 4TH STREET
UTICA, NE 68456
(402)534-2081
Seward
283432
MILFORD FAMILY MEDICAL CENTER
119 SOUTH C STREET
MILFORD, NE 68405
(402)761-3307
Seward
283430
MORRILL COUNTY HOSPITAL CLINIC
1320 S STREET
BRIDGEPORT, NE 69336
(308)262-1755
Morrill
283458
NANCE COUNTY MEDICAL CLINIC
405 BROADWAY STREET
FULLERTON, NE 68638
(308)536-2446
Nance
288522
NEBRASKA CITY MEDICAL CLINIC
1301 GRUNDEMAN BLVD, SUITE A
NEBRASKA CITY, NE 68410
(402)873-4242
Otoe
283485
OAKLAND FAMILY PRACTICE
100 WEST 9TH STREET
OAKLAND, NE 68045
(402)685-5120
Burt
283456
OAKLAND MERCY MEDICAL CLINIC
211 NORTH ENGDAHL
OAKLAND, NE 68045
(402)685-5116
Burt
283471
ORCHARD MEDICAL CLINIC
103 WASHINGTON STREET
ORCHARD, NE 68764
(402)893-5155
Antelope
288535
OSMOND FAMILY PRACTICE CLINIC
418 N STATE STREET
OSMOND, NE 68765
(402)748-3366
Pierce
283878
PARK STREET MEDICAL CLINIC PC
505 SOUTH PARK STREET
GENOA, NE 68640
(402)993-2206
Nance
283984
PAWNEE COUNTY RURAL HEALTH CLINIC
600 I STREET, P O BOX 433
PAWNEE CITY, NE 68420
(402)852-2311
Pawnee
288526
PENDER MEDICAL CLINIC
100 VALLEY VIEW DRIVE, SUITE 1
PENDER, NE 68047
(402)385-3033
Thurston
283870
PONCA MERCY MEDICAL CLINIC
111 2ND STREET
PONCA, NE 68770
(402)755-2231
Dixon
283441
903 BAILEY STREET
STRATTON, NE 69043
(308)276-2411
Hitchock
1313 N. CHEYENNE - P O BOX 710
BENKELMAN, NE 69021
(308)423-2151
Dundy
288533
QUALITY HEALTHCARE SERVICES MEDICAL
CLINIC
QUALITY HEALTHCARE SERVICES MEDICAL
CLINIC
RANDOLPH FAMILY PRACTICE CLINIC
106 E WAYNE STREET
RANDOLPH, NE 68771
(402)337-0200
Cedar
283440
REGIONAL WEST GARDEN COUNTY CLINIC
1100 WEST 2ND STREET
OSHKOSH, NE 69154
(308)772-3283
Garden
283442
Run Date: 10/08/2015
Job # 41303463
Last Update: 10/07/2015
Page 4 of 5
CASPER Report 0006D
Name and Address Listing
For Rural Health Clinic
Based on Current Survey
Nebraska
CCN
Provider Name
Address
City, State and ZIP
Telephone # County Name
283821
REGIONAL WEST PHYSICIANS CLINIC
302 CENTER AVENUE
MORRILL, NE 69358
(308)247-3475
Scotts Bluff
283443
ROCK COUNTY CLINIC
801 S STATE STREET
BASSETT, NE 68714
(402)684-2906
Rock
283451
RUSHVILLE CLINIC
307 CONRAD STREET
RUSHVILLE, NE 69360
(308)327-2757
Sheridan
283857
SALINE MEDICAL SPECIALTIES
969 EAST HIGHWAY 33
CRETE, NE 68333
(402)826-3222
Saline
283990
SAUNDERS MEDICAL CENTER - CLINIC
1760 COUNTY ROAD J
WAHOO, NE 68066
(402)443-4191
Saunders
283486
SCRIBNER MEDICAL CLINIC
429 MAIN STREET
SCRIBNER, NE 68057
(402)664-3414
Dodge
283409
SEWARD FAMILY MEDICAL CENTER
250 NORTH COLUMBIA
SEWARD, NE 68434
(402)643-4800
Seward
288513
CHAPPELL, NE 69129
(308)874-2255
Deuel
SIDNEY, NE 69162
(308)254-5544
Cheyenne
283481
SIDNEY REG MEDICAL CTR PHYSICIANS CLINIC- 562 VINCENT AVENUE
CHAPPELL
SIDNEY REGIONAL MEDICAL CENTER
1625 DORWART DRIVE
PHYSICIANS CLINIC
SPALDING MEDICAL CLINIC
151 NORTH CHESTNUT
SPALDING, NE 68665
(308)497-2485
Greeley
283863
ST EDWARD MEDICAL CLINIC
1102 WATER STREET
SAINT EDWARD, NE 68660
(402)678-2232
Boone
283479
SUPERIOR FAMILY MEDICAL CENTER
76 WEST 8TH STREET
NELSON, NE 68961
(402)225-2375
Nuckolls
283478
SUPERIOR FAMILY MEDICAL CENTER
PO BOX 407, 525 EAST 11TH STREET
SUPERIOR, NE 68978
(402)879-4781
Nuckolls
288514
283494
SUTTON FAMILY PRACTICE
1106 NORTH SAUNDERS
SUTTON, NE 68979
(402)773-2130
Clay
283470
SYRACUSE MEDICAL CENTER
277 EAST 17TH STREET
SYRACUSE, NE 68446
(402)269-2411
Otoe
283433
TCHS BRUNING MEDICAL CLINIC
108 SOUTH FILLMORE
BRUNING, NE 68322
(402)353-2055
Thayer
283996
TECUMSEH FAMILY HEALTH
202 HIGH STREET, SUITE 100
TECUMSEH, NE 68450
(402)335-2811
Johnson
288501
TEKAMAH MERCY MEDICAL CLINIC
1121 SOUTH 13TH STREET
TEKAMAH, NE 68061
(402)685-7590
Burt
283446
THAYER CO HLTH SVS DESHLER MED
615 4TH STREET
DESHLER, NE 68340
(402)365-7604
Thayer
283434
120 PARK AVENUE
HEBRON, NE 68370
(402)768-7203
Thayer
4800 HOSPITAL PARKWAY, SUITE 202
BEATRICE, NE 68310
(402)228-3117
Gage
283826
THAYER COUNTY HEALTH SERVICES HEBRON
MEDICAL CLINI
THE BEATRICE WOMEN'S AND CHILDREN'S
CLINIC
THE FAIRBURY CLINIC P.C.
825 22ND ST
FAIRBURY, NE 68352
(402)729-3361
Jefferson
288500
TRENTON REGIONAL MEDICAL CENTER
406 EAST 1ST STREET
TRENTON, NE 69044
(308)334-5155
Hitchock
288504
283872
VALENTINE MEDICAL CLINIC, LLC
502 N CHERRY STREET
VALENTINE, NE 69201
(402)376-2200
Cherry
283424
VALLEY MEDICAL CLINIC OF BIG SPRINGS
PO BOX 299, 100 WEST 3RD
BIG SPRINGS, NE 69122
(308)889-3376
Deuel
288529
VCHS MEDICAL CLINIC
130 NORTH 6TH STREET, SUITE B
LOUP CITY, NE 68853
(308)745-0324
Sherman
283463
VCHS MEDICAL CLINIC
150 NORTH 9TH AVENUE, SUITE B
BURWELL, NE 68823
(308)346-5442
Garfield
283464
VCHS MEDICAL CLINIC
111 SOUTH C STREET
NORTH LOUP, NE 68859
(308)496-4464
Valley
283465
VCHS MEDICAL CLINIC
2707 L STREET, SUITE 1
ORD, NE 68862
(308)728-4202
Valley
288534
WAUSA MEDICAL CLINIC
100 N LINCOLN STREET
WAUSA, NE 68786
(402)586-2244
Knox
283408
WEBSTER COUNTY CLINIC
P O BOX 465, 6TH & FRANKLIN STS
RED CLOUD, NE 68970
(402)746-5614
Webster
288503
WEEPING WATER MEDICAL CENTER
204 NORTH RANDOLPH STREET
WEEPING WATER, NE 68463
(402)267-5330
Cass
283488
WEST HOLT MEDICAL CLINIC
405 WEST PEARL STREET
ATKINSON, NE 68713
(402)925-2811
Holt
Run Date: 10/08/2015
Job # 41303463
Last Update: 10/07/2015
Page 5 of 5
CASPER Report 0006D
Name and Address Listing
For Rural Health Clinic
Based on Current Survey
Nebraska
CCN
Provider Name
Address
City, State and ZIP
Telephone # County Name
283469
WILBER MEDICAL CLINIC
203 WEST 4TH STREET
WILBER, NE 68465
(402)821-3293
Saline
283484
WISNER FAMILY PRACTICE
2100 21ST CIRCLE SUITE A
WISNER, NE 68791
(402)529-6516
Cuming
283868
WITTER FAMILY MEDICINE
358 S 10TH, P O BOX 110
DAVID CITY, NE 68632
(402)367-3322
Butler
283415
WYMORE MEDICAL CLINIC
116 EAST H STREET
WYMORE, NE 68466
(402)645-3310
Gage
Total Providers for this State = 139
Run Date: 10/08/2015
Job # 41303463
Last Update: 10/07/2015
Page 1 of 2
CASPER Report 0006D
Name and Address Listing
For Rural Health Clinic
Based on Current Survey
Colorado
CCN
Provider Name
Address
City, State and ZIP
Telephone # County Name
068507
AKRON CLINIC
82 MAIN
AKRON, CO 80720
(970)345-6336
Washington
063873
ARKANSAS VALLEY FAMILY PRACTICE LLC
2317 SAN JUAN AVE
LA JUNTA, CO 81050
(719)383-2325
Otero
063876
BASIN CLINIC
421 WEST ADAMS ROAD
NATURITA, CO 81422
(970)865-2665
Montrose
063979
BRUSH FAMILY CLINIC
2400 W EDISON
BRUSH, CO 80723
(970)842-6740
Morgan
063986
BUENA VISTA HEALTH CENTER
28374 COUNTY ROAD 317
BUENA VISTA, CO 81211
(719)395-9048
Chafeee
063866
BUTTON FAMILY PRACTICE
715 SOUTH 9TH STREET
CANON CITY, CO 81212
(719)269-8820
Fremont
063829
CENTENNIAL FAMILY HEALTH CENTER
319 MAIN STREET
ORDWAY, CO 81063
(719)267-3503
Crowley
063864
COLORADO PLAINS CLINIC - WIGGINS
226 MAIN STREET
WIGGINS, CO 80654
(970)483-7283
Morgan
068510
CONVENIENT CARE CLINIC
403 KENDELL DRIVE
LAMAR, CO 81052
(719)336-6767
Prowers
068519
CORTEZ PRIMARY CARE CLINIC
118 NORTH CHESTNUT
CORTEZ, CO 81321
(970)564-9777
Montezuma
068503
802 RIO GRANDE AVENUE
CREEDE, CO 81130
(719)658-0929
Mineral
063804
CREEDE FAMILY PRACTICE OF RIO GRANDE
HOSPITAL
CUSTER COUNTY MEDICAL CENTER
704 EDWARDS
WESTCLIFFE, CO 81252
(719)783-2380
Custer
063862
DOLORES MEDICAL CENTER
507 CENTRAL AVENUE
DOLORES, CO 81323
(970)882-7221
Montezuma
068501
EADS MEDICAL CLINIC
1211 LUTHER STREET
EADS, CO 81036
(719)438-2251
Kiowa
063858
EASTERN PLAINS MEDICAL CLINIC OF CALHAN
560 CRYSTOLA STREET
CALHAN, CO 80808
(719)347-0100
El Paso
068500
FAMILY CARE CLINIC
615 FAIRHURST
STERLING, CO 80751
(970)521-3223
Logan
063400
FAMILY PRACTICE OF HOLYOKE
1001 EAST JOHNSON STREET
HOLYOKE, CO 80734
(970)854-2500
Phillips
063851
FLORENCE MEDICAL CENTER
501 W 5TH ST
FLORENCE, CO 81226
(719)784-4816
Fremont
063872
FORT MORGAN PEDIATRIC CLINIC, PC
1000 LINCOLN STREET, STE 202
FORT MORGAN, CO 80701
(970)542-9187
Morgan
063996
GRAND RIVER HEALTH CLINIC WEST
201 SIPPERELLE DRIVE
PARACHUTE, CO 81635
(970)285-7046
Garfield
063980
GRAND RIVER PRIMARY CARE
501 AIRPORT ROAD
RIFLE, CO 81650
(970)625-1100
Garfield
063854
HAVENS FAMILY CLINIC
109 LATIGO LANE, STE C
CANON CITY, CO 81212
(719)276-3211
Fremont
063999
KIT CARSON CLINIC
102 EAST 2ND AVENUE
KIT CARSON, CO 80825
(719)962-3501
Cheyenne
063810
LAKE CITY AREA MEDICAL CENTER
700 N HENSON STREET
LAKE CITY, CO 81235
(970)944-2331
Hinsdale
068512
LAMAR MEDICAL CLINIC
403 KENDALL DRIVE
LAMAR, CO 81052
(719)336-6767
Prowers
068521
MANCOS VALLEY HEALTH CENTER
111 RAILROAD AVE
MANCOS, CO 81328
(970)564-2104
Montezuma
063869
MEADOWS FAMILY MEDICAL CENTER
115 15TH AVE, PO BOX 3243
IDAHO SPRINGS, CO 80452
(303)567-2668
Clear Creek
063403
MEEKER FAMILY HEALTH CENTER
345 CLEVELAND STREET
MEEKER, CO 81641
(970)878-4014
Rio Blanco
063404
MT SAN RAFAEL HOSPITAL HEALTH CLINIC
400 BENEDICTA STE A
TRINIDAD, CO 81082
(719)846-2206
Las Animas
068518
NORTH PARK MEDICAL CENTER - WALDEN
350 MCKINLEY STREET
WALDEN, CO 80480
(970)723-4255
Jackson
068509
PAGOSA MOUNTAIN CLINIC
95 SOUTH PAGOSA BLVD
PAGOSA SPRINGS, CO 81147
(970)731-3700
Archuleta
063997
PARKE HEALTH CLINIC
182 16TH ST
BURLINGTON, CO 80807
(719)346-9481
Kit Carson
063834
PEDIATRIC ASSOCIATION OF CANON CITY
1335 PHAY AVENUE, SUITE A
CANON CITY, CO 81212
(719)269-1727
Fremont
063985
PRAIRIE VIEW RURAL HEALTH CLINIC
615 WEST 5TH NORTH
CHEYENNE WELLS, CO 80810
(719)767-5669
Cheyenne
Run Date: 10/08/2015
Job # 41303463
Last Update: 10/07/2015
Page 2 of 2
CASPER Report 0006D
Name and Address Listing
For Rural Health Clinic
Based on Current Survey
Colorado
CCN
Provider Name
Address
City, State and ZIP
Telephone # County Name
068504
RIO GRANDE HOSPITAL CLINIC
0310C COUNTY RD 14
DEL NORTE, CO 81132
(719)657-2418
Rio Grande
063837
ROCKY FORD FAMILY HEALTH CENTER
1014 ELM AVENUE
ROCKY FORD, CO 81067
(719)254-7421
Otero
063870
SABATINI PEDIATRICS PC
612 YALE PLACE
CANON CITY, CO 81212
(719)275-3442
Fremont
063992
SAN LUIS VALLEY HEALTH ANTONITO CLINIC
115 MAIN STREET
ANTONITO, CO 81120
(719)376-2308
Conejos
068513
SAN LUIS VALLEY LA JARA MEDICAL CLINIC
509 MAIN STREET
LA JARA, CO 81140
(719)274-5000
Conejos
068523
SLV HEALTH MONTE VISTA COMMUNITY CLINIC 103 CHICO CT
MONTE VISTA, CO 81144
(719)589-8194
Rio Grande
063998
SOUTHEAST COLORADO PHYSICIANS CLINIC
SPRINGFIELD, CO 81073
(719)523-6628
Baca
068506
SOUTHWEST MEMORIAL PRIMARY CARE
33 NORTH ELM STREET
CORTEZ, CO 81321
(970)565-8556
Montezuma
068520
SOUTHWEST WALK-IN CARE
2095 NORTH DOLORES ROAD, STE C
CORTEZ, CO 81321
(970)564-1037
Montezuma
068517
SPANISH PEAKS FAMILY CLINIC
23400 US HIGHWAY 160
WALSENBURG, CO 81089
(719)738-4591
Huerfano
063401
STRATTON MEDICAL CLINIC
500 NEBRASKA AVENUE
STRATTON, CO 80836
(719)348-4650
Kit Carson
900 CHURCH STREET
063831
SURFACE CREEK FAMILY PRACTICE
255 SW 8TH AVE
CEDAREDGE, CO 81413
(970)856-3146
Delta
063840
TMC - PRIMARY CARE
500 W PACIFIC AVENUE
TELLURIDE, CO 81435
(970)728-3848
San Miguel
063995
VALLEY MEDICAL CLINIC
116 E NINTH STREET
JULESBURG, CO 80737
(970)474-3376
Sedgwick
063874
WALSH MEDICAL CLINIC
137 KANSAS STREET
WALSH, CO 81090
(719)324-5253
Baca
063868
WASHINGTON COUNTY CLINIC
482 ADAMS AVENUE
AKRON, CO 80720
(970)345-2262
Washington
063994
YUMA CLINIC
1000 W 8TH AVENUE
YUMA, CO 80759
(970)848-4792
Yuma
Total Providers for this State = 51
Run Date: 10/08/2015
Job # 41303463
Last Update: 10/07/2015
Page 1 of 2
CASPER Report 0006D
Name and Address Listing
For Rural Health Clinic
Based on Current Survey
Montana
CCN
Provider Name
Address
City, State and ZIP
Telephone # County Name
273975
BAIR MEDICAL CLINIC
16 W MAIN
WHITE SULPHUR SPRING, MT 59645
(406)547-3321
Meagher
273986
BAIR MEMORIAL CLINIC
530 3RD ST NW
HARLOWTON, MT 59036
(406)632-4351
Wheatland
273818
BASIN MEDICAL CENTER
76 CENTRAL AVE
STANFORD, MT 59479
(406)566-2773
Judith Basin
273414
BENEFIS TETON RURAL HEALTH CLINIC
915 4TH ST NW
CHOTEAU, MT 59422
(406)466-5763
Teton
273985
BENTON MEDICAL CENTER
1203 15TH ST
FORT BENTON, MT 59442
(406)622-5485
Chouteau
273989
BIG SANDY MEDICAL CENTER RHC
166 MONTANA AVE E
BIG SANDY, MT 59520
(406)378-2189
Chouteau
273419
BITTERROOT PHYSICIANS CLINIC
1200 WESTWOOD DR
HAMILTON, MT 59840
(406)363-1100
Ravalli
273817
BOULDER MEDICAL CLINIC INC
214 S MAIN
BOULDER, MT 59632
(406)225-4201
Jefferson
273981
COMMUNITY CLINIC OF FALLON CO
202 S 4TH WEST ST
BAKER, MT 59313
(406)778-2833
Fallon
273420
CONVENIENT CARE CLINIC
1200 WESTWOOD DR STE H
HAMILTON, MT 59840
(406)363-0597
Ravalli
273418
CORVALLIS FAMILY MEDICINE
1037 MAIN ST
CORVALLIS, MT 59828
(406)961-4661
Ravalli
273976
DAHL MEMORIAL CLINIC
215 SANDY ST
EKALAKA, MT 59324
(406)775-8739
Carter
273998
DANIELS MEMORIAL MEDICAL CLINIC
105 5TH AVE E
SCOBEY, MT 59263
(406)487-2296
Daniels
273991
DEER LODGE MEDICAL CENTER
1100 HOLLENBECK LN
DEER LODGE, MT 59722
(406)846-1722
Powell
273411
GABERT CLINIC
107 DILWORTH
GLENDIVE, MT 59330
(406)345-8900
Dawson
273406
GLASGOW CLINIC, INC
221 5TH AVE S
GLASGOW, MT 59230
(406)228-3400
Valley
273400
GRANITE COUNTY CLINIC
310 SANSOME
PHILIPSBURG, MT 59858
(406)859-3271
Granite
273412
HARRISON CLINIC
7558 US HWY 287
HARRISON, MT 59735
(406)685-3250
Madison
273425
HOLY ROSARY HEALTHCARE RHC
2600 WILSON ST
MILES CITY, MT 59301
(406)233-2600
Custer
273980
HOT SPRINGS MEDICAL CLINIC
209 MAIN ST
HOT SPRINGS, MT 59845
(406)741-3602
Sanders
273826
LIBBY CLINIC
211 E 2ND ST
LIBBY, MT 59923
(406)293-8711
Lincoln
273992
LISTERUD RURAL HEALTH CLINIC
301 KNAPP ST
WOLF POINT, MT 59201
(406)653-6501
Roosevelt
273995
LIVINGSTON HEALTHCARE
1001 RIVER DR
LIVINGSTON, MT 59047
(406)222-0800
Park
273427
309 ELLIOTT ST N
WILSALL, MT 59086
(406)578-2580
Park
273402
LIVINGSTON HEALTHCARE SHIELDS VALLEY
CLINIC
MADISON VALLEY CLINIC
305 N MAIN
ENNIS, MT 59729
(406)682-4223
Madison
273828
MAIN STREET MEDICAL
907 MAIN ST
THOMPSON FALLS, MT 59873
(406)827-4307
Sanders
273404
MARGO BOWERS HEALTH CENTER
26 E BROAD ST
DRUMMOND, MT 59832
(406)288-3627
Granite
273988
MISSION MOUNTAIN MEDICINE ST IGNATIUS
330 SIX TRACT LN
SAINT IGNATIUS, MT 59865
(406)745-2781
Lake
273978
MONDAK FAMILY CLINIC
304 S ELLERY AVE
FAIRVIEW, MT 59221
(406)742-5261
Richland
273982
MUSSELSHELL CO MEDICAL CENTER
1202 THIRD ST W
ROUNDUP, MT 59072
(406)323-2301
Musselshell
273423
NORTH COUNTRY MEDICAL CLINIC
1343 US HWY 93 N
EUREKA, MT 59917
(406)297-2438
Lincoln
273424
NORTH VALLEY PROFESSIONAL CENTER
2165 9TH ST W
COLUMBIA FALLS, MT 59912
(406)892-3208
Flathead
273408
NORTHERN MONTANA FAMILY MEDICAL
CENTER
NORTHERN MONTANA MEDICAL GROUP WEST
1410 1ST AVE
HAVRE, MT 59501
(406)265-5408
Hill
20 13TH ST W
HAVRE, MT 59501
(406)265-7831
Hill
273990
Run Date: 10/08/2015
Job # 41303463
Last Update: 10/07/2015
Page 2 of 2
CASPER Report 0006D
Name and Address Listing
For Rural Health Clinic
Based on Current Survey
Montana
CCN
Provider Name
Address
City, State and ZIP
Telephone # County Name
273984
NORTHERN ROCKIES MEDICAL CLINIC
226 9TH AVE SE
CUT BANK, MT 59427
(406)873-5507
Glacier
273987
PHILLIPS COUNTY FAMILY HEALTH CLINIC
311 S 8TH AVE E
MALTA, MT 59538
(406)654-1800
Phillips
273421
PHYSICIAN'S CLINIC
1170 WESTWOOD DR STE B
HAMILTON, MT 59840
(406)363-5101
Ravalli
273407
PIONEER MEDICAL CENTER CLINIC
701 STOCK ST
BIG TIMBER, MT 59011
(406)932-4199
Sweet Grass
273997
PLAINS MEDICAL CLINIC
10 KRUGER RD
PLAINS, MT 59859
(406)826-4800
Sanders
273996
PONDERA MEDICAL CENTER CLINIC
809 SUNSET BLVD
CONRAD, MT 59425
(406)271-3231
Pondera
273410
PRAIRIE COUNTY RURAL HEALTH CLINIC
409 BOWEN
TERRY, MT 59349
(406)635-5863
Prairie
273415
6 13TH AVE E
POLSON, MT 59860
(406)883-5680
Lake
63351 U S HWY 93 S
RONAN, MT 59864
(406)676-5680
Lake
273829
PROVIDENCE ST JOSEPH MEDICAL CENTER
POLSON
PROVIDENCE ST JOSEPH MEDICAL CENTER
RONAN
RAVALLI FAMILY MEDICINE
411 W MAIN ST
HAMILTON, MT 59840
(406)363-5104
Ravalli
273993
RIVERSIDE FAMILY CLINIC, INC
209 1/2 H ST E
POPLAR, MT 59255
(406)768-5171
Roosevelt
273977
ROOSEVELT MEDICAL CLINIC
818 2ND AVE E
CULBERTSON, MT 59218
(406)787-6400
Roosevelt
273413
ROSEBUD HEALTH CARE CLINIC
281 N 17TH AVE
FORSYTH, MT 59327
(406)346-2916
Rosebud
273405
RUBY VALLEY MEDICAL CLINIC
210 E CROFOOT ST
SHERIDAN, MT 59749
(406)842-5056
Madison
273417
SHERIDAN MEMORIAL CLINIC
440 W LAUREL AVE
PLENTYWOOD, MT 59254
(406)765-3700
Sheridan
273426
STILLWATER BILLINGS CLINIC
710 N 11TH ST
COLUMBUS, MT 59019
(406)322-5316
Stillwater
273403
TAMARACK MEDICAL CLINIC
1208 6TH AVE E
SUPERIOR, MT 59872
(406)822-4278
Mineral
273979
THOMPSON FALLS CLINIC
120 POND ST
THOMPSON FALLS, MT 59873
(406)827-4442
Sanders
273824
THREE RIVERS CLINIC, LLC
16 RAILWAY AVE
THREE FORKS, MT 59752
(406)285-3251
Gallatin
273994
TRIANGLE HEALTH CARE
418 W MONROE
CHESTER, MT 59522
(406)759-5194
Liberty
273409
TWIN BRIDGES MEDICAL CLINIC
104 S MADISON ST
TWIN BRIDGES, MT 59754
(406)684-5546
Madison
273416
Total Providers for this State = 55
Run Date: 10/08/2015
Job # 41303463
Last Update: 10/07/2015
Page 1 of 2
CASPER Report 0006D
Name and Address Listing
For Rural Health Clinic
Based on Current Survey
North Dakota
CCN
Provider Name
Address
City, State and ZIP
Telephone # County Name
353423
AMC CLINIC
612 CENTER AVE N
ASHLEY, ND 58413
(701)288-3448
Mcintosh
353419
AMC ZEELAND CLINIC
203 MAIN AVENUE SOUTH
ZEELAND, ND 58581
(701)423-5403
Mcintosh
353837
AVERA CLINIC OF ELLENDALE
240 MAIN
ELLENDALE, ND 58436
(701)349-3666
Dickey
353985
BEACH MEDICAL CLINIC
95 2ND ST NW
BEACH, ND 58621
(701)872-3777
Golden Valley
353437
CAVALIER COUNTY MEMORIAL HOSPITAL
CLINIC
CLINICARE
901 2ND ST
LANGDON, ND 58249
(701)256-6120
Cavalier
301 MOUNTAIN ST E
CAVALIER, ND 58220
(701)265-6307
Pembina
353428
353979
COOPERSTOWN MEDICAL CENTER
1200 ROBERTS AVE NE
COOPERSTOWN, ND 58425
(701)797-2128
Griggs
353413
CROSBY CLINIC
702 1ST ST SW
CROSBY, ND 58730
(701)965-6349
Divide
353852
FAMILY MEDICAL CLINIC
10 9TH AVENUE EAST
LISBON, ND 58054
(701)683-4711
Ransom
353405
FIRST CARE HEALTH CENTER
115 VIVIAN ST
PARK RIVER, ND 58270
(701)284-7555
Walsh
353995
FOSTER COUNTY MED CTR
820 N 5TH ST
CARRINGTON, ND 58421
(701)652-2515
Foster
353412
GARRISON FAMILY CLINIC
407 3RD AVE SE
GARRISON, ND 58540
(701)463-2245
Mclean
353449
GLEN ULLIN FAMILY MEDICAL CLINIC
602 ASH AVE
GLEN ULLIN, ND 58631
(701)348-9175
Morton
353450
HEART OF AMERICA JOHNSON CLINIC
800 S MAIN AVE
RUGBY, ND 58368
(701)776-5235
Pierce
353451
215 MAIN ST SE
DUNSEITH, ND 58329
(701)224-5694
Rolette
301 ROOSEVELT AVE
MADDOCK, ND 58348
(701)438-2555
Benson
603 EAST STREET NORTH
ELGIN, ND 58533
(701)584-3338
Grant
353854
HEART OF AMERICA JOHNSON CLINIC DUNSEITH
HEART OF AMERICA JOHNSON CLINIC MADDOCK
JACOBSON MEMORIAL HOSPITAL COMMUNITY
CLINIC
KIDDER COUNTY COMMUNITY HEALTH CENTER
110 W BROADWAY
STEELE, ND 58482
(701)475-2910
Kidder
353976
KILLDEER MEDICAL CLINIC
150 CENTRAL AVE N
KILLDEER, ND 58640
(701)764-5822
Dunn
353452
353442
353430
LIGNITE CLINIC
115 MAIN ST
LIGNITE, ND 58752
(701)933-2220
Burke
353415
LINTON MEDICAL CENTER
511 ELM ST
LINTON, ND 58552
(701)254-4531
Emmons
353438
525 N MAIN ST
WATFORD CITY, ND 58854
(701)842-3771
Mckenzie
353402
MCKENZIE COUNTY HEALTHCARE SYSTEMS
CLINIC
MILNOR CLINIC
401 MAIN
MILNOR, ND 58060
(701)427-5300
Sargent
353407
MOUNTRAIL COUNTY MEDICAL CENTER RHC
615 6TH ST SE
STANLEY, ND 58784
(701)638-2505
Mountrial
353977
108 N MAIN ST
MCVILLE, ND 58254
(701)322-4347
Nelson
353997
NELSON COUNTY HEALTH SYSTEM - MCVILLE
CLINIC
NEW ROCKFORD COMMUNITY CLINIC
118 1ST ST S
NEW ROCKFORD, ND 58356
(701)947-2021
Eddy
353456
NORTHWOOD DEACONESS HEALTH CENTER
611 TOWNER AVE
LARIMORE, ND 58251
(701)587-6060
Grand Forks
353455
4 N PARK ST
NORTHWOOD, ND 58267
(701)587-6060
Grand Forks
353454
NORTHWOOD DEACONESS HEALTH CENTER
NORTHWOOD CLINIC
OAKES COMMUNITY CLINIC
1200 N 7TH ST
OAKES, ND 58474
(701)742-3600
Dickey
358506
PRESENTATION CLINIC
213 2ND AVE NE
ROLLA, ND 58367
(701)477-3161
Rolette
353899
RICHARDTON HEALTH CENTER - RICHARDTON
CLINIC
RURAL HEALTH GACKLE
215 3RD AVE W
RICHARDTON, ND 58652
(701)974-3372
Stark
321 MAIN STREET
GACKLE, ND 58442
(701)485-3611
Logan
353443
Run Date: 10/08/2015
Job # 41303463
Last Update: 10/07/2015
Page 2 of 2
CASPER Report 0006D
Name and Address Listing
For Rural Health Clinic
Based on Current Survey
North Dakota
CCN
Provider Name
Address
City, State and ZIP
Telephone # County Name
353411
RURAL HEALTH KULM
4 1ST AVE SE
KULM, ND 58456
(701)647-2345
La Moure
353989
RURAL HEALTH NAPOLEON
420 MAIN
NAPOLEON, ND 58561
(701)754-2323
Logan
353408
RURAL HEALTH WISHEK
PO BOX 647
WISHEK, ND 58495
(701)452-2364
Mcintosh
353445
SAKAKAWEA BEULAH CLINIC
1101 3RD AVE NW
BEULAH, ND 58523
(701)873-4242
Mercer
353444
SAKAKAWEA HAZEN CLINIC
517 8TH AVE NE
HAZEN, ND 58545
(701)748-2256
Mercer
353848
SANFORD HEALTH ELLENDALE CLINIC
141 MAIN ST
ELLENDALE, ND 58436
(701)349-3331
Dickey
353822
SANFORD HEALTH ENDERLIN CLINIC
201 4TH AVE, SUITE 1
ENDERLIN, ND 58027
(701)437-3320
Ransom
353847
SANFORD HEALTH FORMAN CLINIC
336 MAIN ST
FORMAN, ND 58032
(701)724-3221
Sargent
353825
SANFORD HEALTH HILLSBORO CLINIC
315 EAST CALEDONIA
HILLSBORO, ND 58045
(701)636-5311
Traill
353844
SANFORD HEALTH LAMOURE CLINIC
100 1ST AVE SW
LAMOURE, ND 58458
(701)883-5048
La Moure
353406
SOUTHWEST MEDICAL CLINIC
14 6TH AVE SW
BOWMAN, ND 58623
(701)523-3226
Bowman
353851
ST ANDREW'S BOTTINEAU CLINIC LLC
314 OHMER ST
BOTTINEAU, ND 58318
(701)228-9400
Bottineau
353987
TIOGA MEDICAL CENTER - POWERS LAKE RHC
117 MAIN ST
POWERS LAKE, ND 58773
(701)464-5668
Burke
353986
TIOGA MEDICAL CENTER TIOGA RHC
710 N WELO ST
TIOGA, ND 58852
(701)664-3305
Williams
353988
TIOGA MEDICAL CENTER-RAY RHC
RAY MALL
RAY, ND 58849
(701)585-3624
Williams
353404
TOWNER COUNTY MEDICAL CENTER
HIGHWAY 281 NORTH
CANDO, ND 58324
(701)968-4411
Towner
353992
TRINITY COMMUNITY CLINIC - KENMARE
307 1ST AVE NW
KENMARE, ND 58746
(701)385-4283
Ward
353978
UNITY MEDICAL CENTER/GRAFTON FAMILY
CLINIC
WASHBURN FAMILY CLINIC
155 W 14TH ST
GRAFTON, ND 58237
(701)352-2000
Walsh
353434
353982
353980
353981
353983
WEST RIVER HEALTH SERVICES BOWMAN
CLINIC
WEST RIVER HEALTH SERVICES MOTT CLINIC
1177 BORDERLANE
WASHBURN, ND 58577
(701)462-3396
Mclean
608 HWY 12 WEST
BOWMAN, ND 58623
(701)523-3271
Bowman
420 PACIFIC AVE
MOTT, ND 58646
(701)824-2391
Hettinger
NEW ENGLAND, ND 58647
(701)579-4507
Hettinger
SCRANTON, ND 58653
(701)275-6336
Bowman
WEST RIVER HEALTH SERVICES NEW ENGLAND 820 2ND AVE W
CLINIC
WEST RIVER HEALTH SERVICES SCRANTON
211 MAIN ST S
CLINIC
Total Providers for this State = 55
Run Date: 10/08/2015
Job # 41303463
Last Update: 10/07/2015
Page 1 of 2
CASPER Report 0006D
Name and Address Listing
For Rural Health Clinic
Based on Current Survey
South Dakota
CCN
Provider Name
Address
City, State and ZIP
Telephone # County Name
433859
AVERA MEDICAL GROUP CORSICA
265 MAIN STREET
CORSICA, SD 57328
(605)946-5411
Douglas
433840
AVERA MEDICAL GROUP HOWARD
213 S MAIN POB 370
HOWARD, SD 57349
(605)772-4426
Miner
433435
AVERA MEDICAL GROUP MILBANK
803 EAST MILBANK AVE
MILBANK, SD 57252
(605)432-4587
Grant
433413
AVERA MEDICAL GROUP REVILLO
103 EAST 3RD STREET PO BOX 6
REVILLO, SD 57259
(605)623-4695
Grant
433883
AVERA MEDICAL GROUP SALEM
741 S HILL STREET
SALEM, SD 57058
(605)425-3038
Mccook
433438
AVERA MEDICAL GROUP VOLGA
210 KASAN AVENUE
VOLGA, SD 57071
(605)627-5701
Brookings
433886
AVERA MEDICAL GROUP WAUBAY
80 N MAIN STREET PO BOX 215
WAUBAY, SD 57273
(605)947-3422
Day
433876
AVERA MEDICAL GROUP WILMOT
409 4TH STREET
WILMOT, SD 57279
(605)938-4351
Roberts
433408
AVERA ST BENEDICT CRHC/LAKE ANDES
756 E LAKE PO BOX 279
LAKE ANDES, SD 57356
(605)487-7878
Charles Mix
433409
AVERA ST BENEDICT CRHC/PARKSTON
401 WEST GLYNN DRIVE
PARKSTON, SD 57366
(605)928-7961
Hutchinson
433410
AVERA ST BENEDICT CRHC/TRIPP
306 SOUTH MAIN STREET
TRIPP, SD 57376
(605)935-7211
Hutchinson
433888
BELLE FOURCHE REGIONAL MEDICAL CLINIC
2200 13TH AVENUE
BELLE FOURCHE, SD 57717
(605)723-8970
Butte
433890
BLACK HILLS FAMILY HEALTH CLINIC, PC
1100 HWY 71 S SUITE 101
HOT SPRINGS, SD 57747
(605)745-5188
Fall River
433418
BON HOMME FAMILY PRACTICE-AVON
MAIN STREET PO BOX 164
AVON, SD 57315
(605)286-3888
Bon Homme
433416
BON HOMME FAMILY PRACTICE-TYNDALL
410 WEST 16TH STREET
TYNDALL, SD 57066
(605)589-3322
Bon Homme
433422
BONESTEEL MEDICAL CLINIC
314 MELLETTE
BONESTEEL, SD 57317
(605)654-9021
Gregory
433419
BOWDLE CLINIC
8001 WEST 5TH STREET
BOWDLE, SD 57428
(605)285-6832
Edmunds
433433
104 W BIRCH POST OFFICE BOX 291
ARLINGTON, SD 57212
(605)983-3283
Kingsbury
302 EAST 5TH STREET
WHITE, SD 57276
(605)629-3333
Brookings
433407
BROOKINGS HEALTH SYSTEM ARLINGTON
CLINIC
BROOKINGS HEALTH SYSTEM WHITE MEDICAL
CLINIC
BURKE MEDICAL CLINIC
814 JACKSON ST POST OFFICE BOX 358
BURKE, SD 57523
(605)775-2621
Gregory
433989
CAMPBELL COUNTY CLINIC-HERREID
208 MAIN STREET N
HERREID, SD 57632
(605)437-2304
Campbell
433436
POST OFFICE BOX 158
433428
CENTERVILLE MEDICAL CLINIC
512 BROADWAY POST OFFICE BOX 70
CENTERVILLE, SD 57014
(605)563-2411
Turner
433420
205 ORCHARD DRIVE
SISSETON, SD 57262
(605)698-7681
Roberts
433423
COTEAU DES PRAIRIES HOSPITAL - SISSETON
CLINIC
FALL RIVER CLINIC
1201 HIGHWAY 71 SOUTH
HOT SPRINGS, SD 57747
(605)745-5491
Fall River
433401
FAULKTON AREA MEDICAL CENTER
1300 OAK STREET POST OFFICE BOX 100
FAULKTON, SD 57438
(606)598-6239
Faulk
433429
FLANDREAU MEDICAL CLINIC / AVERA HEALTH
212 N PRAIRIE AVENUE
FLANDREAU, SD 57028
(605)997-2471
Moody
433414
GEDDES MEDICAL CLINIC
322 MAIN
GEDDES, SD 57342
(605)337-3197
Charles Mix
433424
KADOKA CLINIC
601 CHESTNUT STREET POST OFFICE BOX 460
KADOKA, SD 57543
(605)837-2257
Jackson
433878
MCGREEVY CLINIC SALEM
740 SOUTH HILL
SALEM, SD 57058
(605)425-2855
Mccook
438500
MOBRIDGE MEDICAL CLINIC
1309 10TH AVENUE WEST PO BOX 580
MOBRIDGE, SD 57601
(605)845-8225
Walworth
433427
PARKER MEDICAL CLINIC
100 EAST SANBORN, SUITE #1
PARKER, SD 57053
(605)297-3888
Turner
433411
PHILIP CLINIC
503 W PINE PO BOX 550
PHILIP, SD 57567
(605)859-2566
Haakon
433415
PLATTE MEDICAL CLINIC
612 E 7TH PO BOX 818
PLATTE, SD 57369
(605)337-2633
Charles Mix
433402
PRAIRIE HEALTH CLINIC - ARMOUR
708 8TH STREET
ARMOUR, SD 57313
(605)724-2151
Douglas
Run Date: 10/08/2015
Job # 41303463
Last Update: 10/07/2015
Page 2 of 2
CASPER Report 0006D
Name and Address Listing
For Rural Health Clinic
Based on Current Survey
South Dakota
CCN
Provider Name
Address
City, State and ZIP
Telephone # County Name
433426
PRAIRIE HEALTH CLINIC - CORSICA
230 MAIN STREET
CORSICA, SD 57328
(605)946-5959
Douglas
433425
PRAIRIE HEALTH CLINIC - STICKNEY
301 MAIN STREET
STICKNEY, SD 57375
(605)732-4508
Aurora
433432
PRAIRIE HEALTH CLINIC - WAGNER
310 W HWY 46
WAGNER, SD 57380
(605)384-4577
Charles Mix
433404
REDFIELD CLINIC
1010 W 1ST PO BOX 590
REDFIELD, SD 57469
(605)472-0510
Spink
433861
RURAL MEDICAL CLINICS
307 EAST STATE STREET POST OFFICE BOX 9
MARION, SD 57043
(605)648-3559
Turner
433891
RURAL MEDICAL CLINICS
208 S MAIN POST OFFICE BOX 17
BRIDGEWATER, SD 57319
(605)729-2421
Mccook
433841
RURAL MEDICAL CLINICS
301 S HIGH STREET
MENNO, SD 57045
(605)387-5435
Hutchinson
433828
SANFORD BERESFORD CLINIC
600 W CEDAR STREET
BERESFORD, SD 57004
(605)763-3700
Union
433857
SANFORD CLINIC CLARK
211 N COMMERCIAL ST
CLARK, SD 57225
(605)532-3676
Clark
433403
SANFORD CLINIC DEUEL COUNTY
701 3RD AVENUE S
CLEAR LAKE, SD 57226
(605)874-2141
Deuel
433858
SANFORD CLINIC ESTELLINE
305 HOSPITAL DRIVE
ESTELLINE, SD 57234
(605)873-2222
Hamlin
433874
SANFORD CLINIC IPSWICH
110 5TH AVENUE
IPSWICH, SD 57451
(605)426-6040
Edmunds
433836
SANFORD CLINIC LAKE NORDEN
512 MAIN STREET POST OFFICE BOX 79
LAKE NORDEN, SD 57248
(605)785-3633
Hamlin
433827
SANFORD CLINIC LENNOX
108 S MAIN
LENNOX, SD 57039
(605)647-2841
Lincoln
433412
SANFORD CLINIC WEBSTER
101 PEABODY DRIVE PO BOX 381
WEBSTER, SD 57274
(605)345-4141
Day
433993
VIBORG MEDICAL CLINIC
103 PIONEER PO BOX 337
VIBORG, SD 57070
(605)326-5201
Turner
433802
WALL REGIONAL MEDICAL CLINIC
112 7TH AVENUE
WALL, SD 57790
(605)279-2149
Pennington
433889
WEBER MEDICAL SERVICES PC
109 PUGH STREET POST OFFICE BOX 370
MARTIN, SD 57551
(605)685-1450
Bennett
433995
WEST DAKOTA HEALTH CENTER
906 MAIN STREET PO BOX 206
TIMBER LAKE, SD 57656
(605)865-3258
Dewey
433430
WEST RIVER HEALTH CLINIC
103 1ST AVE EAST POST OFFICE BOX 520
MC LAUGHLIN, SD 57642
(605)823-4253
Corson
433987
WEST RIVER HEALTH CLINIC - LEMMON
401 6TH AVENUE W
LEMMON, SD 57638
(605)374-3773
Perkins
433439
WHITE LAKE MEDICAL CLINIC AVERA
306 SOUTH JOHNSTON STREET
WHITE LAKE, SD 57383
(605)337-1529
Aurora
438501
WINNER REGIONAL CLINIC
825 EAST 8TH STREET SUITE 100
WINNER, SD 57580
(605)842-2626
Tripp
Total Providers for this State = 57
POST OFFICE BOX 662
Run Date: 10/08/2015
Job # 41303463
Last Update: 10/07/2015
Page 1 of 1
CASPER Report 0006D
Name and Address Listing
For Rural Health Clinic
Based on Current Survey
Utah
CCN
Provider Name
Address
City, State and ZIP
Telephone # County Name
463810
BEAVER MEDICAL CLINIC
1059 NORTH 100 WEST
BEAVER, UT 84713
(435)438-7280
Beaver
463991
BEAVER/ MILFORD MEDICAL CLINIC
850 NORTH MAIN
MILFORD, UT 84751
(435)438-7280
Beaver
463989
BLANDING MEDICAL CLINIC
804 NORTH 400 WEST
BLANDING, UT 84511
(435)678-2254
San Juan
463981
BRYCE VALLEY CLINIC
25 SOUTH REDROCK DRIVE
CANNONVILLE, UT 84718
(435)679-8545
Garfield
463980
CIRCLEVILLE CLINIC
145 WEST MAIN
CIRCLEVILLE, UT 84723
(435)577-2958
Piute
463816
COALVILLE HEALTH CENTER
142 SOUTH 50 EAST
COALVILLE, UT 84017
(435)336-4403
Summit
463979
DUCHESNE VALLEY MEDICAL CLINIC
50 EAST 200 SOUTH
DUCHESNE, UT 84021
(435)738-2426
Duchesne
463985
EMERY MEDICAL CENTER
90 WEST MAIN STREET
CASTLE DALE, UT 84513
(435)381-2305
Emery
463984
GARFIELD MEMORIAL CLINIC
200 NORTH 400 EAST
PANGUITCH, UT 84759
(435)676-8842
Garfield
463814
HURRICANE FAMILY PRACTICE CENT
11 SOUTH MAIN
HURRICANE, UT 84737
(435)635-9444
Washington
463815
KAMAS HEALTH CENTER
228 WEST 200 SOUTH
KAMAS, UT 84036
(435)783-4385
Summit
463821
MOAB MEDICAL CENTER INC
380 NORTH 500 WEST
MOAB, UT 84532
(435)259-0408
Grand
463818
MONUMENT VALLEY HEALTH CENTER
4 ROCK CANYON ROAD
MONUMENT VALLEY, UT 84536
(435)727-3242
San Juan
463813
MOUNTAIN UTAH FAMILY MEDICINE
879 NORTH MAIN
RICHFIELD, UT 84701
(435)896-9561
Sevier
463820
PAROWAN MEDICAL CLINIC
450 EAST CLINIC WAY
PAROWAN, UT 84761
(435)477-3344
Iron
463993
SAN JUAN CLINIC
380 WEST 100 NORTH, SUITE A
MONTICELLO, UT 84535
(435)587-5054
San Juan
Total Providers for this State = 16
Run Date: 10/08/2015
Job # 41303463
Last Update: 10/07/2015
Page 1 of 1
CASPER Report 0006D
Name and Address Listing
For Rural Health Clinic
Based on Current Survey
Wyoming
CCN
Provider Name
Address
City, State and ZIP
Telephone # County Name
533985
BIG HORN CLINIC
156 N 6TH STREET
BASIN, WY 82410
(307)568-2499
Big Horn
533809
CASTLE ROCK HOSPITAL DISTRICT
PO BOX 219
GREEN RIVER, WY 82935
(307)872-4500
Sweetwater
533819
GLENROCK HEALTH CENTER
925 W BIRCH, PO BOX 786
GLENROCK, WY 82637
(307)436-9206
Converse
533978
HULETT CLINIC
PO BOX 65
HULETT, WY 82720
(307)467-5281
Crook
533803
MEDICINE BOW HEALTH CENTER
PO BOX 37
MEDICINE BOW, WY 82329
(307)379-2222
Carbon
533981
MIDWAY CLINIC
388 HIGHWAY 20 SOUTH
BASIN, WY 82410
(307)568-3311
Big Horn
533977
MOORCROFT CLINIC
PO BOX 187
MOORCROFT, WY 82721
(307)756-3414
Crook
533806
NEWCASTLE REGIONAL MEDICAL CLINIC
1121 WASHINGTON BLVD
NEWCASTLE, WY 82701
(307)746-3582
Weston
533984
NORTH BIG HORN HOSPITAL CLINIC
1115 LANE 12
LOVELL, WY 82431
(307)548-5201
Big Horn
533987
OREGON TRAILS
PO BOX 1648
GLENROCK, WY 82637
(307)436-8838
Converse
533986
RAWHIDE RURAL HEALTH CLINIC
921 BALLANCEE AVE
LUSK, WY 82225
(307)334-4000
Niobrara
533811
RED ROCK FAMILY PRACTICE
120 NORTH C AVE
THERMOPOLIS, WY 82443
(307)864-2351
Hot Springs
533820
RED ROCK FAMILY PRACTICE-WORLAND
1125 CHARLES AVENUE
WORLAND, WY 82401
(307)347-2449
Washakie
533989
REGISTER CLIFF RURAL HEALTH CLINIC
650 W WHALEN ST
GUERNSEY, WY 82214
(307)836-3009
Platte
533976
SUNDANCE CLINIC
713 OAK STREET
SUNDANCE, WY 82729
(307)283-2476
Crook
533807
UPTON REGIONAL MEDICAL CENTER
PO BOX 676
UPTON, WY 82730
(307)468-2302
Weston
Total Providers for this State = 16
Run Date: 10/08/2015
Job # 41303463
Last Update: 10/07/2015
Page 1 of 1
CASPER Report 0006D
Name and Address Listing
For Rural Health Clinic
Based on Current Survey
Arizona
CCN
Provider Name
Address
City, State and ZIP
Telephone # County Name
033999
BOUSE MEDICAL CLINIC
44031 EAST PLUMOSA ROAD, BOX 866
BOUSE, AZ 85325
(928)851-2177
La Paz
038502
COMMUNITY HOSPITAL CLINIC-CONGRESS
26750 B SOUTH SANTA FE ROAD
CONGRESS, AZ 85332
(928)684-5421
Yavapai
033998
COMMUNITY HOSPITAL CLINIC-WICKENBURG
519 ROSE LANE
WICKENBURG, AZ 85390
(928)668-1833
Maricopa
038503
COPPER MOUNTAIN CLINIC
2250 WEST 16TH STREET
SAFFORD, AZ 85546
(928)348-4006
Graham
033830
COPPER QUEEN MEDICAL ASSOCIATES-BISBEE 101 COLE AVENUE
BISBEE, AZ 85603
(520)432-2042
Cochise
033829
100 EAST 5TH STREET
DOUGLAS, AZ 85607
(520)364-7659
Cochise
033985
COPPER QUEEN MEDICAL ASSOCIATESDOUGLAS
GREASEWOOD CLINIC
PO BOX 457, HIGHWAY 264
GANADO, AZ 86505
(928)654-3208
Apache
033997
KEARNY CLINIC
100 TILBURY DRIVE
KEARNY, AZ 85237
(928)425-3261
Pinal
033987
LA PAZ MEDICAL SERVICES QUARTZSITE
150 EAST TYSON ROAD, BOX 4618
QUARTZSITE, AZ 85359
(928)927-8747
La Paz
033996
10524 EAST HIGHWAY 92
PALOMINAS, AZ 85615
(520)366-0300
Cochise
038504
PALOMINAS / HEREFORD RURAL HEALTH
CLINIC
PARKER MEDICAL CENTER
905 FIESTA AVENUE
PARKER, AZ 85344
(928)669-2225
La Paz
038500
PLEASANT VALLEY COMM MEDICAL CENTER
124 NORTH TEWKSBURY BOULEVARD
YOUNG, AZ 85554
(928)462-3435
Gila
033984
SAGE OUTPATIENT CLINIC
PO BOX 457, HIGHWAY 264
GANADO, AZ 86505
(928)755-3411
Apache
033835
214 WEST MAIN STREET
SOMERTON, AZ 85350
(928)627-1120
Yuma
1896 EAST BABBIT LANE
SAN LUIS, AZ 85349
(928)722-6112
Yuma
033834
SAN LUIS WALK-IN CLINIC URGENT CARE &
FAMILY CENTE
SAN LUIS WALK-IN CLINIC-FAMILY & ADULT
CENTER
SONORAN FAMILY PRACTICE
171 WEST CENTRAL AVENUE
COOLIDGE, AZ 85128
(520)723-7726
Pinal
033992
SULPHUR SPRINGS MEDICAL CENTER
900 WEST SCOTT
WILLCOX, AZ 85643
(520)384-4421
Cochise
038501
2931 SOUTH HIGHWAY 260
OVERGAARD, AZ 85933
(928)535-3616
Navajo
033989
SUMMIT HEALTHCARE HEBER-OVERGAARD
COMMUNITY CLINIC
SUNSITES MEDICAL CLINIC
223 NORTH FRONTAGE ROAD
PEARCE, AZ 85625
(520)826-1089
Cochise
033993
SUPERIOR CLINIC
1134 WEST US HIGHWAY 60
SUPERIOR, AZ 85173
(520)689-2423
Pinal
033994
TRI-VALLEY MEDICAL CENTER
39726 HARQUAHALA ROAD, BOX 85
SALOME, AZ 85348
(928)859-3460
La Paz
033831
Total Providers for this State = 21
Run Date: 10/08/2015
Job # 41303463
Last Update: 10/07/2015
Page 1 of 10
CASPER Report 0006D
Name and Address Listing
For Rural Health Clinic
Based on Current Survey
California
CCN
Provider Name
Address
City, State and ZIP
Telephone # County Name
058635
ADVENTIST HEALTH COMMUNITY CARE AVENAL
ADVENTIST HEALTH COMMUNITY CARE DINUBA WEST
ADVENTIST HEALTH COMMUNITY CARE REEDLEY CYPRESS
ADVENTIST HEALTH COMMUNITY CARE - TAFT
216 E FRESNO STREET
AVENAL, CA 93204
(559)386-5364
Kings
250 W EL MONTE AVENUE
DINUBA, CA 93618
(559)638-8155
Tulare
372 W CYPRESS AVE
REEDLEY, CA 93654
(559)643-8083
Fresno
501 6TH STREET
TAFT, CA 93268
(661)763-5131
Kern
ADVENTIST HEALTH COMMUNITY CARE
REEDLEY CHILDREN'S
ADVENTIST HEALTH COMMUNITY CARE- SELMA
CENTRAL
ADVENTIST HEALTH COMMUNITY CARE-AVENAL
WEST
ADVENTIST HEALTH COMMUNITY CARECARUTHERS
ADVENTIST HEALTH COMMUNITY CARECARUTHERS EAST
ADVENTIST HEALTH COMMUNITY CARECOALINGA
ADVENTIST HEALTH COMMUNITY CARECORCORAN
ADVENTIST HEALTH COMMUNITY CARECORCORAN EAST
ADVENTIST HEALTH COMMUNITY CARECUTLER
ADVENTIST HEALTH COMMUNITY CARE-DINUBA
1433 N ACACIA
REEDLEY, CA 93654
(209)638-8155
Fresno
2141 HIGH STREET
SELMA, CA 93662
(559)891-8940
Fresno
337 E KINGS STREET
AVENAL, CA 93204
(559)638-8155
Kings
2440 WEST TAHOE
CARUTHERS, CA 93609
(559)864-3212
Fresno
2357 W TAHOE
CARUTHERS, CA 93609
(559)864-5200
Fresno
155 S 5TH STREET
COALINGA, CA 93210
(559)935-4282
Fresno
1212 HANNA STREET
CORCORAN, CA 93212
(559)992-2800
Kings
1310 HANNA AVENUE, SUITE 1 AND SUITE 3
CORCORAN, CA 93212
(559)638-8155
Kings
40657 ROAD 128
CUTLER, CA 93615
(559)528-3860
Tulare
1451 E EL MONTE WAY
DINUBA, CA 93618
(559)591-3342
Tulare
ADVENTIST HEALTH COMMUNITY CAREFOWLER
ADVENTIST HEALTH COMMUNITY CAREHANFORD
ADVENTIST HEALTH COMMUNITY CARE-HOME
GARDEN
ADVENTIST HEALTH COMMUNITY CARE-HURON
119 SOUTH SIXTH STREET
FOWLER, CA 93625
(559)834-1614
Fresno
1025 N DOUTY ST
HANFORD, CA 93230
(559)583-2254
Kings
11899 SHAW PLACE
HANFORD, CA 93230
(559)585-3437
Kings
16916 5TH STREET
HURON, CA 93234
(559)945-9090
Fresno
ADVENTIST HEALTH COMMUNITY CAREKERMAN
ADVENTIST HEALTH COMMUNITY CAREKERMAN CENTRAL
ADVENTIST HEALTH COMMUNITY CAREKETTLEMAN CITY
ADVENTIST HEALTH COMMUNITY CAREKINGSBURG
ADVENTIST HEALTH COMMUNITY CARELEMOORE
ADVENTIST HEALTH COMMUNITY CAREOAKHURST
ADVENTIST HEALTH COMMUNITY CAREORANGE COVE
ADVENTIST HEALTH COMMUNITY CAREPARLIER NEWMARK
1000 SOUTH MADERA AVENUE
KERMAN, CA 93630
(559)846-9370
Fresno
275 S MADERA AVENUE, STE 201
KERMAN, CA 93630
(559)846-5240
Fresno
304 BECKY PEASE STREET
KETTLEMAN CITY, CA 93239
(559)386-2205
Kings
1251 DRAPER STREET
KINGSBURG, CA 93631
(559)897-6610
Fresno
810 E 'D' STREET
LEMOORE, CA 93245
(559)583-2271
Kings
48677 VICTORIA LANE
OAKHURST, CA 93644
(559)683-2711
Madera
1455 PARK BLVD
ORANGE COVE, CA 93646
(559)638-8155
Fresno
155 S NEWMARK
PARLIER, CA 93648
(559)964-6120
Fresno
058568
058589
058973
058540
058610
058665
058592
058669
058596
058552
058666
058671
058613
058595
553983
058630
058611
058599
058668
058943
058653
058600
058675
058621
058569
Run Date: 10/08/2015
Job # 41303463
Last Update: 10/07/2015
Page 2 of 10
CASPER Report 0006D
Name and Address Listing
For Rural Health Clinic
Based on Current Survey
California
CCN
Provider Name
Address
City, State and ZIP
Telephone # County Name
058638
ADVENTIST HEALTH COMMUNITY CAREREEDLEY
ADVENTIST HEALTH COMMUNITY CAREREEDLEY JEFFERSON
ADVENTIST HEALTH COMMUNITY CAREREEDLEY WOMEN'S HE
ADVENTIST HEALTH COMMUNITY CARERIVERDALE
ADVENTIST HEALTH COMMUNITY CARESANGER
ADVENTIST HEALTH COMMUNITY CARE-SELMA
811 11TH STREET
REEDLEY, CA 93654
(559)638-3227
Fresno
1150 E WASHINGTON AVENUE
REEDLEY, CA 93654
(559)638-2154
Fresno
550 W CYPRESS AVE
REEDLEY, CA 93654
(559)637-2455
Fresno
3567 MT WHITNEY AVENUE
RIVERDALE, CA 93656
(559)567-7200
Fresno
1939 ACADEMY AVENUE
SANGER, CA 93657
(559)875-6900
Fresno
1041 ROSE AVENUE
SELMA, CA 93662
(559)891-6345
Fresno
058664
058985
058667
058644
058617
553885
AMERICAN DESERT MEDICAL CLINICS
6186 ADOBE ROAD
29 PALMS, CA 92277
(760)361-8525
San Bernardino
553832
ANDERSON MEDICAL ASSOCIATES
2830 EAST STREET
ANDERSON, CA 96007
(916)365-2545
Shasta
058908
APEX MEDICAL GROUP, INC
311 WEST I STREET
LOS BANOS, CA 93635
(209)826-2222
Merced
058631
ARBUCKLE MEDICAL OFFICE
900 KING STREET
ARBUCKLE, CA 95912
(530)458-5821
Colusa
058963
ARVIN MEDICAL CLINIC
146 NORTH HILL STREET
ARVIN, CA 93203
(661)855-4468
Kern
058930
AURORA GRACE E HWANG, MD RHC
835 NORTH SEQUOIA AVENUE
LINDSAY, CA 93247
(559)562-5177
Tulare
058921
AVENAL MEDICAL CLINIC
148 EAST KINGS
AVENAL, CA 93204
(559)386-9000
Kings
058950
BAART CARTWRIGHT CLINIC
3103 EAST CARTWRIGHT AVENUE
FRESNO, CA 93725
(559)498-7100
Fresno
053968
BAECHTEL CREEK MEDICAL CLINIC
1245 SOUTH MAIN STREET
WILLITS, CA 95490
(707)459-6861
Mendocino
058580
BARTON COMMUNITY HEALTH CENTER
2201 SOUTH AVENUE
SOUTH LAKE TAHOE, CA 96150
(530)542-7094
Eldorado
553933
BAUTISTA RURAL MEDICAL CLINICS, INC
2570 JENSEN AVENUE, SUITE 106
SANGER, CA 93657
(559)875-3428
Fresno
058614
BEAR VALLEY RURAL HEALTH CLINIC
1028 W BIG BEAR BLVD
BIG BEAR CITY, CA 92314
(909)878-8277
San Bernardino
058949
153-A PIONEER LANE
BISHOP, CA 93514
(760)872-7059
Inyo
553894
BISHOP FAMILY AND MATERNITY CARE
MEDICAL CLINIC
CAL CITY CLINIC
9300 NORTH LOOP
CALIF CITY, CA 93505
(619)373-1256
Kern
058902
CAL FAMILY HEALTH, INC
1415 N ACACIA, SUITE 101
REEDLEY, CA 93654
(559)638-8187
Fresno
058607
CALEXICO HEALTH CENTER
450 EAST BIRCH STREET
CALEXICO, CA 92231
(760)768-6262
Imperial
058536
CALEXICO OUTPATIENT CENTER
495 BIRCH STREET, SUITE A
CALEXICO, CA 92231
(760)370-3700
Imperial
553952
CAMPUS FAMILY HEALTH MEDICAL CENTER
355 CAMPUS DRIVE, SUITE E
HANFORD, CA 93230
(559)584-2721
Kings
053888
CANBY FAMILY PRACTICE CLINIC
670 COUNTY ROAD 83
CANBY, CA 96015
(530)335-5457
Modoc
553891
CASTLE FAMILY HEALTH CENTER AT BLOSS
1251 GROVE STREET
ATWATER, CA 95301
(209)358-8201
Merced
053917
CEDAR FAMILY PRACTICE
12700 WELCH STREET
WATERFORD, CA 95386
(209)874-2345
Stanislaus
058603
CHARLIE MITCHELL RURAL HEALTH CLINIC
41169 GOODWIN WAY, RM 100
MADERA, CA 93638
(559)353-6425
Madera
058912
CHILDREN'S CLINIC
348 MARKET STREET, SUITE B
COLUSA, CA 95932
(530)458-2300
Colusa
553925
CHOWCHILLA FAMILY CLINIC
1020 VENTURA BLVD
CHOWCHILLA, CA 93610
(559)665-0275
Madera
058639
CHOWCHILLA MEDICAL CENTER
285 HOSPITAL DRIVE
CHOWCHILLA, CA 93610
(559)665-3781
Madera
553931
CHUK NDULUE MEDICAL OFFICE
135 SPRUCE STREET
GRIDLEY, CA 95948
(530)846-1400
Butte
058608
CMH CENTER FOR FAMILY HEALTH - FILLMORE 852 VENTURA ST
FILLMORE, CA 93015
(805)524-2672
Ventura
Run Date: 10/08/2015
Job # 41303463
Last Update: 10/07/2015
Page 3 of 10
CASPER Report 0006D
Name and Address Listing
For Rural Health Clinic
Based on Current Survey
California
CCN
Provider Name
Address
City, State and ZIP
Telephone # County Name
058609
242 E HARVARD BLVD STE C
SANTA PAULA, CA 93060
(805)652-5490
Ventura
1165 PHELPS AVENUE, STE 105
COALINGA, CA 93210
(559)935-6537
Fresno
1145 PHELPS AVENUE, STE B
COALINGA, CA 93210
(559)935-4374
Fresno
36617 CENTRAL AVENUE,
HURON, CA 93234
(559)945-9251
Fresno
058551
CMH CENTER FOR FAMILY HEALTH - SANTA
PAULA
COALINGA REGIONAL MEDICAL CENTER RURAL
HEALTH CLIN
COALINGA VALLEY HEALTH CLINICS INCCOALINGA
COALINGA VALLEY HEALTH CLINICS, INCHURON
COLUSA HEALTH CLINIC
151 EAST WEBSTER ST
COLUSA, CA 95932
(916)458-5003
Colusa
058504
COMMUNITY MEDICAL CENTER OAKHURST
48677 VICTORIA LANE
OAKHURST, CA 93644
(209)683-2992
Madera
553824
COPPER TOWERS FAMILY MEDICAL CLINIC
240 N CLOVERDALE BLVD
CLOVERDALE, CA 95425
(707)894-4229
Sonoma
058591
1310 HANNA AVENUE, SUITE 3
CORCORAN, CA 93212
(559)992-5051
Kings
058676
CORCORAN DISTRICT HOSPITAL HEALTH
CENTER
CORNING RURAL HEALTH CLINIC
155 SOLANO ST
CORNING, CA 96021
(530)824-4663
Tehama
553866
DE ANZA CLINIC
1001 BLAIR STREET
CALEXICO, CA 92231
(760)357-7867
Imperial
058901
DEL PUERTO HEALTH CENTER
1700 KEYSTONE PACIFIC PARKWAY UNIT B
PATTERSON, CA 95363
(209)892-9100
Stanislaus
553869
DELANO DISTRICT MEDICAL CENTER
1004 14TH AVENUE
DELANO, CA 93215
(661)725-5676
Kern
058539
2300 7TH STREET
WASCO, CA 93280
(661)758-4184
Kern
058588
DELANO REGIONAL MEDICAL CENTER RURAL
HEALTH CLINIC
DELANO WOMEN'S MEDICAL CLINIC
1201 JEFFERSON STREET
DELANO, CA 93215
(661)721-0737
Kern
053965
DELHI MEDICAL CLINIC
9696 STEPHENS ST
DELHI, CA 95315
(209)667-0702
Merced
553817
DINUBA MEDICAL CENTER
247 NORTH L STREET
DINUBA, CA 93618
(559)591-1820
Tulare
053940
DINUBA MEDICAL CLINIC
271 N L ST
DINUBA, CA 93618
(559)591-1820
Tulare
553898
DINUBA RURAL HEALTH MEDICAL CENTER
420 EAST EL MONTE WAY
DINUBA, CA 93618
(559)595-9500
Tulare
058514
DIVIDE WELLNESS CENTER
6065 HIGHWAY 193
GEORGETOWN, CA 95634
(916)333-2548
Eldorado
058947
DON PEDRO FAMILY PRACTICE
3191 EL PRADO STREET, SUITE D
LA GRANGE, CA 95329
(209)852-2764
Stanislaus
058598
DOS PALOS MEMORIAL RURAL HEALTH CLINIC
2118 MARGUERITE STREET
DOS PALOS, CA 93620
(209)392-6121
Merced
058654
553916
553927
553928
DR NDULUE MEDICAL PRACTICE
620 E STREET
MARYSVILLE, CA 95901
(530)741-2600
Yuba
058929
DR OCHOA FAMILY CLINIC
3275 MCCALL AVENUE, STE 102
SELMA, CA 93662
(559)896-3808
Fresno
553808
DR'S PHILIP OLKIN & C RAY JONES, MD'S
3302 RENNER DRIVE
FORTUNA, CA 95540
(707)725-3318
Humboldt
058967
EARLIMART SCHOOL BASED COMMUNITY
HEALTHCARE CENTER
EASTERN PLUMAS HOSPITAL - LOYALTON
MEDICAL CLINIC
EEL VALLEY RURAL HEALTH CLINIC
398 SOUTH CHURCH STREET
EARLIMART, CA 93219
(559)366-1150
Tulare
725 THIRD STREET
LOYALTON, CA 96118
(530)993-1225
Sierra
129 WILDWOOD SUITE E
RIO DELL, CA 95562
(707)764-3139
Humboldt
058597
058926
058518
385 WEST MAIN STREET
EL CENTRO, CA 92243
(760)482-9100
Imperial
058663
EL CENTRO REGIONAL MEDICAL CTR
OUTPATIENT CLINIC
EMANUEL FAMILY PRACTICE
1010 W LAS PALMAS AVE
PATTERSON, CA 95363
(209)895-7100
Stanislaus
058606
ESCALON COMMUNITY HEALTH CLINIC
2080 MCHENRY AVENUE #200
ESCALON, CA 95320
(209)847-3011
San Joaquin
053955
EUREKA PEDIATRICS
2800 HARRIS ST
EUREKA, CA 95501
(707)445-8416
Humboldt
Run Date: 10/08/2015
Job # 41303463
Last Update: 10/07/2015
Page 4 of 10
CASPER Report 0006D
Name and Address Listing
For Rural Health Clinic
Based on Current Survey
California
CCN
Provider Name
Address
City, State and ZIP
Telephone # County Name
553849
EUREKA PEDIATRICS MCKINLEYVILLE CLINIC
2192 CENTRAL AVENUE SUITE A
MCKINLEYVILLE, CA 95521
(209)777-7777
Humboldt
058634
FAIRCHILD MEDICAL CLINIC
475 BRUCE ST
YREKA, CA 96097
(530)842-3507
Siskiyou
053975
FAMILY CARE
315 EAST 13TH STREET
MERCED, CA 95340
(209)385-7060
Merced
058941
FAMILY HEALTH CENTER OF JOSHUA TREE
63532 TWENTY NINE PALMS HWY, SUITE C
JOSHUA TREE, CA 92252
(760)366-7555
San Bernardino
058564
FAMILY HEALTH CENTER RHC
41820 GARSTIN DRIVE
BIG BEAR LAKE, CA 92315
(909)878-8246
San Bernardino
058951
FAMILY HEALTH MEDICAL CENTER
1045 5TH STREET
LOS BANOS, CA 93635
(559)665-0275
Merced
053990
FAMILY HEALTH SERVICES ANNEX
1210 E ALMOND
MADERA, CA 93637
(209)673-5101
Madera
058574
FAMILY MEDICAL CENTER - ANGELS CAMP
222 SOUTH MAIN STREET
ANGELS CAMP, CA 95222
(209)736-0813
Calaveras
058573
FAMILY MEDICAL CENTER - ARNOLD
2182 HIGHWAY 4, SUITE A100
ARNOLD, CA 95223
(209)795-4193
Calaveras
058548
FAMILY MEDICAL CENTER - COPPEROPOLIS
3505 SPRANGLER LANE #400
COPPEROPOLIS, CA 95228
(209)789-7000
Calaveras
058940
FAMILY MEDICAL CENTER - SAN ANDREAS
704 MOUNTAIN RANCH ROAD, SUITE 103 - 104
SAN ANDREAS, CA 95249
(209)754-3521
Calaveras
058571
FAMILY MEDICAL CENTER - VALLEY SPRINGS
1919 VISTA DEL LAGO
VALLEY SPRINGS, CA 95252
(209)772-9538
Calaveras
058656
FAMILY MEDICINE PRACTICE
2721 OLIVE HWY SUITE 9
OROVILLE, CA 95966
(530)538-3020
Butte
058585
FAMILY PRACTICE ASSOCIATES
2809 OLIVE HIGHWAY SUITE 260
OROVILLE, CA 95966
(530)532-6588
Butte
058587
FEATHER RIVER HOSP FAMILY HEAL
5730 CANYON VIEW DRIVE
PARADISE, CA 95969
(530)876-3179
Butte
058604
5125 SKYWAY
PARADISE, CA 95969
(530)872-2000
Butte
5734 CANYON VIEW DRIVE
PARADISE, CA 95969
(530)872-2000
Butte
053930
FEATHER RIVER HOSPITAL - FEATHER RIVER
HEALTH CENT
FEATHER RIVER HOSPITAL CANYON VIEW
CLINIC
FIREBAUGH FAMILY HEALTH CLINIC
944 O STREET
FIREBAUGH, CA 93622
(209)659-3011
Fresno
058922
FIRST CARE MEDICAL ASSOCIATES, INC
750 EAST WALKER STREET SUITE A
ORLAND, CA 95963
(530)865-4400
Glenn
553887
FIRST VALLEY MEDICAL GROUP
1535 NORTH CHINA LAKE BLVD SUITE A
RIDGECREST, CA 93555
(619)446-1691
Kern
053991
193 FAIRVIEW LANE
SONORA, CA 95370
(209)536-5100
Tuolumne
553847
FOREST ROAD HEALTH AND WELLNESS
CENTER
FORT BRAGG RURAL HEALTH CENTER
850 SEQUOIA CIRCLE
FORT BRAGG, CA 95437
(707)964-0259
Mendocino
053936
FORTUNA FAMILY MEDICAL GROUP
874 MAIN ST
FORTUNA, CA 95540
(707)725-3334
Humboldt
053951
FOWLER MEDICAL CENTER INC
210 E MERCED
FOWLER, CA 93625
(209)834-5341
Fresno
553909
FRONTIER VILLAGE FAMILY HEALTH CENTER,
INC
GALT MEDICAL SERVICES
645 ANTELOPE BLVD, SUITE 24
RED BLUFF, CA 96080
(530)528-7650
Tehama
387 CIVIC DRIVE
GALT, CA 95632
(209)339-7560
Sacramento
2760 BALLS FERRY ROAD
ANDERSON, CA 96007
(530)365-4412
Shasta
058594
058546
553862
058572
053981
058658
058970
553884
GATEWAY MED CTR DBA ANDERSON WALK-IN
MEDICAL CLNC
GLENN FAMILY MEDICAL GROUP
130 NORTH ENRIGHT
WILLOWS, CA 95988
(530)934-4681
Glenn
GLENN MEDICAL CENTER FAMILY MEDICAL
CENTER
GLENN MEDICAL RURAL HEALTH CLINIC
1133 W SYCAMORE STREET
WILLOWS, CA 95988
(530)934-8822
Glenn
1144-A W SYCAMORE ST
WILLOWS, CA 95988
(530)934-1800
Glenn
GLORIA NELSON CENTER FOR WOMEN AND
CHILDREN
GONZALES MEDICAL GROUP INC
1500 6TH AVENUE
DELANO, CA 93215
(661)725-1010
Kern
133 FOURTH STREET
GONZALES, CA 93926
(831)675-3601
Monterey
Run Date: 10/08/2015
Job # 41303463
Last Update: 10/07/2015
Page 5 of 10
CASPER Report 0006D
Name and Address Listing
For Rural Health Clinic
Based on Current Survey
California
CCN
Provider Name
Address
City, State and ZIP
Telephone # County Name
553852
GOOSE LAKE MEDICAL SERVICES
535 S MAIN ST
ALTURAS, CA 96101
(916)233-2288
Modoc
553985
GRAEAGLE MEDICAL CLINIC RHC
7597 HIGHWAY 89
GRAEAGLE, CA 96103
(916)836-1122
Plumas
058964
GREEN VALLEY MEDICAL CLINIC
41689 ROAD 128
OROSI, CA 93647
(559)628-1777
Tulare
553942
1908 NORTH BEALE ROAD, SUITE E
MARYSVILLE, CA 95901
(530)743-6888
Yuba
553954
HARMONY HEALTH MEDICAL CLINIC AND
FAMILY RESOURCE
HAROLD S BUDHRAM MD INC
5145 SHASTA DAM BLVD
SHASTA LAKE, CA 96019
(530)275-5421
Shasta
058646
HAYFORK COMMUNITY HEALTH CLINIC
6961 HIGHWAY 3
HAYFORK, CA 96041
(530)628-5517
Trinity
058590
HAZEL HAWKINS HEALTH CLINIC
301 THE ALAMEDA, SUITE B3
SAN JUAN BAUTISTA, CA 95045
(831)637-5711
San Benito
553861
HEALTH CARE MEDICAL ASSOCIATE
2787 HARRIS STREET
EUREKA, CA 95503
(707)444-3100
Humboldt
553846
HEALTH VALLEY MEDICAL GROUP INC
812 EAST D STREET
LEMOORE, CA 93245
(209)925-1000
Kings
553845
HIGH DESERT FAMILY MEDICAL CLINIC
7350 CHURCH STREET
YUCCA VALLEY, CA 92284
(760)369-3069
San Bernardino
058974
HILMAR FAMILY MEDICAL CENTER
19901 1ST STREET
HILMAR, CA 95324
(209)658-8701
Merced
058945
HORISONS UNLIMITED
1120 WEST I STREET, SUITE B
LOS BANOS, CA 93635
(209)826-1900
Merced
058978
HORISONS UNLIMITED
5320 STATE HIGHWAY 49 N
MARIPOSA, CA 95338
(209)383-5200
Mariposa
058965
HORISONS UNLIMITED
101 FRONT STREET
CHOWCHILLA, CA 93610
(209)201-2099
Madera
2275 F STREET, SUITE 1 & 2
058911
HORISONS UNLIMITED HEALTH CARE
LIVINGSTON, CA 95334
(209)394-8854
Merced
058900
HORISONS UNLIMITED HEALTH CARE-GUSTINE 554 5TH STREET
GUSTINE, CA 95322
(209)854-3854
Merced
058505
HUMBOLDT FAMILY CARE
1733 CENTRAL AVE
MCKINLEYVILLE, CA 95521
(707)839-4852
Humboldt
553802
IMMEDIATE HEALTH CARE, RHC
1850 WHITSON AVE
SELMA, CA 93662
(209)896-6666
Fresno
058984
608 G STREET
BRAWLEY, CA 92227
(760)351-1011
Imperial
058636
IMPERIAL VALLEY FAMILY CARE MEDICAL
GROUP
INDIAN VALLEY MEDICAL CLINIC
176 HOT SPRINGS ROAD
GREENVILLE, CA 95947
(530)832-6116
Plumas
553964
JAMES CORONA, MD
203 WALKER STREET, SUITE 2
ORLAND, CA 95963
(530)865-6430
Glenn
553900
JAMES OOI, MD
320 SOLANO STREET
CORNING, CA 96021
(916)824-3283
Tehama
058938
JAVIER AMU, MD, PROFESSIONAL
CORPORATION
JOANNE E REID MD INC
1121 F STREET
REEDLEY, CA 93654
(559)743-7340
Fresno
263 N VILLA AVE
WILLOWS, CA 95988
(530)934-8700
Glenn
COULTERVILLE, CA 95311
(209)878-0155
Mariposa
058937
058637
MARIPOSA, CA 95338
(209)966-3631
Mariposa
053992
JOHN C FREMONT HEALTHCARE DISTRICT
6386 GREELEY HILL ROAD
NORTHSIDE
JOHN C FREMONT HEALTHCARE DISTRICT-RHC 5186 HOSPITAL ROAD
II
JOHN C FREMONT MEDICAL CLINIC
5189 HOSPITAL ROAD
MARIPOSA, CA 95338
(209)966-3631
Mariposa
058677
KAWEAH DELTA DINUBA HEALTH CLINIC
355 MONTE VISTA DRIVE, SUITE A
DINUBA, CA 93618
(559)624-2000
Tulare
058508
KAWEAH DELTA EXETER HEALTH CLINIC
1014 SAN JUAN AVENUE
EXETER, CA 93221
(559)592-7314
Tulare
058649
KAWEAH DELTA LINDSAY HEALTH CLINIC
839 N SEQUOIA AVE
LINDSAY, CA 93247
(559)624-2000
Tulare
058659
KAWEAH DELTA WOODLAKE HEALTH CLINIC
180 EAST ANTELOPE
WOODLAKE, CA 93286
(559)624-2000
Tulare
058561
KERN VALLEY HEALTHCARE DIST RHC
4300 BIRCH AVENUE
LAKE ISABELLA, CA 93240
(760)379-1791
Kern
553912
KHUSAL MEHTA, MD RHC
430 VERMONT AVENUE
DINUBA, CA 93618
(559)591-1060
Tulare
058605
Run Date: 10/08/2015
Job # 41303463
Last Update: 10/07/2015
Page 6 of 10
CASPER Report 0006D
Name and Address Listing
For Rural Health Clinic
Based on Current Survey
California
CCN
Provider Name
Address
City, State and ZIP
Telephone # County Name
053995
KINGSBURG RURAL HEALTH CLINIC
1200 SMITH ST
KINGSBURG, CA 93631
(209)897-5841
Fresno
553830
850 WEST CALIFORNIA ST
ESCALON, CA 95320
(209)838-2278
San Joaquin
324 F STREET
WATERFORD, CA 95386
(209)874-2321
Stanislaus
553957
KRISHNAMOORTHI MD INC, A PROFESSIONAL
MEDICAL CORP
KRISHNAMOORTHI MD INC, A PROFESSIONAL
MEDICAL CORP
LASSEN MEDICAL GROUP-COTTONWOOD
20833 LONG BRANCH DRIVE
COTTONWOOD, CA 96022
(530)347-3418
Shasta
553955
LASSEN MEDICAL GROUP-RED BLUFF
2450 SISTER MARY COLUMBA DRIVE
RED BLUFF, CA 96080
(530)527-0414
Tehama
058918
LINDSAY FAMILY AND PEDIATRIC CLINIC
825 NORTH SEQUOIA
LINDSAY, CA 93247
(559)562-1960
Tulare
553967
LUCERNE COMMUNITY CLINIC
6300 E HIGHWAY 20
LUCERNE, CA 95458
(707)274-9299
Lake
058660
MABIE FIRST STREET HEALTHCARE CENTER
321 FIRST STREET
HOLLISTER, CA 95023
(831)638-1652
San Benito
058641
MABIE SAN JUAN ROAD HEALTHCARE CENTER
991 SAN JUAN ROAD
HOLLISTER, CA 95023
(831)636-3277
San Benito
553965
MAGALIA-PINES FAMILY PRACTICE MEDICAL
CLINIC
MAMMOTH HOSPITAL RURAL HEALTH
14662 SKYWAY
MAGALIA, CA 95954
(530)873-1676
Butte
553829
058523
85 SIERRA PARK ROAD
MAMMOTH LAKES, CA 93546
(760)934-3311
Mono
221 TWIN LAKES ROAD
BRIDGEPORT, CA 93517
(760)932-7012
Mono
553926
MAMMOTH HOSPITAL RURAL HEALTH CLINIC BRIDGEPORT
MARIAN COMMUNITY CLINICS GUADALUPE
4723 W MAIN ST STE H
GUADALUPE, CA 93434
(805)343-2004
Santa Barbara
553871
MARIPOSA FAMILY MEDICINE ASSOCIATES
5300 HWY 49N PO BOX 155
MARIPOSA, CA 95338
(209)966-3672
Mariposa
058682
MARSHALL PEDIATRIC CLINIC
4341 GOLDEN CENTER DRIVE, BUILDING A
PLACERVILLE, CA 95667
(530)626-1144
Eldorado
058640
058958
MARTIN ROCHA MD INC
251 NORTH HIGHWAY 173 SUITE 6
LAKE ARROWHEAD, CA 92352
(909)336-3670
San Bernardino
058960
MARYSVILLE CLINIC
330 H STREET SUITE A
MARYSVILLE, CA 95901
(530)674-2100
Yuba
058962
MCFARLAND SINGH MEDICAL CLINIC INC
733 3RD STREET
MC FARLAND, CA 93250
(661)792-3097
Kern
058535
MCH MEDICAL CLINIC
29099 HOSPITAL ROAD
LAKE ARROWHEAD, CA 92352
(909)336-3651
San Bernardino
058558
MEE MEMORIAL HOSPITAL MEDICAL CLINIC
467 EL CAMINO ROAD
GREENFIELD, CA 93927
(831)674-0112
Monterey
058562
MEE MEMORIAL HOSPITAL MEDICAL CLINIC
210 CANAL STREET
KING CITY, CA 93930
(831)385-6000
Monterey
553998
MEMORIAL HOSP LOS BANOS RURAL HLTH CLI
400 WEST I STREET, SUITE C
LOS BANOS, CA 93635
(209)826-0591
Merced
053914
MENDOTA FAMILY HEALTH CENTER
507 OLLER STREET
MENDOTA, CA 93640
(209)655-4211
Fresno
058662
MERCY LAKE SHASTINA COMMUNITY CLINIC
16337 EVERHART DRIVE
WEED, CA 96094
(530)938-2297
Siskiyou
058650
MERCY MT SHASTA COMMUNITY CLINIC
912 PINE ST
MOUNT SHASTA, CA 96067
(530)926-5105
Siskiyou
058975
MICHAEL KOMIN, MD, MEDICAL CORPORATION
1150 EAST LERDO HIGHWAY
SHAFTER, CA 93263
(661)630-5890
Kern
053988
MODOC MED CTR - FAMILY PRACTIC
229 W MCDOWELL AVE
ALTURAS, CA 96101
(916)233-5176
Modoc
553949
MOUNTAIN VIEW MEDICAL CLINIC
468 VERMONT AVENUE
DINUBA, CA 93618
(559)591-6200
Tulare
058935
NEWMAN MEDICAL CLINIC
1349 MAIN STREET
NEWMAN, CA 95360
(209)862-3604
Stanislaus
058629
NORTH COAST FAMILY HEALTH CENTER
721 RIVER DRIVE, SUITE A & B & C
FORT BRAGG, CA 95437
(707)964-7241
Mendocino
058952
NORTH VALLEY FAMILY PHYSICIANS MEDICAL
GROUP
NORTH VALLEY FAMILY PHYSICIANS MEDICAL
GROUP
173 EAST WEBSTER ST
COLUSA, CA 95932
(530)458-8050
Colusa
501 E ST SUITE C
WILLIAMS, CA 95987
(530)473-5255
Colusa
058953
Run Date: 10/08/2015
Job # 41303463
Last Update: 10/07/2015
Page 7 of 10
CASPER Report 0006D
Name and Address Listing
For Rural Health Clinic
Based on Current Survey
California
CCN
Provider Name
Address
City, State and ZIP
Telephone # County Name
058578
150 PIONEER LANE
BISHOP, CA 93514
(760)873-2849
Inyo
058553
NORTHERN INYO HOSPITAL RURAL HEALTH
CLINIC
OAK VIEW FAMILY PRACTICE
655 N VENTURA AVE
OAK VIEW, CA 93022
(805)649-3750
Ventura
553978
OAKDALE COMMUNITY HEALTH CENTER
1420 WEST H STREET
OAKDALE, CA 95361
(209)848-1743
Stanislaus
553982
284 SPRUCE ST
GRIDLEY, CA 95948
(916)846-5671
Butte
058942
ORCHARD HOSPITAL MEDICAL SPECIALTY
CENTER
ORCHARD MEDICAL CENTER
555 SIXTH STREET
ORANGE COVE, CA 93646
(559)626-7118
Fresno
058936
ORLAND CHILDREN'S CENTER
203 WALKER ST SUITE 3
ORLAND, CA 95963
(530)865-5400
Glenn
553911
OROSI FAMILY MEDICAL CENTER
12683 AVENUE 416
OROSI, CA 93647
(559)528-4717
Tulare
553935
OROSI RURAL HEALTH CLINIC
12572 AVENUE 416, SUITE B
OROSI, CA 93647
(559)528-4779
Tulare
058925
41696 ROAD 128
OROSI, CA 93647
(559)528-6966
Tulare
058581
OROSI URGENT CARE CENTER MEDICAL
CLINIC, INC
OROVILLE FAMILY PRACTICE
2809 OLIVE HWY, SUITES 210 & 320
OROVILLE, CA 95966
(530)532-8687
Butte
058601
OROVILLE HOSPITAL - MEDICAL CLINIC
2767 OLIVE HIGHWAY, ANNEX BUILDING
OROVILLE, CA 95966
(530)532-8544
Butte
058661
OROVILLE WOMEN'S HEALTH
2809 OLIVE HIGHWAY SUITES 260 & 310
OROVILLE, CA 95966
(530)532-8636
Butte
058582
OVOVILLE PEDIATRIC PRACTICE
2809 OLIVE HIGHWAY, #270
OROVILLE, CA 95966
(530)533-4422
Butte
058642
PARA TU SALUD CHERRY STREET
922 CHERRY STREET
TULARE, CA 93274
(559)684-4530
Tulare
553889
PARADISE WALK IN MEDICAL CLINIC
7321 SKYWAY
PARADISE, CA 95969
(916)876-8120
Butte
053971
PATHWAY HEALTHCARE
190 SOUTH OAK AVENUE, BLDG 2, SUITE 1
OAKDALE, CA 95361
(209)848-8410
Stanislaus
058583
PEDIATRIC PRACTICE ASSOCIATES
2809 OLIVE HIGHWAY, SUITE 330
OROVILLE, CA 95966
(530)533-0774
Butte
058674
PINE STREET CLINIC
408 PINE ST
MOUNT SHASTA, CA 96067
(530)926-7196
Siskiyou
058678
PIONEERS HEALTH CENTER
751 WEST LEGION ROAD, SUITE 103
BRAWLEY, CA 92227
(760)351-4400
Imperial
053845
PIT RIVER HEALTH SERVICE, INC
36977 PARK AVENUE, PO BOX 2720
BURNEY, CA 96013
(916)335-3651
Shasta
553825
PIXLEY MEDICAL GROUP
205 EAST DAVIS STREET, DRAWER Y
PIXLEY, CA 93256
(559)757-2000
Tulare
553810
PLACER COUNTY MEDICAL CLINIC
11583 C AVENUE
AUBURN, CA 95603
(916)889-7215
Placer
553867
PLACER MEDICAL CLINIC - TAHOE (RH)
PO BOX 1785/8665 SALMON STREET
KINGS BEACH, CA 96143
(916)546-6356
Placer
053989
PLUMAS RURAL HEALTH CENTERS
1060 VALLEY VIEW DR
QUINCY, CA 95971
(530)283-2121
Plumas
058522
PORTOLA MEDICAL/DENTAL CLINIC RHC
480 FIRST AVENUE
PORTOLA, CA 96122
(916)832-4211
Plumas
058584
PREMIER HEALTH CENTER
900 ORO DAM BOULEVARD
OROVILLE, CA 95966
(530)532-8824
Butte
553811
PRIMARY CARE CONSULTANTS, INC
49063 RD 426 STE C AND D
OAKHURST, CA 93644
(209)642-1500
Madera
058983
RAN HEALTH SERVICES INC
489 5TH ST
GUSTINE, CA 95322
(209)854-3728
Merced
553943
RANCHOS FAMILY HEALTH SERVICES
11976 ROAD 37, AVENUE 12
MADERA, CA 93637
(559)645-4191
Madera
053916
REDWOOD FAMILY PRACTICE, INC
2350 BUHNE STREET, SUITE A
EUREKA, CA 95501
(707)443-4593
Humboldt
553836
REDWOOD PEDIATRIC MEDICAL GROUP
3305 RENNER DRIVE
FORTUNA, CA 95540
(707)725-9355
Humboldt
058957
REDWOOD WOMEN'S CENTER P C
3309 RENNER DRIVE
FORTUNA, CA 95540
(707)725-6108
Humboldt
553879
REDWOODS RURAL HEALTH CENTER
321 5TH STREET
ALDERPOINT, CA 95511
(707)926-1070
Humboldt
Run Date: 10/08/2015
Job # 41303463
Last Update: 10/07/2015
Page 8 of 10
CASPER Report 0006D
Name and Address Listing
For Rural Health Clinic
Based on Current Survey
California
CCN
Provider Name
Address
City, State and ZIP
Telephone # County Name
058655
1111 NORTH CHINA LAKE BOULEVARD, SUITE 190
RIDGECREST, CA 93555
(760)446-3551
Kern
058913
RIDGECREST REGIONAL HOSPITAL RURAL
HEALTH CLINIC
RIGOBERTO O GUTIERREZ, MD
2809 OLIVE HWY #370
OROVILLE, CA 95966
(530)538-9410
Butte
058528
RIVERBANK COMMUNITY HEALTH CENTER
2603 PATTERSON ROAD, SUITE 3
RIVERBANK, CA 95367
(209)869-8102
Stanislaus
553859
3227 STANISLAUS ST SUITE A
RIVERBANK, CA 95367
(209)869-0131
Stanislaus
053969
RIVERBANK PRIMARY CARE MEDICAL CLINIC,
INC
ROBERT RUSHTON, MD RHC
844 S DORA ST
UKIAH, CA 95482
(707)462-8603
Mendocino
058632
RUNNING SPRINGS RURAL HEALTH CLINIC
31900 HILLTOP BOULEVARD
RUNNING SPRINGS, CA 92382
(909)336-9715
San Bernardino
058934
SALAS MEDICAL CLINIC, INC
973 NORTH SEQUOIA AVENUE
LINDSAY, CA 93247
(559)562-7799
Tulare
058946
SAMUEL DIXON FAMILY HEALTH CENTER, INC
30257 SAN MARTINEZ ROAD
VAL VERDE, CA 91384
(661)257-4008
Los Angeles
058512
SAN BENITO COMMUNITY HEALTH CLINIC
930 SUNSET DRIVE BUILDING #3
HOLLISTER, CA 95023
(831)637-5711
San Benito
553822
SAN JOAQUIN PRIME CARE MEDICAL
330 EAST PINE STREET
EXETER, CA 93221
(559)592-2134
Tulare
058928
30924 E KINGS CANYON ROAD
SQUAW VALLEY, CA 93675
(559)332-9399
Fresno
553939
SAN JOAQUIN PRIME CARE MEDICAL
CORPORATION
SAN JOAQUIN PRIME CARE MEDICAL CORP
682 EAST VISALIA ROAD
FARMERSVILLE, CA 93223
(559)594-4564
Tulare
553947
SAN JOAQUIN PRIME CARE MEDICAL CORP
826 EAST MANNING AVENUE
REEDLEY, CA 93654
(559)592-2134
Fresno
553882
SANTA ROSA DEL VALLE MEDICAL GROUP, INC
1293 SIXTH STREET
COACHELLA, CA 92236
(760)391-5151
Riverside
058517
SCOTT VALLEY RURAL HEALTH CLINIC
155 DIGGLES STREET
ETNA, CA 96027
(916)467-5393
Siskiyou
553886
SEAN R THOMAS, MD, INC
55585 29 PALMS HIGHWAY
YUCCA VALLEY, CA 92284
(760)228-3366
San Bernardino
553946
SELMA RURAL HEALTH CENTER
2057 HIGH STREET
SELMA, CA 93662
(559)891-9100
Fresno
058593
SENECA HEALTHCARE DISTRICT LAKE
ALMANOR CLINIC
SEQUOIA FAMILY MEDICAL CENTER
199 REYNOLDS ROAD
CHESTER, CA 96020
(530)258-2169
Plumas
590 W PUTNAM AVE
PORTERVILLE, CA 93257
(559)781-4100
Tulare
553820
058944
SESPE MEDICAL INC
552 SESPE AVE
FILLMORE, CA 93015
(805)524-2559
Ventura
553818
SHAFTER RURAL HEALTH CARE CLIN
406 JAMES STREET
SHAFTER, CA 93263
(661)746-5788
Kern
553819
SHAFTER RURAL HEALTH CARE CLINIC
565 KERN STREET
SHAFTER, CA 93263
(661)746-4937
Kern
058971
SHARMA MEDICAL CLINIC, INC
323 LEXINGTON STREET
DELANO, CA 93215
(661)725-2512
Kern
058966
SHASTA FAMILY CARE
725 PINE ST
MOUNT SHASTA, CA 96067
(530)926-4556
Siskiyou
553951
SHYAM BHASKAR MD INC
1001 VAN DORSTEN AVENUE
CORCORAN, CA 93212
(559)992-2337
Kings
058982
SHYAM BHASKAR MD, INC
1425 MAIN STREET
DELANO, CA 93215
(661)778-0920
Kern
553864
SISKIYOU MEDICAL GROUP
50 ALAMO AVENUE
WEED, CA 96094
(916)938-3491
Siskiyou
553881
SISKIYOU MEDICAL GROUP DR LA GRO
824 PINE STRRET
MOUNT SHASTA, CA 96067
(916)926-5261
Siskiyou
553883
SISKIYOU MEDICAL GROUP DR PARKER
822 PINE STREET
MOUNT SHASTA, CA 96067
(916)926-5261
Siskiyou
553938
SOLEDAD MEDICAL CLINIC
600 MAIN STREET
SOLEDAD, CA 93960
(831)678-2462
Monterey
553855
SONOMA VALLEY COMMUNITY CENTER
430 WEST NAPA STREET #F
SONOMA, CA 95476
(707)939-6070
Sonoma
553991
SOUTHERN HUMBOLDT COMMUNITY CL
509 ELM ST
GARBERVILLE, CA 95542
(707)923-3925
Humboldt
058511
SOUTHERN INYO HOSP DIST CLINIC
510 E LOCUST
LONE PINE, CA 93545
(760)876-1146
Inyo
Run Date: 10/08/2015
Job # 41303463
Last Update: 10/07/2015
Page 9 of 10
CASPER Report 0006D
Name and Address Listing
For Rural Health Clinic
Based on Current Survey
California
CCN
Provider Name
Address
City, State and ZIP
Telephone # County Name
553995
ST HELENA FAMILY HEALTH CENTER KELSEYVILLE
ST HELENA FAMILY HEALTH CENTER CLEARLAKE
ST HELENA FAMILY HEALTH CENTER MIDDLETOWN
ST HELENA KONOCTI WELLNESS CENTER
5290 STATE STREET
KELSEYVILLE, CA 95451
(707)279-8813
Lake
15230 LAKESHORE DRIVE
CLEARLAKE, CA 95422
(707)994-0407
Lake
21337 BUSH STREET
MIDDLETOWN, CA 95461
(707)987-3311
Lake
9430 - C LAKE STREET
LOWER LAKE, CA 95457
(707)995-5630
Lake
058533
058586
058681
058633
STONYFORD RURAL HEALTH CLINIC
5080 STONYFORD-LODOGA RD
STONYFORD, CA 95979
(530)963-3145
Colusa
053983
SURPRISE VALLEY MEDICAL CLINIC
745 MAIN STREET
CEDARVILLE, CA 96104
(916)279-6115
Modoc
058519
SUTTER COAST HEALTH CENTER
785 EAST WASHINGTON BLVD SUITE 10
CRESCENT CITY, CA 95531
(707)464-8511
Del Norte
058547
SUTTER LAKESIDE COMMUNITY HEALTH
CENTER
SUTTER LAKESIDE FAMILY MEDICINE CLINIC
750 OLD LUCERNE ROAD
UPPER LAKE, CA 95485
(707)275-9066
Lake
5176 HILL ROAD EAST
LAKEPORT, CA 95453
(707)262-5088
Lake
5176 HILL ROAD EAST
LAKEPORT, CA 95453
(707)262-5001
Lake
9279 LOCUST STREET
PLYMOUTH, CA 95669
(209)245-6968
Amador
16911 WILLOW GLEN ROAD
BROWNSVILLE, CA 95919
(530)675-0466
Yuba
058579
SUTTER LAKESIDE HOSPITAL MOBILE HEALTH
CLINIC
SUTTER MEDICAL FOUNDATION PLYMOUTH
HEALTH CENTER
SUTTER NORTH BROWNSVILLE FAMILY
PRACTICE CTR
TDHS MOBILE HEALTH CLINIC
300 NORTH SCHOOL
PIXLEY, CA 93256
(559)685-3413
Tulare
553977
TEHACHAPI FAMILY HEALTH CENTER
105 WEST E STREET
TEHACHAPI, CA 93561
(661)822-3241
Kern
553979
TEHACHAPI FAMILY HEALTH CENTER - MOJAVE 2041 BELSHAW STREET
MOJAVE, CA 93501
(661)824-4511
Kern
058620
9350 NORTH LOOP BOULEVARD
CALIF CITY, CA 93505
(760)373-1785
Kern
058910
TEHACHAPI FAMILY HEALTH CENTERCALIFORNIA CITY
TEHAMA COUNTY HEALTH CENTER CL
1850 WALNUT ST
RED BLUFF, CA 96080
(916)527-0350
Tehama
553969
TIPTON MEDICAL CLINIC
575 NORTH THOMPSON ROAD
TIPTON, CA 93272
(559)762-4147
Tulare
058657
TRINITY COMMUNITY DENTAL CLINIC
121 BARBARA AVE
WEAVERVILLE, CA 96093
(530)623-5541
Trinity
553994
058652
058969
553950
058618
TRINITY COMMUNITY HEALTH CLINIC
31 EASTER AVENUE
WEAVERVILLE, CA 96093
(530)623-5541
Trinity
058670
TRONA RURAL HEALTH CLINIC
82820 TRONA ROAD
TRONA, CA 93562
(760)499-3902
San Bernardino
058648
TULARE HOSPITAL AND CLINICS HILLMAN
CENTER
TULARE HOSPITAL AND CLINICS LINDSAY
CENTER
UKIAH VALLEY PRIMARY CARE / ADVENTIST
1062 SOUTH K STREET
TULARE, CA 93274
(559)685-2500
Tulare
845 NORTH SEQUOIA AVENUE
LINDSAY, CA 93247
(559)562-6391
Tulare
260 HOSPITAL DRIVE, STE 102,103,107,201,204 &
209
487 S MAIN ST
UKIAH, CA 95482
(707)468-0491
Mendocino
LAKEPORT, CA 95453
(707)263-4631
Lake
1165 SOUTH DORA STREET, SUITE E1 & E2
UKIAH, CA 95482
(707)463-8000
Mendocino
1165 SOUTH DORA STREET, SUITE B1
UKIAH, CA 95482
(707)462-1201
Mendocino
1050 NORTH STATE STREET
UKIAH, CA 95482
(707)468-1471
Mendocino
1472 B STREET STE A
LIVINGSTON, CA 95334
(209)394-7614
Merced
058647
058624
058625
058623
058622
058626
058939
UKIAH VALLEY PRIMARY CARE / ADVENTIST
HEALTH
UKIAH VALLEY PRIMARY CARE / ADVENTIST
HEALTH
UKIAH VALLEY PRIMARY CARE / ADVENTIST
HEALTH
UKIAH VALLEY PRIMARY CARE / ADVENTIST
HEALTH
UNIVERSAL MEDICAL CENTER, INC
Run Date: 10/08/2015
Job # 41303463
Last Update: 10/07/2015
Page 10 of 10
CASPER Report 0006D
Name and Address Listing
For Rural Health Clinic
Based on Current Survey
California
CCN
Provider Name
Address
City, State and ZIP
Telephone # County Name
058915
VIDA SANA MEDICAL GROUP, INC
755 NORTH SEQUOIA AVENUE, SUITE B
LINDSAY, CA 93247
(559)562-9399
Tulare
058927
VIDA SANA MEDICAL GROUP, INC
781 NORTH SEQUOIA AVENUE, SUITE 2
LINDSAY, CA 93247
(559)562-9399
Tulare
058977
WAHID MEDICAL CORPORATION
1108 WARD AVE
PATTERSON, CA 95363
(209)892-1300
Stanislaus
058909
WESTERN SIERRA MEDICAL CENTER
3070 CAMINO HEIGHTS DRIVE, SUITE B
CAMINO, CA 95709
(530)647-9762
Eldorado
553929
WESTSIDE MEDICAL GROUP
1107 O STREET
FIREBAUGH, CA 93622
(559)569-9000
Fresno
058916
WESTSIDE MEDICAL GROUP OF MENDOTA, INC 450 OLLER STREET, STE 101
MENDOTA, CA 93640
(559)655-1000
Fresno
553988
WILLIAMS, CA 95987
(530)473-5641
Colusa
058961
WILLIAMS URGENT CARE AND MEDICAL
CENTER
WILLOWS FIRSTCARE INC
460 W SYCAMORE ST
WILLOWS, CA 95988
(530)934-3385
Glenn
553937
WOMENS AND CHILDREN HEALTHCARE
57463 TWENTYNINE PALMS HWY, SUITE 202
YUCCA VALLEY, CA 92284
(760)365-0808
San Bernardino
058976
YUCCA FAMILY MEDICAL CARE INC
57675 29 PALMS HWY SUITE 111
YUCCA VALLEY, CA 92284
(760)365-8500
San Bernardino
Total Providers for this State = 292
501 E STREET SUITE B
Run Date: 10/08/2015
Job # 41303463
Last Update: 10/07/2015
Page 1 of 1
CASPER Report 0006D
Name and Address Listing
For Rural Health Clinic
Based on Current Survey
Hawaii
CCN
Provider Name
Address
City, State and ZIP
Telephone # County Name
123976
KAU HOSPITAL RURAL HEALTH CLIN
1 KAMANI STREET
PAHALA, HI 96777
(808)928-2050
Hawaii
123977
MOLOKAI GENERAL HOSPITAL
280 HOME OLU PLACE
KAUNAKAKAI, HI 96748
(808)553-5331
Maui
Total Providers for this State = 2
Run Date: 10/08/2015
Job # 41303463
Last Update: 10/07/2015
Page 1 of 1
CASPER Report 0006D
Name and Address Listing
For Rural Health Clinic
Based on Current Survey
Nevada
CCN
Provider Name
Address
City, State and ZIP
Telephone # County Name
293984
BATTLE MOUNTAIN CLINIC
535 SOUTH HUMBOLDT STREET, STE A
BATTE MTN, NV 89820
(775)635-2424
Lander
293961
HUMBOLDT GENERAL HOSPITAL RHC
118 E HASKELL STREET
WINNEMUCCA, NV 89445
(775)623-5222
Humboldt
293982
LINCOLN COUNTY HOSPITAL DISTRICT
700 NORTH SPRING STREET
CALIENTE, NV 89008
(775)726-3171
Lincoln
293811
MINDEN FAMILY MEDICINE AND COMPLETE
CARE
MOUNT GRANT MEDICAL BUILDING
1649 LUCERNE ST UNIT A & B
MINDEN, NV 89423
(775)782-1603
Douglas
1ST & A STREETS/PO BOX 1510
HAWTHORNE, NV 89415
(775)945-2461
Mineral
850 SIXTH STREET/PO BOX 661
LOVELOCK, NV 89419
(775)273-2621
Pershing
293962
PERSHING GENERAL HOSP & NURSING HOME
PHYSICIAN CTR
SILVER SPRINGS RURAL HEALTH CENTERS
3595 HWY 50 WEST
SILVER SPRINGS, NV 89429
(775)982-6508
Lyon
293978
SMITH VALLEY PHYSICIANS CLINIC
445 STATE HWY 338
WELLINGTON, NV 89444
(775)465-2587
Lyon
293979
213 S WHITACRE STREET
YERINGTON, NV 89447
(775)463-2301
Lyon
293980
SOUTH LYON MEDICAL CENTER-BARNETT
CLINIC
SOUTH LYON PHYSICIANS CLINIC
311 SURPRISE STREET
YERINGTON, NV 89447
(775)463-2301
Lyon
293985
TOPAZ RANCH MEDICAL CLINIC
3919 CARTER DR
WELLINGTON, NV 89444
(775)783-3096
Lyon
293977
WILLIAM BEE RIRIE HOSPITAL-RHC
6 STEPTOE CIRCLE
ELY, NV 89301
(775)289-3001
White Pine
293975
293981
Total Providers for this State = 12
Run Date: 10/08/2015
Job # 41303463
Last Update: 10/07/2015
Page 1 of 2
CASPER Report 0006D
Name and Address Listing
For Rural Health Clinic
Based on Current Survey
Idaho
CCN
Provider Name
Address
City, State and ZIP
Telephone # County Name
133838
ASSOCIATES IN FAMILY PRACTICE GOODING
425 IDAHO STREET
GOODING, ID 83330
(208)934-5900
Gooding
133845
ASSOCIATES IN FAMILY PRACTICE HAGERMAN
640 FROGS LANDING
HAGERMAN, ID 83332
(208)837-6161
Gooding
133850
ASSOCIATES IN FAMILY PRACTICE WENDELL
410 NORTH IDAHO STREET
WENDELL, ID 83355
(208)536-5900
Gooding
138514
BEAR LAKE FAMILY CARE & OB/GYN
465 WASHINGTON STREET
MONTPELIER, ID 83254
(208)847-1630
Bear Lake
138505
BEAR LAKE INTERNAL MEDICINE
166 SOUTH 5TH STREET
MONTPELIER, ID 83254
(208)847-1110
Bear Lake
133831
BLACKFOOT MEDICAL CENTER
1441 PARKWAY DRIVE
BLACKFOOT, ID 83221
(208)785-2600
Bingham
133859
BONNERS FERRY FAMILY MEDICINE
6488 CHINOOK ST
BONNERS FERRY, ID 83805
(208)267-8779
Boundary
138521
BOUNDARY COMMUNITY CLINICS
6641 KANIKSU STREET
BONNERS FERRY, ID 83805
(208)267-3141
Boundary
133993
CASCADE FAMILY PRACTICE
402 LAKE CASCADE PKWY
CASCADE, ID 83611
(208)382-4285
Valley
133832
CHALLIS AREA HEALTH CENTER
611 CLINIC ROAD
CHALLIS, ID 83226
(208)879-4351
Custer
133851
CLAY I CAMPBELL
166 SOUTH 5TH STREET
MONTPELIER, ID 83254
(208)847-3847
Bear Lake
133985
CLINIC AT WILDER, THE
124 5TH ST, STE A
WILDER, ID 83676
(208)482-7430
Canyon
138511
DRIGGS MEDICAL CLINIC
283 NORTH 1ST EAST
DRIGGS, ID 83422
(208)354-2302
Teton
133833
EMMETT MEDICAL CENTER
1102 EAST LOCUST
EMMETT, ID 83617
(208)365-6004
Gem
138515
1350 PARKWAY DRIVE
BLACKFOOT, ID 83221
(208)782-2410
Bingham
138520
FIRST CHOICE URGENT CARE & MEDICAL
CLINIC
GOODING FAMILY PHYSICIANS
134 4TH AVENUE WEST
GOODING, ID 83330
(208)934-4446
Gooding
138502
IDAHO PHYSICIANS CLINIC
98 POPLAR STREET
BLACKFOOT, ID 83221
(208)785-3800
Bingham
133997
KENDRICK CLINIC
606 EAST MAIN STREET
KENDRICK, ID 83537
(208)289-3841
Latah
138506
LAKEVIEW MEDICAL CLINIC
300 SOUTH THIRD WEST
SODA SPRINGS, ID 83276
(208)547-3118
Caribou
133981
LOST RIVERS RURAL HEALTH CLINIC
551 HIGHLAND DRIVE
ARCO, ID 83213
(208)527-8206
Butte
133990
MACKAY CLINIC
313 EAST CUSTER STREET
MACKAY, ID 83251
(208)588-2993
Custer
138507
MINIDOKA MEDICAL CENTER
1308 8TH STREET, SUITE 1
RUPERT, ID 83350
(208)436-4322
Minidoka
133858
MOSCOW MEDICAL, P A
213 N MAIN STREET
MOSCOW, ID 83843
(208)882-7565
Latah
133983
NEW PLYMOUTH FAMILY HEALTH CLINIC
112 SOUTH PLYMOUTH STREET
NEW PLYMOUTH, ID 83655
(208)278-3406
Payette
138509
ONEIDA COUNTY CLINIC
220 BANNOCK STREET
MALAD, ID 83252
(208)766-2600
Oneida
133860
PALOUSE PEDIATRICS-MOSCOW
1420 S BLAINE ST STE 5
MOSCOW, ID 83843
(509)322-2605
Latah
133986
PARMA FAMILY HEALTH CLINIC
307 GROVE STREET
PARMA, ID 83660
(208)722-5147
Canyon
138512
PHYSICIANS & SURGEONS CLINIC OF SHELLEY
275 W LOCUST STREET
SHELLEY, ID 83274
(208)357-3960
Bingham
133989
PIONEER MEDICAL CLINIC
105 CARLE STREET
PIERCE, ID 83546
(208)464-2578
Clearwater
133995
POTLATCH CLINIC
156 6TH ST
POTLATCH, ID 83855
(208)875-2380
Latah
138500
POWER COUNTY FAMILY CLINIC
502 TYHEE STREET
AMERICAN FALLS, ID 83211
(208)226-1057
Power
133808
SALMON RIVER CLINIC
1 NIECE AVENUE
STANLEY, ID 83278
(208)774-3565
Custer
133839
SHELLEY FAMILY MEDICAL CENTER
210 SOUTH EMERSON
SHELLEY, ID 83274
(208)357-7405
Bingham
133826
ST ALPHONSUS MEDICAL GROUP - ELM
315 EAST ELM STREET
CALDWELL, ID 83605
(208)459-7415
Canyon
Run Date: 10/08/2015
Job # 41303463
Last Update: 10/07/2015
Page 2 of 2
CASPER Report 0006D
Name and Address Listing
For Rural Health Clinic
Based on Current Survey
Idaho
CCN
Provider Name
Address
City, State and ZIP
Telephone # County Name
133835
ST ALPHONSUS MEDICAL GROUP - GARRITY
1200 GARRITY BOULEVARD
NAMPA, ID 83687
(208)466-9092
Canyon
133825
ST ALPHONSUS MEDICAL GROUP - IOWA
211 WEST IOWA AVENUE
NAMPA, ID 83686
(208)465-7377
Canyon
138516
ST LUKE'S CLINIC - SALMON RIVER MEDICAL
214 N MAIN STREET
RIGGINS, ID 83549
(208)628-3666
Idaho
133992
ST LUKE'S CLINIC JEROME FAMILY MEDICINE
132 5TH AVENUE WEST
JEROME, ID 83338
(208)324-5286
Jerome
133999
ST LUKE'S TRINITY MOUNTAIN
465 MCKENNA DRIVE
MOUNTAIN HOME, ID 83647
(208)587-9703
Elmore
138503
ST MARIES FAMILY MEDICINE
229 8TH STREET
ST MARIES, ID 83861
(208)245-2591
Benewah
133996
STEELE MEMORIAL CLINIC
805 MAIN STREET
SALMON, ID 83467
(208)756-6212
Lemhi
138518
SYRINGA KOOSKIA CLINIC
022 N MAIN ST
KOOSKIA, ID 83539
(208)926-4776
Idaho
138517
SYRINGA PRIMARY CARE CLINIC
722 W NORTH ST
GRANGEVILLE, ID 83530
(208)983-8590
Idaho
133836
TWO RIVERS MEDICAL CLINIC, P A
683 EAST THIRD STREET
WEISER, ID 83672
(208)549-0211
Washington
133856
UPPER VALLEY FAMILY MEDICINE
711 RIGBY LAKE DRIVE
RIGBY, ID 83442
(208)745-5021
Jefferson
138510
VICTOR HEALTH CLINIC
252 SOUTH MAIN STREET
VICTOR, ID 83455
(208)787-9898
Teton
Total Providers for this State = 46
Run Date: 10/08/2015
Job # 41303463
Last Update: 10/07/2015
Page 1 of 3
CASPER Report 0006D
Name and Address Listing
For Rural Health Clinic
Based on Current Survey
Oregon
CCN
Provider Name
Address
City, State and ZIP
Telephone # County Name
388516
1105 SOUTHWEST JETTY AVENUE SUITE C
LINCOLN CITY, OR 97367
(541)614-0482
Lincoln
38505 BROOTEN RD
PACIFIC CITY, OR 97135
(503)965-6555
Tillamook
1100 THIRD STREET
TILLAMOOK, OR 97141
(503)815-2260
Tillamook
1011 THIRD STREET
TILLAMOOK, OR 97141
(503)815-2260
Tillamook
10445 NEAHKAHNIE CREEK ROAD
MANZANITA, OR 97130
(503)368-6244
Tillamook
383807
ADVENTIST HEALTH BAYSHORE MEDICAL
LINCOLN CITY
ADVENTIST HEALTH BAYSHORE MEDICAL
PACIFIC CITY
ADVENTIST HEALTH TILLAMOOK MEDICAL
GROUP
ADVENTIST HEALTH TILLAMOOK MEDICAL
GROUP BAY OCEAN
ADVENTIST HEALTH TILLAMOOK MEDICAL
GROUP MANZANITA
ALSEA RURAL HEALTH CARE, INC
201 NORTH 4TH
ALSEA, OR 97324
(541)487-7116
Benton
383887
APPLEGATE VALLEY FAMILY MEDICINE LLC
8600 NEW HOPE ROAD
GRANTS PASS, OR 97527
(541)862-2836
Josephine
383866
C SCOTT GRAHAM, DO, PC
620 SOUTH J STREET
LAKEVIEW, OR 97630
(541)947-2331
Lake
383883
CANBY HEALTH CARE CLINIC LLC
703 SE 1ST AVE
CANBY, OR 97013
(503)266-7687
Clackamas
383886
CASCADE DIRECT CARE
750 NW 4TH STREET
PRINEVILLE, OR 97754
(541)362-8688
Crook
383873
CENTER FOR WOMEN & THE FAMILY
17 SW FRAZER, SUITE 282
PENDLETON, OR 97801
(541)278-3377
Umatilla
388502
CHI ST ANTHONY HOSPITAL FAMILY CLINIC
1312 SE SECOND STREET
PENDLETON, OR 97801
(541)278-3220
Umatilla
388515
CMH PRIMARY CLINIC
1639 SE ENSIGN LANE #B 103
WARRENTON, OR 97146
(503)338-4500
Clatsop
383836
COASTAL HEALTH PRACTITIONERS
3015 WEST DEVILS LAKE ROAD
LINCOLN CITY, OR 97367
(541)994-5591
Lincoln
383882
COLUMBIA GORGE FAMILY MEDICINE
1750 12TH STREET
HOOD RIVER, OR 97031
(541)386-5070
Hood River
383996
COLUMBIA HILLS FAMILY MEDICINE
1620 E 12TH STREET
THE DALLES, OR 97058
(541)296-9151
Wasco
383990
CURRY FAMILY MEDICAL
525 MADRONA STREET
PORT ORFORD, OR 97465
(541)332-3861
Curry
388513
DUNES FAMILY HEALTH CARE
620 RANCH ROAD
REEDSPORT, OR 97467
(541)271-2163
Douglas
383831
ELGIN FAMILY HEALTH CLINIC, LLC
1400 DIVISION STREET
ELGIN, OR 97827
(541)437-6321
Union
383880
EVERGREEN FAMILY MEDICINE PC
2570 NW EDENBOWER BLVD STE 100
ROSEBURG, OR 97471
(541)677-7200
Douglas
383891
EVERGREEN FAMILY MEDICINE SOUTH
145 NE BROADWAY ST
MYRTLE CREEK, OR 97457
(541)863-3146
Douglas
383884
FAMILY HEALTH ASSOCIATES
600 NW 11TH, SUITE E-15
HERMISTON, OR 97838
(541)567-6434
Umatilla
383856
GIFFORD MEDICAL
1050 W ELM AVENUE, SUITE 110
HERMISTON, OR 97838
(541)567-2995
Umatilla
383985
GOOD SHEPHERD MEDICAL GROUP
600 NW 11TH STREET
HERMISTON, OR 97838
(541)567-5305
Umatilla
383848
GRANT COUNTY HEALTH DEPARTMENT
528 EAST MAIN, SUITE E
JOHN DAY, OR 97845
(541)575-0429
Grant
388512
HARNEY DISTRICT HOSPITAL FAMILY CARE
559 W WASHINGTON ST
BURNS, OR 97720
(541)573-2074
Harney
383858
236 E NEWPORT AVENUE
HERMISTON, OR 97838
(541)567-1137
Umatilla
383987
HERMISTON FAMILY PRACTICE AND URGENT
CARE
IRRIGON MEDICAL CLINIC
220 NORTH MAIN STREET
IRRIGON, OR 97844
(541)922-5880
Morrow
383867
LEGACY CLINIC ST HELENS
500 N COLUMBIA RIVER HIGHWAY, SUITE 6
ST HELENS, OR 97051
(503)397-0471
Columbia
383881
LEGACY MEDICAL GROUP - FIRWOOD
36860 INDUSTRIAL WAY
SANDY, OR 97055
(503)826-0206
Clackamas
383862
LISA CALLAHAN, CPNP
1465 B NE 7TH STREET
GRANTS PASS, OR 97526
(541)471-0100
Josephine
383859
MADRAS MEDICAL GROUP
76 NE 12TH STREET
MADRAS, OR 97741
(541)475-3874
Jefferson
383817
MALHEUR MEMORIAL HEALTH CENTER
410 MAIN STREET
NYSSA, OR 97913
(541)372-2211
Malheur
388514
388504
388507
388510
Run Date: 10/08/2015
Job # 41303463
Last Update: 10/07/2015
Page 2 of 3
CASPER Report 0006D
Name and Address Listing
For Rural Health Clinic
Based on Current Survey
Oregon
CCN
Provider Name
Address
City, State and ZIP
Telephone # County Name
383802
MCKENZIE RIVER CLINIC
51730 DEXTER STREET
BLUE RIVER, OR 97413
(503)822-3341
Lane
383863
MILTON-FREEWATER CLINIC
10 NE 5TH
MILTON FREEWATER, OR 97862
(541)938-3314
Umatilla
388505
MMORE CARE
1103 NE ELM ST
PRINEVILLE, OR 97754
(541)447-2501
Crook
383999
MOUNT ANGEL FAMILY MEDICINE
250 W MARQUIM ST
MOUNT ANGEL, OR 97362
(503)845-2000
Marion
383876
NORTH BEND MEDICAL CENTER BANDON
110 E TENTH STREET
BANDON, OR 97411
(541)347-5191
Coos
383853
NORTH BEND MEDICAL CENTER GOLD BEACH
94180 SECOND STREET
GOLD BEACH, OR 97444
(541)247-7047
Curry
383840
NORTH LAKE CLINIC LLC
87520 BAY ROAD
CHRISTMAS VALLEY, OR 97641
(541)576-2343
Lake
383839
OAK STREET HEALTH CARE CENTER
446 OAK STREET
BROOKINGS, OR 97415
(541)412-8898
Curry
383849
OHSU FAMILY MEDICINE AT SCAPPOOSE
51377 OLD PORTLAND ROAD SUITE C
SCAPPOOSE, OR 97056
(503)418-4222
Columbia
383890
ORCHID HEALTH
47815 HWY 58
OAKRIDGE, OR 97463
(541)782-8304
Lane
383808
PEACEHEALTH MEDICAL GROUP - DEXTER
38843 DEXTER ROAD
DEXTER, OR 97431
(541)937-2134
Lane
383874
PEDIATRIC SPECIALISTS OF PENDLETON, L L C 2461 SW PERKINS AVE
PENDLETON, OR 97801
(541)276-0250
Umatilla
383869
PINE EAGLE CLINIC
218 N PINE STREET
HALFWAY, OR 97834
(541)742-5023
Baker
383984
PIONEER MEMORIAL CLINIC
130 THOMPSON AVENUE
HEPPNER, OR 97836
(541)676-9133
Morrow
383981
PROVIDENCE NORTH COAST CLINIC
727 SOUTH WAHANNA ROAD
SEASIDE, OR 97138
(503)717-7000
Clatsop
383993
RIVER VIEW CLINIC
1825 E 19TH STREET
THE DALLES, OR 97058
(541)296-1151
Wasco
388506
RIVERVIEW FAMILY MEDICINE
1935 E 19TH STREET, SUITE 100
THE DALLES, OR 97058
(541)296-7677
Wasco
383991
SAMARITAN COASTAL CLINIC
825 NW HIGHWAY 101
LINCOLN CITY, OR 97367
(541)994-3661
Lincoln
388509
SAMARITAN LINCOLN CITY MEDICAL CENTER
2870 WEST DEVILS LAKE ROAD
LINCOLN CITY, OR 97367
(541)557-6490
Lincoln
383825
SHADY COVE CLINIC
21990 HIGHWAY 62
SHADY COVE, OR 97539
(541)878-2022
Jackson
383820
SHERMAN COUNTY MEDICAL CLINIC
110 MAIN STREET
MORO, OR 97039
(541)565-3325
Sherman
383843
SISKIYOU PEDIATRIC CLINIC LLP
700 SW RAMSEY, SUITE 204
GRANTS PASS, OR 97527
(541)955-5683
Josephine
383892
SNAKE RIVER PEDIATRICS
1050 SW 3RD AVE, SUITE 3200
ONTARIO, OR 97914
(541)881-2380
Malheur
383805
SOUTH GILLIAM HEALTH CENTER
422 NORTH MAIN
CONDON, OR 97823
(541)384-2061
Gilliam
388511
3820 17TH STREET
BAKER CITY, OR 97814
(541)523-4465
Baker
3175 POCAHONTAS ROAD
BAKER CITY, OR 97814
(541)523-4415
Baker
3950 17TH STREET, SUITE A
BAKER CITY, OR 97814
(541)523-1001
Baker
180 FORD ROAD
JOHN DAY, OR 97845
(541)575-0404
Grant
383868
ST ALPHONSUS MEDICAL CENTER VALLEY
MEDICAL CLINIC
ST ALPHONSUS MEDICAL GROUP-BAKER
CLINIC
ST LUKE'S CLINIC-EASTERN OREGON MEDICAL
ASSOCIATES
STRAWBERRY WILDERNESS COMMUNITY
CLINIC
TREASURE VALLEY PEDIATRIC CLINIC P C
1219 SW 4TH AVENUE, SUITE 1
ONTARIO, OR 97914
(541)889-2668
Malheur
383872
UMPQUA REGIONAL MEDICAL CENTER, LLC
1813 W HARVARD SUITE 201
ROSEBURG, OR 97471
(541)459-3500
Douglas
383830
UNION FAMILY HEALTH CENTER
142 E DEARBORN
UNION, OR 97883
(541)562-6062
Union
388508
383852
383998
383878
URGENTCARE NW-ASTORIA, PC
2120 EXCHANGE ST, SUITE 111
ASTORIA, OR 97103
(503)666-5050
Clatsop
383885
VERNONIA HEALTH CENTER
1005 COUGAR STREET
VERNONIA, OR 97064
(503)429-0622
Columbia
Run Date: 10/08/2015
Job # 41303463
Last Update: 10/07/2015
Page 3 of 3
CASPER Report 0006D
Name and Address Listing
For Rural Health Clinic
Based on Current Survey
Oregon
CCN
Provider Name
Address
City, State and ZIP
Telephone # County Name
383994
WATER'S EDGE MEDICAL CLINIC
551 LONE PINE BLVD
THE DALLES, OR 97058
(541)296-2353
Wasco
383864
WINDING WATERS CLINIC P C - ENTERPRISE
603 MEDICAL PARKWAY
ENTERPRISE, OR 97828
(541)426-4502
Wallowa
388500
WOODBURN FAMILY MEDICINE
1475 MOUNT HOOD AVE
WOODBURN, OR 97071
(503)982-2174
Marion
388501
WOODBURN INTERNAL MEDICINE
693 GLATT CIRCLE
WOODBURN, OR 97071
(503)982-0403
Marion
383889
WOODBURN PEDIATRIC CLINIC LLP
2050 PROGRESS WAY
WOODBURN, OR 97071
(503)981-5348
Marion
Total Providers for this State = 71
Run Date: 10/08/2015
Job # 41303463
Last Update: 10/07/2015
Page 1 of 4
CASPER Report 0006D
Name and Address Listing
For Rural Health Clinic
Based on Current Survey
Washington
CCN
Provider Name
Address
City, State and ZIP
Telephone # County Name
508550
ADVENTIST HEALTH MEDICAL GROUP
1111 S 2ND AVENUE
WALLA WALLA, WA 99362
(509)522-0100
Walla Walla
508505
ANACORTES FAMILY MEDICINE
2511 M AVENUE, SUITE B
ANACORTES, WA 98221
(360)293-5102
Skagit
508554
BENTON CITY CLINIC
701 DALE AVE
BENTON CITY, WA 99320
(800)356-1011
Benton
503905
BIRCH BAY FAMILY MEDICINE
8097 HARBORVIEW RD
BLAINE, WA 98230
(360)371-5855
Whatcom
508539
BIRCH STREET MEDICAL CENTER
222 EAST 2ND STREET
GRANDVIEW, WA 98930
(509)882-3500
Yakima
503872
BLUE MOUNTAIN MEDICAL GROUP
1111 S 2ND AVE
WALLA WALLA, WA 99362
(509)522-0100
Walla Walla
508520
BOGACHIEL CLINIC
390 FOUNDERS WAY
FORKS, WA 98331
(360)374-6998
Clallam
508502
CAMANO COMMUNITY HEALTH CLINIC
127 N EAST CAMANO DR
CAMANO CITY, WA 98292
(360)387-5398
Snohomish
503992
CASCADE MEDICAL CENTER
817 COMMERCIAL STREET
LEAVENWORTH, WA 98826
(509)548-5815
Chelan
508509
CASCADE VALLEY DARRINGTON CLINIC
1190 RIDDLE ST
DARRINGTON, WA 98241
(360)436-1055
Snohomish
503900
CENTRALIA SPECIALTY CENTER
1707 COOKS HILL ROAD
CENTRALIA, WA 98531
(360)740-4001
Lewis
503897
CHEHALIS CHILDRENS CLINIC
370 S MARKET BLVD
CHEHALIS, WA 98532
(360)748-6693
Lewis
503868
CHEWELAH ASSOCIATED PHYSICIANS
410 EAST KING STREET
CHEWELAH, WA 99109
(509)935-8711
Stevens
503975
CLALLAM BAY MEDICAL CLINIC
6TH & BOGACHIEL
CLALLAM BAY, WA 98326
(206)963-2202
Clallam
508541
CLE ELUM FAMILY MEDICINE CTR
201 ALPHA WAY
CLE ELUM, WA 98922
(509)674-5331
Kittitas
503985
COLUMBIA BASIN FAMILY MEDICINE
200 NAT WASHINGTON WAY
EPHRATA, WA 98823
(509)754-4631
Grant
503977
COLUMBIA FAMILY CLINIC
1012 SOUTH 3RD STREET
DAYTON, WA 99328
(509)382-2531
Columbia
503920
CONFLUENCE HEALTH BREWSTER
418 W MAIN ST
BREWSTER, WA 98812
(509)663-8711
Okanogan
508523
CONFLUENCE HEALTH CASHMERE
303 COTTAGE AVENUE
CASHMERE, WA 98815
(509)782-1541
Chelan
508515
CONFLUENCE HEALTH EAST WENATCHEE
100 HIGHLINE DRIVE
EAST WENATCHEE, WA 98802
(509)884-0614
Douglas
508516
CONFLUENCE HEALTH MOSES LAKE
840 EAST HILL DRIVE
MOSES LAKE, WA 98837
(509)765-0216
Grant
508512
CONFLUENCE HEALTH OMAK
916 KOALA AVENUE
OMAK, WA 98841
(509)826-1800
Okanogan
508513
CONFLUENCE HEALTH OROVILLE
1617 MAIN STREET
OROVILLE, WA 98844
(509)476-3631
Okanogan
503854
CONFLUENCE HEALTH ROYAL CITY
101 CAMELIA NW
ROYAL CITY, WA 99357
(509)346-1447
Grant
508517
CONFLUENCE HEALTH TONASKET
17 SOUTH WESTERN AVENUE
TONASKET, WA 98855
(509)486-2174
Okanogan
508568
CONFLUENCE HEALTH WATERVILLE
117 S CHELAN AVE
WATERVILLE, WA 98858
(509)663-8711
Douglas
508514
CONFLUENCE HEALTH WENATCHEE
820 NORTH CHELAN AVENUE
WENATCHEE, WA 98801
(509)663-8711
Chelan
508535
COULEE CITY CLINIC
130 N ADAMS STREET
COULEE CITY, WA 99115
(509)632-5701
Grant
503981
COULEE FAMILY MEDICINE
411 FORTUYN ROAD
GRAND COULEE, WA 99133
(509)633-1911
Grant
508533
CURLEW MEDICAL CLINIC
9 KETTLE RIVER ROAD
CURLEW, WA 99118
(509)779-4049
Ferry
508529
DAVENPORT CLINIC
100 THIRD STREET
DAVENPORT, WA 99122
(509)725-7501
Lincoln
503885
DEER PARK FAMILY CARE CLINIC
905 EAST D STREET
DEER PARK, WA 99006
(509)276-5005
Spokane
503919
EAST CAMPUS INTERNAL MEDICINE
1006 N H STREET
ABERDEEN, WA 98520
(360)537-6496
Grays Harbor
503881
ELLENSBURG PEDIATRICS
611 S CHESTNUT, SUITE E
ELLENSBURG, WA 98926
(509)962-5437
Kittitas
508556
ELMA FAMILY MEDICINE
575 E MAIN STREET BLDG 2
ELMA, WA 98541
(360)482-3711
Grays Harbor
Run Date: 10/08/2015
Job # 41303463
Last Update: 10/07/2015
Page 2 of 4
CASPER Report 0006D
Name and Address Listing
For Rural Health Clinic
Based on Current Survey
Washington
CCN
Provider Name
Address
City, State and ZIP
Telephone # County Name
503904
EVERSON FAMILY MEDICINE
407 E MAIN ST
EVERSON, WA 98247
(360)966-3441
Whatcom
503863
2511 M AVENUE STE A
ANACORTES, WA 98221
(360)293-9813
Skagit
503886
FAMILY CARE NETWORK ISLAND FAMILY
PHYSICIANS
FAMILY HEALTH CARE OF ELLENSBURG
107 E MOUNTAIN VIEW AVENUE, SUITE #1
ELLENSBURG, WA 98926
(509)962-6348
Kittitas
508500
FAMILY HEALTH CENTER NEWPORT
714 W PINE STREET
NEWPORT, WA 99156
(509)447-2441
Pend Oreille
508518
FAMILY MEDICINE NEWPORT
SOUTH 100 SCOTT AVENUE
NEWPORT, WA 99156
(509)447-3139
Pend Oreille
503873
FAMILY MEDICINE OF PORT ANGEL
240 WEST FRONT STREET, SUITE A
PORT ANGELES, WA 98362
(360)425-7891
Clallam
508519
FAMILY PRACTICE CLINIC
711 EAST COLLINS DR
GOLDENDALE, WA 98620
(509)773-4017
Klickitat
503903
FERNDALE FAMILY MEDICAL CENTER
5580 NORDIC WAY
FERNDALE, WA 98248
(360)384-1511
Whatcom
508548
FIDALGO MEDICAL ASSOCIATES AT ISLAND
HOSPITAL
GRANDVIEW MEDICAL CENTER
1213 24TH STREET, SUITE 100
ANACORTES, WA 98221
(360)293-4655
Skagit
508540
503824
208 N EUCLID ROAD
GRANDVIEW, WA 98930
(509)882-1855
Yakima
461 G STREET SW
FORKS, WA 98331
(360)374-6224
Clallam
615 NORTH F STREET
ABERDEEN, WA 98520
(360)533-4599
Grays Harbor
503917
HARRISON HEALTH PARTNERS FAMILY
MEDICAL CENTER
HIGHLANDS PEDIATRICS
508526
JEFFERSON GENERAL MEDICAL GROUP
915 SHERIDAN AVENUE, SUITE B103
PT TOWNSEND, WA 98368
(360)385-4848
Jefferson
508525
JEFFERSON HEALTHCARE FAMILY MEDICINE
1010 SHERIDAN AVE SUITE 1
PT TOWNSEND, WA 98368
(360)379-8631
Jefferson
508569
JOHN HUGHES STUDENT HEALTH CENTER
1801 E EDISON AVE
SUNNYSIDE, WA 98944
(509)837-1650
Yakima
508545
700 E MANITOBA STE 101
ELLENSBURG, WA 98926
(509)925-6100
Kittitas
503894
KITTITAS VALLEY HEALTHCARE FAMILY
MEDICINE - ELLEN
L KEITH HANSON PLLC
520 W INDIAN AVENUE # A
BREWSTER, WA 98812
(509)689-2525
Okanogan
508567
LAKE CHELAN CLINIC, PC
219 EAST JOHNSON
CHELAN, WA 98816
(509)682-2511
Chelan
508538
LINCOLN AVENUE FAMILY MEDICINE
803 E LINCOLN AVENUE
SUNNYSIDE, WA 98944
(509)837-6911
Yakima
503995
LOPEZ ISLAND MEDICAL CLINIC
103 WASHBURN
LOPEZ ISLAND, WA 98261
(360)468-2245
San Juan
503902
LYNDEN FAMILY MEDICINE
1610 GROVER ST #D-1
LYNDEN, WA 98264
(360)354-1333
Whatcom
503998
MARK REED HEALTHCARE DISTRICT
157 S HOWARD ST #405
SPOKANE, WA 99201
(360)495-3244
Spokane
503898
MARY'S CORNER MEDICAL CLINIC
4254 JACKSON HIGHWAY
CHEHALIS, WA 98532
(360)262-3966
Lewis
508551
2300 KATI COURT, SUITE A
SHELTON, WA 98584
(360)426-0955
Mason
247 PROFFESSIONAL WAY BUILDING
SHELTON, WA 98584
(360)426-3102
Mason
939 MOUNTAIN VIEW DRIVE, SUITE 100
SHELTON, WA 98584
(360)426-2653
Mason
503866
MASON GEN HOSP MOUNTAIN VIEW WOMEN'S
HEALTH CENTER
MASON GENERAL HOSPITAL OAKLAND BAY
PEDIATRICS
MASON GENERAL HOSPITAL SHELTON FAMILY
MEDICINE
METHOW VALLEY FAMILY PRACTICE
541 EAST 2ND AVENUE
TWISP, WA 98856
(509)997-2011
Okanogan
503907
MID-VALLEY COMMUNITY CLINIC PLLC
700 S 11TH ST
SUNNYSIDE, WA 98944
(509)839-6822
Yakima
508527
508549
503858
MID-VALLEY MEDICAL GROUP
529 JASMINE STREET
OMAK, WA 98841
(509)826-1600
Okanogan
503877
MORTON MEDICAL CENTER PLLC
531 ADAMS STREET
MORTON, WA 98356
(360)496-5145
Lewis
503850
MOUNTAIN VIEW WOMEN'S HEALTH C
2300 KATI COURT, SUITE A
SHELTON, WA 98584
(360)426-0955
Mason
503832
NAPAVINE MEDICAL CLINIC
305 LINHART AVENUE NE
NAPAVINE, WA 98565
(360)262-3990
Lewis
Run Date: 10/08/2015
Job # 41303463
Last Update: 10/07/2015
Page 3 of 4
CASPER Report 0006D
Name and Address Listing
For Rural Health Clinic
Based on Current Survey
Washington
CCN
Provider Name
Address
City, State and ZIP
Telephone # County Name
503984
NASELLE CLINIC
NORTH VALLEY ROAD
NASELLE, WA 98638
(206)484-7161
Pacific
503996
NORTH WHIDBEY COMMUNITY CLINIC
1300 NE GOLDIE STREET
OAK HARBOR, WA 98277
(360)679-5590
Island
503835
NORTHSHORE MEDICAL GROUP
212 SKYLINE DRIVE
WHITE SALMON, WA 98672
(509)493-2133
Klickitat
503836
NORTHSHORE MEDICAL GROUP
875 SW ROCK CREEK DRIVE
STEVENSON, WA 98648
(509)427-4212
Skamania
503915
NORTHWEST PEDIATRIC CENTER
18313 PAULSON STREET SW
ROCHESTER, WA 98579
(360)273-1150
Thurston
503899
NORTHWEST PEDIATRIC CENTER INC PS
193 S MARKET BLVD
CHEHALIS, WA 98532
(360)748-3366
Lewis
503888
NW PEDIATRIC CENTER INC PS
1911 COOKS HILL ROAD
CENTRALIA, WA 98531
(360)736-6778
Lewis
508555
167 1ST AVENUE NORTH, PO BOX N
ILWACO, WA 98624
(360)642-6300
Pacific
503988
OCEAN BEACH HOSPITAL & CLINICS WOMENS
HEALTH CTR
OCEAN BEACH MEDICAL CLINIC
176 FIRST AVENUE NORTH, PO BOX N
ILWACO, WA 98624
(360)642-3747
Pacific
508501
ODESSA MEMORIAL HEALTHCARE CENTER
510 E AMENDE DRIVE
ODESSA, WA 99159
(509)982-2611
Lincoln
503906
ORCAS FAMILY HEALTH CENTER
1286 MT BAKER ROAD #B 102
EASTSOUND, WA 98245
(360)376-7778
San Juan
508558
ORCAS MEDICAL CENTER PLLC
7 DEYE LANE
EASTSOUND, WA 98245
(360)376-2561
San Juan
508562
PACIFIC FAMILY HEALTH CENTER
826 ALDER STREET
SOUTH BEND, WA 98586
(360)875-5579
Pacific
503910
PACIFIC PRIMARY CARE
800 N 5TH AVE, SUITE 101
SEQUIM, WA 98382
(360)582-2690
Clallam
503883
PALOUSE HEALTH CENTER
235 E MAIN STREET
PALOUSE, WA 99161
(509)878-8000
Whitman
503837
PE ELL HEALTH CLINIC
402 NORTH MAIN STREET
PE ELL, WA 98572
(360)291-3232
Lewis
503876
PENINSULA CHILDRENS CLINIC INC
902 E CAROLINE
PORT ANGELES, WA 98362
(360)457-8578
Clallam
503982
POMEROY MEDICAL CLINIC
446 PATAHA
POMEROY, WA 99347
(509)843-1491
Garfield
503913
POPE'S KIDS PLACE
230 WASHINGTON WAY
CENTRALIA, WA 98531
(360)736-9147
Lewis
508524
PORT TOWNSEND FAMILY PHYSICIANS
934 SHERIDAN AVENUE
PT TOWNSEND, WA 98368
(360)385-6200
Jefferson
503860
840 S MEYERS STREET
KETTLE FALLS, WA 99141
(509)685-7848
Stevens
1200 EAST COLUMBIA
COLVILLE, WA 99114
(509)684-3701
Stevens
503976
PROVIDENCE NORTHEAST WASHINGTON
MEDICAL GROUP
PROVIDENCE NORTHEAST WASHINGTON
MEDICAL GROUP
QUINCY VALLEY CLINIC
908 TENTH AVENUE SW
QUINCY, WA 98848
(509)787-3531
Grant
508511
RANDLE CLINIC
108 KINDLE ROAD
RANDLE, WA 98377
(360)497-3333
Lewis
503865
508528
REARDAN HEALTH CLINIC
E 550 E BROADWAY
REARDAN, WA 99029
(509)796-2737
Spokane
508522
REPUBLIC MEDICAL CLINIC
10 ROS CIRCLE
REPUBLIC, WA 99166
(509)775-3153
Ferry
508557
RIFFE MEDICAL CENTER
745 WILLIAMS STREET
MOSSYROCK, WA 98564
(360)983-8990
Lewis
503983
RITZVILLE MEDICAL CLINIC
903 SOUTH ADAMS
RITZVILLE, WA 99169
(509)659-1200
Adams
503839
ROCHESTER FAMILY MED CLINIC
18313 PAULSON SW
ROCHESTER, WA 98579
(360)273-8818
Thurston
508536
SAMARITAN CLINIC
1550 S PIONEER WAY
MOSES LAKE, WA 98837
(509)766-4185
Grant
508559
SAMARITAN PARKVIEW PEDIATRICS
615 SOUTH DIVISION
MOSES LAKE, WA 98837
(509)766-9450
Grant
503909
SAN JUAN HEALTHCARE
689 AIRPORT CENTER STE B
FRIDAY HARBOR, WA 98250
(360)378-1338
San Juan
503997
SOUTH COUNTY MEDICAL CLINIC
294843 HIGHWAY 101
QUILCENE, WA 98376
(360)765-3111
Jefferson
508506
SOUTH WHIDBEY COMM CLINIC
11245 STATE ROUTE 525
CLINTON, WA 98236
(360)341-5252
Island
Run Date: 10/08/2015
Job # 41303463
Last Update: 10/07/2015
Page 4 of 4
CASPER Report 0006D
Name and Address Listing
For Rural Health Clinic
Based on Current Survey
Washington
CCN
Provider Name
Address
City, State and ZIP
Telephone # County Name
503901
STECK MEDICAL CENTER
1299 BISHOP ROAD
CHEHALIS, WA 98532
(360)748-0211
Lewis
508570
SUNNYSIDE COMMUNITY HOSPITAL AND CLINIC 355 CHARDONNAY AVE
PROSSER, WA 99350
(509)781-6366
Benton
508547
SUNNYSIDE PEDIATRICS
812 MILLER AVENUE, SUITE C
SUNNYSIDE, WA 98944
(509)837-7551
Yakima
503908
SWOFFORD & HALMA CLINIC INC PS
2303 REITH WAY
SUNNYSIDE, WA 98944
(509)837-3933
Yakima
503857
TENINO FAMILY PRACTICE
273 EAST SUSSEX
TENINO, WA 98589
(360)264-5665
Thurston
503921
THE HOQUIAM CLINIC
815 K STREET
HOQUIAM, WA 98550
(360)553-2734
Grays Harbor
508553
THE VALLEY CLINIC
716 EAST MANITOBA AVENUE
ELLENSBURG, WA 98926
(509)925-3151
Kittitas
503809
TULALIP HEALTH CLINIC
7520 TOTEM BEACH ROAD
TULALIP, WA 98271
(360)651-4511
Snohomish
508546
VALLEY INTERNAL MEDICINE
2925 ALLEN RD
SUNNYSIDE, WA 98944
(509)837-4949
Yakima
508563
VALLEY REGIONAL RHC V
2705 E LINCOLN AVE
SUNNYSIDE, WA 98944
(509)836-4848
Yakima
503978
WAITSBURG CLINIC
111 PRESTON AVENUE
WAITSBURG, WA 99361
(509)337-6311
Walla Walla
503846
WALLA WALLA CLINIC
55 WEST TIETAN
WALLA WALLA, WA 99362
(509)525-3720
Walla Walla
508542
WASHTUCNA MEDICAL CLINIC
545 SE CHURCH ST
WASHTUCNA, WA 99371
(509)646-3290
Adams
503803
WATERVILLE CLINIC
117 SOUTH CHELAN
DOUGLAS, WA 98858
(509)745-8448
Douglas
508530
WILBUR CLINIC
109 MAIN STREET
WILBUR, WA 99185
(509)647-5321
Lincoln
508544
WOMEN'S CLINIC, THE
930 CAROLINE ST
PT ANGELES, WA 98362
(360)417-7365
Clallam
Total Providers for this State = 117