PROVIDENCE HEALTH & SERVICES MT (NPI# 1679730436) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1679730436 |
| Entity Type | Organization |
| Organization Name | PROVIDENCE HEALTH & SERVICES MT |
| Other Organization Name | PMG MT IHI GREAT FALLS |
| Practice Address |
1417 9th St S Suite 203 Great Falls MT 59405-4509 |
| Mailing Address |
Po Box 12 Liberty Lake WA 99019-0012 |
| Practice Telephone | 4067717700 |
| Practice Fax Number | 4063295606 |
| Mailing Telephone | 4063295615 |
| Mailing Fax Number | 4063295606 |
| Enumeration Date | 2008-05-20 |
| Last Update Date | 2013-11-11 |
| Authorized Official Name | MRS. TERI MASTERS (RCM OPERATIONS MANAGER) |
| Authorized Official Telephone | 4063295795 |
| Is Organization Subpart | Y |
| Parent Organization Name | PROVIDENCE HEALTH & SERVICES |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207RI0011X |
Internal Medicine Specialization: Interventional Cardiology |
Allopathic & Osteopathic Physicians | ||
| N | 207RP1001X |
Internal Medicine Specialization: Pulmonary Disease |
Allopathic & Osteopathic Physicians | ||
| Y | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| PMG MT IHI Great Falls | Other Name - Individual/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 |
1417 9TH ST S SUITE 203 |
| City | GREAT FALLS |
| State | MT |
| Zip Code | 59405-4509 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598766826 | Central Montana Imaging LLC | Clinic/Center | 1417 9th St S, Suite 102, Great Falls, MT 59405-4509 | 2005-08-09 |
| 1528413093 | Rocky Mountain Vein Clinic Great Falls Inc | Surgery | 1417 9th St S, Great Falls, MT 59405-4509 | 2016-05-03 |
| 1245419670 | Melissa Ann Pellot | Registered Nurse | 1417 9th St S, Great Falls, MT 59405-4509 | 2007-11-01 |
| 1295825420 | Robert Arthur Neill | Dermatology | 1417 9th St S, Suite 200, Great Falls, MT 59405-4509 | 2006-10-16 |
| 1811089568 | Ro Montana | Pharmacy | 1417 9th St S, Suite 101a, Great Falls, MT 58405 | 2006-09-29 |
| 1346251147 | Brian E. Linnell | Counselor | 1417 9th St S, Great Falls, MT 59405-4509 | 2006-08-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902446180 | Reilly Kunz | Physical Therapist | 2621 15th Ave South, Great Falls, MT 59405 | 2020-01-15 |
| 1336617224 | Brandi Noel Sauer | Behavior Technician | 1601 2nd Ave North Suite 518, Great Falls, MT 59405 | 2018-11-08 |
| 1982103446 | Traci Raines Aprn Pllc | Nurse Practitioner | 120 Marillyn Dr, Great Falls, MT 59405 | 2018-02-09 |
| 1003332818 | Great Falls Health Supplies | Durable Medical Equipment & Medical Supplies | 1720 10th Ave., South, Suite 4-151, Great Falls, MT 59405 | 2017-08-15 |
| 1518489426 | Jessica Lynn Keller | Specialist/Technologist | 720 46th Street South, Great Falls, MT 59405 | 2017-07-12 |
| 1235678475 | Vanessa Claudia Hernandez | Occupational Therapist | 2621 15 Ave So, Great Falls, MT 59405 | 2017-02-21 |
| 1871039339 | Morgan Laux Olsen | Specialist/Technologist | 1301 20th St S, Great Falls, MT 59405 | 2017-01-09 |
| 1558807198 | Greg Robert Lipton | Occupational Therapist | 2621 15th Ave So, Great Falls, MT 59405 | 2017-01-06 |
| 1386180925 | Jessica Lee Krahn | Physical Therapist | 2621 15th Ave So., Great Falls, MT 59405 | 2017-01-06 |
| 1811430150 | Juli Brandvold | Massage Therapist | 2400 4th Ave S., Great Falls, MT 59405 | 2016-11-18 |
| Find all providers in zip 59405 | ||||
| Taxonomy Code | 207RC0000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Cardiovascular Disease |
| An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2008 [7/1/2008: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, http://www.abim.org/. American Osteopathic Board of Internal Medicine, https://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417230855 | Puneet Victor Bansal | Internal Medicine | 1101 25th St S, Great Falls, MT 59405 | 2011-09-22 |
| 1861540593 | Daniel R Walker | Internal Medicine | 2510 Bobcat Way, Great Falls, MT 59405-5169 | 2007-01-08 |
| 1952372294 | Alrich L Gray | Internal Medicine | 401 15th Ave S Ste 202, Great Falls, MT 59405 | 2006-01-26 |
| 1154631893 | Daniel R Walker Md Pllc | Internal Medicine | 2510 Bobcat Way, Great Falls, MT 59405-5169 | 2010-10-15 |
| 1386717437 | Michael E Ritchie | Internal Medicine | 3000 15th Ave S, Great Falls, MT 59405-5240 | 2006-11-16 |
| 1124108634 | Benefis Hospitals, Inc. | Internal Medicine | 1101 26th St S, Great Falls, MT 59405-5161 | 2006-10-17 |
| 1487665592 | Benefis Healthcare Practitioners, PC | Internal Medicine | 1101 26th St S, Great Falls, MT 59405-5161 | 2006-08-11 |
| 1447270764 | Douglas A Waldo | Internal Medicine | 1101 26th St S, 5th Floor, Great Falls, MT 59405-5161 | 2006-07-20 |
| 1811951601 | Jorge Luis Castriz | Internal Medicine | 3000 15th Ave S, Great Falls, MT 59405-5240 | 2006-04-17 |
| 1568447076 | Miroslaw Tadeusz Sochanski | Internal Medicine | 1101 26th St S, Great Falls, MT 59405-5161 | 2005-12-07 |
| Find all providers in GREAT FALLS | ||||
| City | GREAT FALLS |
| Zip Code | 59405 |
Please comment or provide details below to improve the information on PROVIDENCE HEALTH & SERVICES MT.
| 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.