PROVIDENCE HEALTH & SERVICES MT (NPI# 1649401076) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1649401076 |
| Entity Type | Organization |
| Organization Name | PROVIDENCE HEALTH & SERVICES MT |
| Other Organization Name | PMG MT IHI MONTANA CARDIOLOGY |
| Practice Address |
2829 Great Northern Loop Suite 300 Missoula MT 59808-1752 |
| Mailing Address |
Po Box 34439 Seattle WA 98124-1439 |
| Practice Telephone | 4065417000 |
| Mailing Telephone | 4065417000 |
| Mailing Fax Number | 4065417001 |
| Enumeration Date | 2009-08-03 |
| Last Update Date | 2011-06-23 |
| Authorized Official Name | TERI MASTERS (RCM OPERATIONS MGR) |
| Authorized Official Telephone | 4063295795 |
| Is Organization Subpart | Y |
| Parent Organization Name | PROVIDENCE HEALTH & SERVICES |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RI0011X |
Internal Medicine Specialization: Interventional Cardiology |
Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| PMG MT IHI Montana Cardiology | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326483587 | Providence Health & Services Mt | Internal Medicine | 24001 East Mission Ave. Ste 105, Providence Healtlh and Services, Montana, Liberty Lake, WA 99019-0012 | 2013-05-01 |
| 1679865497 | Providence Health & Services Mt | Physician Assistant | 3050 Highway 83 N, Seeley Lake, MT 59868 | 2011-05-12 |
| 1427281203 | Providence Health & Services Mt | Internal Medicine | 500 W Broadway Street, Missoula, MT 59802-4096 | 2009-08-27 |
| 1538394267 | Providence Health & Services Mt | Internal Medicine | 435 S Crystal St Ste 240, Butte, MT 59701-1523 | 2009-05-26 |
| 1871750554 | Providence Health & Services Mt | Internal Medicine | 300 W Mercury Street, Butte, MT 59701-1652 | 2008-05-20 |
| 1518124379 | Providence Health & Services Mt | Internal Medicine | 1102 E Commercial Ave, Anaconda, MT 59711-2718 | 2008-05-20 |
| 1881191948 | Providence Health & Services Mt | Clinic/Center | 900 N Orange St Ste 304, Missoula, MT 59802-2951 | 2018-04-06 |
| 1174074827 | Providence Health & Services Mt | Nurse Practitioner | 500 W Broadway St, Missoula, MT 59802-4008 | 2016-10-18 |
| 1720477953 | Providence Health & Services Mt | Neurological Surgery | 500 W Broadway St, Missoula, MT 59802-4008 | 2015-01-12 |
| 1215222617 | Providence Health & Services Mt | Internal Medicine | 500 W Broadway St, Missoula, MT 59802-4008 | 2011-06-14 |
| Street Address |
2829 GREAT NORTHERN LOOP SUITE 300 |
| City | MISSOULA |
| State | MT |
| Zip Code | 59808-1752 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922154731 | Thomas Drew Hall | Optometrist | 2829 Great Northern Loop, Suite 100, Missoula, MT 59808-1752 | 2007-01-25 |
| 1194908624 | Montana Family Vision Care, PC | Optometrist | 2829 Great Northern Loop, Suite 100, Missoula, MT 59808-1752 | 2007-12-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447720875 | Megan Elizabeth Galliford | Behavioral Analyst | 1647 Shindig Dr, Apt 303, Missoula, MT 59808 | 2018-11-28 |
| 1518473560 | Willow Mahana Nelson Griffith | Registered Nurse | 2829 Great Northern Loop Ste 300, Missoula, MT 59808 | 2017-12-28 |
| 1043739428 | Carol Elizabeth Mckenzie | Student in an Organized Health Care Education/Training Program | 2705 Oshaughnessy St, Missoula, MT 59808 | 2017-09-16 |
| 1558884064 | Sharon Marie Herndon | Nurse Practitioner | 2230 N Reserve St Ste 402, Missoula, MT 59808 | 2017-07-18 |
| 1427594761 | Erin Boggs | Specialist/Technologist | 2921 Dublin St, Missoula, MT 59808 | 2017-01-10 |
| 1942603287 | Benjamin Cody Mcintosh | Chiropractor | 1070 N. Russell St., Missoula, MT 59808 | 2014-10-01 |
| 1518219617 | Pure Medical Inc | Ambulance | 5515 Bonanza Place, Missoula, MT 59808 | 2012-10-12 |
| 1932462231 | Kathleen F Calcagno | Specialist/Technologist | 2615 Connery Way, Suite 2b, Missoula, MT 59808 | 2012-06-21 |
| 1639454127 | Dentyn Dunaway | Pharmacist | 2527 N Reserve Street, Missoula, MT 59808 | 2011-10-15 |
| 1750557690 | Carl Thornblade, Md, Pllc | Allergy & Immunology | 2801 Great Northern Loop Ste 101, Missoula, MT 59808 | 2008-04-30 |
| Find all providers in zip 59808 | ||||
| Taxonomy Code | 207RI0011X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Interventional Cardiology |
| An area of medicine within the subspecialty of cardiology, which uses specialized imaging and other diagnostic techniques to evaluate blood flow and pressure in the coronary arteries and chambers of the heart and uses technical procedures and medications to treat abnormalities that impair the function of the cardiovascular system. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source] Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/ Board Certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. ACGME Accredited Residency Program Requirements: 1 year of training plus a prerequisite of 3 years Internal Medicine, 3 years Cardiovascular Disease for a total of 7 years. ABMS Approved Subspecialty Certificate (Internal Medicine) |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487189874 | P.a. Kelly Md Pllc | Internal Medicine | 2875 Tina Ave, Suite 111, Missoula, MT 59808-1581 | 2017-04-24 |
| 1013115856 | Newton B. Coutinho Md Pllc | Internal Medicine | 2875 Tina Ave, Suite 111, Missoula, MT 59808-1581 | 2007-07-03 |
| 1609903624 | Stephen M Dodge | Internal Medicine | 500 W Broadway St Ste 320, Missoula, MT 59802-4031 | 2007-02-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073770525 | St Patrick Hosp and Health Sci Ctr | Internal Medicine | 357 Airport Rd, St. Ignatius, MT 59865-9720 | 2008-05-21 |
| 1871750554 | Providence Health & Services Mt | Internal Medicine | 300 W Mercury Street, Butte, MT 59701-1652 | 2008-05-20 |
| 1518124379 | Providence Health & Services Mt | Internal Medicine | 1102 E Commercial Ave, Anaconda, MT 59711-2718 | 2008-05-20 |
| 1790851319 | Richard David Paustian | Internal Medicine | 32 Medical Park Dr, Helena, MT 59601 | 2006-11-27 |
| 1669472395 | Robert Zelman | Internal Medicine | 1300 28th St S, Suite 10, Great Falls, MT 59405-5296 | 2005-07-22 |
| 1760819486 | St. Vincent Healthcare | Internal Medicine | 2900 12th Ave N, Suite 204e, Billings, MT 59101-7506 | 2013-09-27 |
| 1932425329 | Shawn C. Kelly | Internal Medicine | 1101 26th St S, Great Falls, MT 59405-5161 | 2010-04-12 |
| 1457675084 | T Raymond Foley Iv | Internal Medicine | 350 Heritage Way Ste 2100, Kalispell, MT 59901-3167 | 2010-03-25 |
| 1396075297 | Per Sommer | Internal Medicine | 801 N 29th St, Billings, MT 59101 | 2009-12-28 |
| 1750510624 | Ronald Brandon Henckel | Internal Medicine | 2900 12th Ave N Ste 204e, Billings, MT 59101-7502 | 2009-07-13 |
| Find all providers with the same taxonomy | ||||
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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.