KATHLEEN MARKLE RACICOT (NPI# 1154655777) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1154655777 |
Entity Type | Individual |
Full Name | KATHLEEN MARKLE RACICOT |
Credential | PA-C |
Practice Address |
2740 South Avenue West Suite 101 Missoula MT 59804-5137 |
Practice Telephone | 4067286101 |
Practice Fax Number | 4067213278 |
Mailing Telephone | 4067286101 |
Mailing Fax Number | 4067213278 |
Enumeration Date | 2009-09-29 |
Last Update Date | 2019-02-01 |
Gender Code | F |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 363A00000X | Physician Assistant | 31214 | MT | Physician Assistants & Advanced Practice Nursing Providers |
Y | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
31214 | MT | Physician Assistants & Advanced Practice Nursing Providers |
Street Address |
2740 SOUTH AVENUE WEST SUITE 101 |
City | MISSOULA |
State | MT |
Zip Code | 59804-5137 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1922008077 | Northern Rockies Orthopaedics, Pllp | Physical Therapist | 2740 South Avenue West, Suite 101, Missoula, MT 59804-5114 | 2005-07-29 |
1912414186 | Nropt Pllc | Durable Medical Equipment & Medical Supplies | 2740 South Avenue West, Suite 101, Missoula, MT 59804-5114 | 2018-01-09 |
1487834305 | Amie Michelle Schillinger | Physician Assistant | 2740 South Avenue West, Suite 101, Missoula, MT 59804-5137 | 2007-11-08 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1063019297 | Momentum Speech Therapy, PC | Speech-Language Pathologist | 9885 O'brien Creek Road, Missoula, MT 59804 | 2020-10-01 |
1033633037 | Marissa Clark | Genetic Counselor, MS | 2827 Fort Missoula Rd., Suite 317, Missoula, MT 59804 | 2017-08-01 |
1104295245 | Scott Richter | Specialist/Technologist | 2892 Ringo Dr, Missoula, MT 59804 | 2015-09-18 |
1467860353 | Zachary Ueland | Pharmacist | 4000 Highway 93 South, Missoula, MT 59804 | 2014-07-24 |
1316378185 | Tracy Laurel Brothers | Counselor | 1305 Wyoming Street, Missoula, MT 59804 | 2013-12-04 |
1447683651 | Granite Pharmacy Missoula, LLC | Durable Medical Equipment & Medical Supplies | 2230 27th Ave. West, Suite 2, Missoula, MT 59804 | 2013-08-12 |
1871843953 | Autum Emerson Howell | Nurse Practitioner | 2831 Ft. Missoula Rd. Bldg 2, 102, Missoula, MT 59804 | 2012-09-14 |
1821353939 | Carlyn Doyle | Nurse Practitioner | 2835 Fort Missoula Rd Ste 203, Missoula, MT 59804 | 2012-07-05 |
1396011961 | Patricia Jean Evans | Internal Medicine | 702 S.w. Higgins, First Choice Medical Clinic, Missoula, MT 59804 | 2012-03-28 |
1205126794 | Pacific Medical, Inc. | Prosthetic/Orthotic Supplier | 2732 South Ave West, Suite 202, Missoula, MT 59804 | 2011-04-18 |
Find all providers in zip 59804 |
Taxonomy Code | 363AS0400X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Physician Assistant |
Specialization | Surgical Technologist |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1598965097 | Travis Lee Harris | Physician Assistant | 500 W. Broadway, Suite 320, St. Patrick Hospital, Missoula, MT 59802-4008 | 2007-07-23 |
1437541471 | Stephen Andrew Shepro | Physician Assistant | 2740 South Ave W Ste 101, Missoula, MT 59804-5137 | 2015-02-27 |
1427312438 | Jesse Jeffrey Doll | Physician Assistant | 2360 Mullan Rd, Ste C, Missoula, MT 59808-1811 | 2012-06-25 |
1790754463 | Jerry J King | Physician Assistant | 2831 Fort Missoula Rd, Suite 232, Missoula, MT 59804-7419 | 2006-03-15 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1457576407 | Rosalee Shorter | Physician Assistant | 341 Montana Hwy 135, Saint Regis, MT 59866-0176 | 2007-04-16 |
1245341874 | Tracy Edward Rogers | Physician Assistant | 202 Conway Dr Ste 200, Kalispell, MT 59901-3153 | 2006-08-31 |
1881604668 | Harley G Morrell | Physician Assistant | 2877 Overland Ave Ste C, Billings, MT 59102-7465 | 2006-08-08 |
1487644597 | Timothy J Devries | Physician Assistant | 111 Sunnyview Ln, Kalispell, MT 59901-3164 | 2005-10-28 |
1447802178 | Reid Merrill Gage | Physician Assistant | 801 N 29th St, Billings, MT 59101-0905 | 2019-07-12 |
1083192025 | Tyson Vanderby | Physician Assistant | 2675 Central Ave, Billings, MT 59102-6686 | 2018-08-01 |
1205384690 | Christine Moen | Physician Assistant | 2900 12th Ave N, Suite 355w, Billings, MT 59101-7506 | 2016-09-14 |
1174973564 | Jacob Wheeler | Physician Assistant | 925 Highland Blvd Ste 1100, Bozeman, MT 59715-6900 | 2016-06-15 |
1427414440 | Kara Haskell | Physician Assistant | 1450 Ellis St, #201, Bozeman, MT 59715 | 2016-01-06 |
1346642667 | Jennifer Vollmer | Physician Assistant | 1450 Ellis St Ste 201, Bozeman, MT 59715-8813 | 2014-09-17 |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.