TIMOTHY J DEVRIES (NPI# 1487644597) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1487644597 |
Entity Type | Individual |
Full Name | TIMOTHY J DEVRIES |
Credential | PAC |
Practice Address |
111 Sunnyview Ln Kalispell MT 59901-3164 |
Practice Telephone | (406) 752-7900 |
Practice Fax Number | 4062570253 |
Mailing Telephone | 4067527900 |
Mailing Fax Number | 4062570253 |
Enumeration Date | 2005-10-28 |
Last Update Date | 2020-06-26 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
211 | MT | Physician Assistants & Advanced Practice Nursing Providers |
N | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
622 | MT | Physician Assistants & Advanced Practice Nursing Providers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
MT | 434282 | 05 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1760458764 | Timothy Dale Devries | Nurse Anesthetist, Certified Registered | 491 Meadow Ridge Ln, Hudson, WI 54016-8742 | 2006-02-28 |
Street Address |
111 SUNNYVIEW LN |
City | KALISPELL |
State | MT |
Zip Code | 59901-3164 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1245767599 | Kalispell Regional Medical Center Inc | Orthopaedic Surgery | 111 Sunnyview Ln, Kalispell, MT 59901-3164 | 2017-05-17 |
1962744011 | Kevin R Criswell | Physical Therapist | 111 Sunnyview Ln, Suite B, Kalispell, MT 59901-3164 | 2013-03-26 |
1790021434 | Randy W Dugan | Physician Assistant | 111 Sunnyview Ln, Kalispell, MT 59901-3164 | 2012-12-28 |
1811270705 | Rodney N Michel | Physical Therapy Assistant | 111 Sunnyview Ln, Suite B, Kalispell, MT 59901-3164 | 2011-09-27 |
1740563014 | Ashley N Wenz | Physical Therapist | 111 Sunnyview Ln, Suite B, Kalispell, MT 59901-3164 | 2011-09-23 |
1992083604 | Marcella D Sandry | Physical Therapist | 111 Sunnyview Ln, Suite B, Kalispell, MT 59901-3164 | 2011-07-29 |
1831325810 | Tyler M Ladenburg | Physical Therapist | 111 Sunnyview Ln, Suite A, Kalispell, MT 59901-3164 | 2009-06-04 |
1972744696 | Kelly L Malmin | Physical Therapist | 111 Sunnyview Ln, B, Kalispell, MT 59901-3164 | 2009-03-09 |
1285898569 | Joseph Henry Bergman | Orthopaedic Surgery | 111 Sunnyview Ln, Kalispell, MT 59901-3164 | 2008-07-15 |
1437356847 | Benjamin W Kingan | Physical Therapist | 111 Sunnyview Ln, Suite B, Kalispell, MT 59901-3164 | 2007-06-29 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1982226650 | Mountain Physical Therapy and Fitness Center LLC | Physical Medicine & Rehabilitation | 2593 Highway 2 East, Suite 6, Kalispell, MT 59901 | 2020-05-15 |
1164058350 | Jessica Leeann Abell | Physical Therapist | 1825 Highway 93 S. Suite C, Kalispell, MT 59901 | 2020-03-19 |
1588216535 | Diversified Therapeutic Services, Pllc | Clinic/Center | 30 E Washinton St, Suite A, Kalispell, MT 59901 | 2019-07-10 |
1467986216 | Jill Shaver | Counselor | 285 2nd Avenue Wn, Suite #100, Kalispell, MT 59901 | 2017-04-19 |
1003270810 | Angela Otto | Counselor | 17 2nd St E Ste 204, Kalispell, MT 59901 | 2016-04-07 |
1548626989 | Pamela Greskowiak | Counselor | 2282 Hwy 93 South, Suite #1, Kalispell, MT 59901 | 2016-01-14 |
1063894921 | Joel Booth | Dentist | 690 N Meridian Rd Ste 106, Kalispell, MT 59901 | 2015-06-26 |
1982085841 | Heather Reddig | Specialist | 751 Snowberry Trail, Kalispell, MT 59901 | 2015-06-16 |
1497147193 | Patricia Greene Hall | Psychologist | 1035 1st Ave W Fl 3, Kalispell, MT 59901 | 2015-03-04 |
1720478886 | Lori Mariani | Social Worker | 1605 Danielson Road, Kalispell, MT 59901 | 2015-01-28 |
Find all providers in zip 59901 |
Taxonomy Code | 363AS0400X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Physician Assistant |
Specialization | Surgical Technologist |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1245341874 | Tracy Edward Rogers | Physician Assistant | 202 Conway Dr Ste 200, Kalispell, MT 59901-3153 | 2006-08-31 |
1205266053 | Tyler Wagstaff | Physician Assistant | 350 Heritage Way Ste 2100, Kalispell, MT 59901-3167 | 2013-11-14 |
1427288836 | Amy Lynn Tangedahl | Physician Assistant | 200 Commons Way Ste B, Kalispell, MT 59901-1915 | 2009-07-20 |
1437243763 | Brianne Peltz | Physician Assistant | 202 Conway Dr Ste 200, Kalispell, MT 59901-3153 | 2006-10-03 |
1710084751 | Samantha J Short | Physician Assistant | 350 Heritage Way, Suite 2100, Kalispell, MT 59901-3158 | 2006-09-20 |
1790896470 | Gregory Urs Danielson | Physician Assistant | 111 Sunnyview Ln, Kalispell, MT 59901-3164 | 2006-08-31 |
1053422626 | Steven Craig Trimble | Physician Assistant | 111 Sunnyview Ln, Kalispell, MT 59901-3164 | 2006-08-31 |
1386752186 | Kristy Ehrmantraut | Physician Assistant | 60 Four Mile Dr Ste 10, Kalispell, MT 59901-2663 | 2006-08-29 |
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 |
1457576407 | Rosalee Shorter | Physician Assistant | 341 Montana Hwy 135, Saint Regis, MT 59866-0176 | 2007-04-16 |
1881604668 | Harley G Morrell | Physician Assistant | 2877 Overland Ave Ste C, Billings, MT 59102-7465 | 2006-08-08 |
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 |
1437541471 | Stephen Andrew Shepro | Physician Assistant | 2740 South Ave W Ste 101, Missoula, MT 59804-5137 | 2015-02-27 |
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.