DR. PETER M KELLEHER (NPI# 1518185982) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1518185982 |
| Entity Type | Individual |
| Full Name | DR. PETER M KELLEHER |
| Credential | MD |
| Practice Address |
536 Cottonwood Rd Suite 100 Bozeman MT 59718 |
| Practice Telephone | 4065868029 |
| Practice Fax Number | 4065868009 |
| Mailing Telephone | 4065868029 |
| Mailing Fax Number | 4065868009 |
| Enumeration Date | 2007-04-23 |
| Last Update Date | 2011-10-28 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207X00000X | Orthopaedic Surgery | MD431276 | PA | Allopathic & Osteopathic Physicians |
| Y | 207XX0005X |
Orthopaedic Surgery Specialization: Sports Medicine |
11795 | MT | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MT | BCBS OF MONTANA | 0000093258 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205876331 | Peter Sean Kelleher | Physical Therapist | 4700 Northgate Blvd Ste 120, Sacramento, CA 95834-1148 | 2006-06-07 |
| 1376713388 | Peter Kelleher | Social Worker | 45 High St, Nashua, NH 03060-3312 | 2008-03-05 |
| Street Address |
536 COTTONWOOD RD SUITE 100 |
| City | BOZEMAN |
| State | MT |
| Zip Code | 59718 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437159944 | Mark C Deibert | Orthopaedic Surgery | 536 Cottonwood Rd, Suite 100, Bozeman, MT 59718 | 2005-07-26 |
| 1033558887 | Alpine Orthopedics | Physician Assistant | 536 Cottonwood Rd, Bozeman, MT 59718 | 2013-06-14 |
| 1215205182 | Jessica Ann Pelton | Physician Assistant | 536 Cottonwood Rd, #100, Bozeman, MT 59718 | 2011-12-07 |
| 1083626832 | Alpine Orthopedics & Sports Medicine | Orthopaedic Surgery | 536 Cottonwood Rd, Suite 100, Bozeman, MT 59718 | 2006-08-12 |
| 1598717662 | Jeffrey S Rasch | Family Medicine | 536 Cottonwood Rd, Suite 100, Bozeman, MT 59718 | 2006-05-17 |
| 1922008374 | Timothy O'brien | Orthopaedic Surgery | 536 Cottonwood Rd, Suite 100, Bozeman, MT 59718 | 2005-07-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932727518 | Alex Mattucci | Pharmacist | 200 South 23rd St, Bozeman, MT 59718 | 2020-07-09 |
| 1285251132 | West Bozeman Surgery Center, LLC | Clinic/Center | 5031 S. Cottonwood Road, Suite 100, Bozeman, MT 59718 | 2020-06-26 |
| 1528680733 | Amanda Harris | Student in an Organized Health Care Education/Training Program | 301 Edelweiss Dr, Unit 7, Bozeman, MT 59718 | 2020-05-11 |
| 1568946291 | Build Physio & Performance, Pllc | Physical Therapist | 609 Pronghorn Trail, Bozeman, MT 59718 | 2018-09-19 |
| 1184107872 | Hunter Family Chiropractic Pllc | Chiropractor | 37 Spanish Peak Drive, Bozeman, MT 59718 | 2018-09-10 |
| 1588179873 | Melissa N Blixt | Nurse Practitioner | 1805 W. Oak, Bozeman, MT 59718 | 2017-12-07 |
| 1861949455 | Kristina Joy Parmelee | Massage Therapist | 1001 West Oak Street #210, Bozeman, MT 59718 | 2016-09-01 |
| 1265883037 | Molly Kathleen Smith | Specialist | 642 S. Cottonwood Rd., Suite 2, Bozeman, MT 59718 | 2016-06-23 |
| 1063891414 | Dutton & Willhite, Inc. | Chiropractor | 2622 W. Main Ste. B, Bozeman, MT 59718 | 2015-05-19 |
| 1548664253 | Stacy Montaigne Aucoin | Social Worker | 102 S. 19th, Suite #5, Bozeman, MT 59718 | 2014-10-09 |
| Find all providers in zip 59718 | ||||
| Taxonomy Code | 207XX0005X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Orthopaedic Surgery |
| Specialization | Sports Medicine |
| An orthopaedic surgeon trained in sports medicine provides appropriate care for all structures of the musculoskeletal system directly affected by participation in sporting activity. This specialist is proficient in areas including conditioning, training and fitness, athletic performance and the impact of dietary supplements, pharmaceuticals, and nutrition on performance and health, coordination of care within the team setting utilizing other health care professionals, field evaluation and management, soft tissue biomechanics and injury healing and repair. Knowledge and understanding of the principles and techniques of rehabilitation, athletic equipment and orthotic devices enables the specialist to prevent and manage athletic injuries. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton changed, source changed] Additional Resources: American Board of Orthopaedic Surgery, 2007. http://www.abos.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Orthopaedic Surgery. ACGME Accredited Program Requirements: 1 year GME in the specialty + 5 years of Orthopaedic Surgery for a total of 6 years |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437159944 | Mark C Deibert | Orthopaedic Surgery | 536 Cottonwood Rd, Suite 100, Bozeman, MT 59718 | 2005-07-26 |
| 1083626832 | Alpine Orthopedics & Sports Medicine | Orthopaedic Surgery | 536 Cottonwood Rd, Suite 100, Bozeman, MT 59718 | 2006-08-12 |
| 1922008374 | Timothy O'brien | Orthopaedic Surgery | 536 Cottonwood Rd, Suite 100, Bozeman, MT 59718 | 2005-07-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083264816 | Montana State University - Billings | Orthopaedic Surgery | 1500 University Dr, Billings, MT 59101-0245 | 2019-09-13 |
| 1073095667 | Rocky Mountain College | Orthopaedic Surgery | 1511 Poly Dr, Billings, MT 59102-1739 | 2018-08-30 |
| 1033154760 | David W Shenton Jr. | Orthopaedic Surgery | 2900 12th Ave N, #100e, Billings, MT 59101-7506 | 2006-06-17 |
| 1497734909 | Colin G Sherrill | Orthopaedic Surgery | 2360 Mullan Rd, Suite C, Missoula, MT 59808-1811 | 2006-01-12 |
| 1831199090 | Michael J. Schutte | Orthopaedic Surgery | 2831 Fort Missoula Rd, Suite 232, Missoula, MT 59804-7419 | 2005-07-28 |
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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.