JESSE A MUMM (NPI# 1760787766) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1760787766 |
| Entity Type | Individual |
| Full Name | JESSE A MUMM |
| Credential | PA-C |
| Practice Address |
160 Heritage Way Ste 202 Kalispell MT 59901-3127 |
| Practice Telephone | (406) 752-8433 |
| Practice Fax Number | 4067566768 |
| Mailing Telephone | 4067528433 |
| Mailing Fax Number | 4067566768 |
| Enumeration Date | 2011-01-21 |
| Last Update Date | 2020-06-26 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
58888 | MT | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363AM0700X |
Physician Assistant Specialization: Medical |
966 | AK | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
160 HERITAGE WAY STE 202 |
| City | KALISPELL |
| State | MT |
| Zip Code | 59901-3127 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467446773 | John Mark Tollerson | Family Medicine | 160 Heritage Way Ste 202, Kalispell, MT 59901-3127 | 2005-09-01 |
| 1720554488 | Julia Marie Tikka | Nurse Practitioner | 160 Heritage Way Ste 202, Kalispell, MT 59901 | 2018-10-22 |
| 1265916589 | Rachael Marie Alsbury | Nurse Practitioner | 160 Heritage Way Ste 202, Kalispell, MT 59901-3127 | 2018-09-21 |
| 1720490907 | Brendon Patrick Smith | Family Medicine | 160 Heritage Way Ste 202, Kalispell, MT 59901-3127 | 2014-05-22 |
| 1093082638 | Kaycee L Mcintosh | Physician Assistant | 160 Heritage Way Ste 202, Kalispell, MT 59901-3127 | 2011-11-28 |
| 1275862625 | Jessica Colleen Glover | Nurse Practitioner | 160 Heritage Way Ste 202, Kalispell, MT 59901-3127 | 2009-12-14 |
| 1114252327 | Douglas S Marbarger | Physician Assistant | 160 Heritage Way Ste 202, Kalispell, MT 59901-3127 | 2009-10-05 |
| 1194984039 | Ivory D Drendel | Family Medicine | 160 Heritage Way Ste 202, Kalispell, MT 59901-3127 | 2008-06-05 |
| 1932262052 | Marci Rae Mangold | Physician Assistant | 160 Heritage Way Ste 202, Kalispell, MT 59901-3127 | 2006-12-19 |
| 1871694463 | Shelley Naomi | Physician Assistant | 160 Heritage Way Ste 202, Kalispell, MT 59901-3127 | 2006-09-26 |
| Find all providers in the same location | ||||
| 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 | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164533618 | David E. Mangold | Physician Assistant | 20 Four Mile Dr Ste 2, Kalispell, MT 59901-2644 | 2006-08-31 |
| 1205858867 | Brooke Kendra Schmidt | Physician Assistant | 1600 Whitefish Stage Ste 1, Kalispell, MT 59901-2172 | 2006-07-24 |
| 1366472698 | Matthew T. Zemacke IIi | Physician Assistant | 245 Windward Way Ste 101, Kalispell, MT 59901-3385 | 2006-07-03 |
| 1538118617 | Patrick A Budin | Physician Assistant | 1281 Burns Way, Kalispell, MT 59901 | 2006-05-08 |
| 1972570596 | Mikal A Bailey | Physician Assistant | 205 Sunnyview Ln, Kalispell, MT 59901-3120 | 2006-03-02 |
| 1922089705 | Shelley Dawn Dugan | Physician Assistant | 350 Heritage Way Ste 2100, Kalispell, MT 59901-3167 | 2005-11-09 |
| 1750826061 | Mackenzie Horn | Physician Assistant | 175 Commons Loop Ste 300, Kalispell, MT 59901-1904 | 2016-12-21 |
| 1386046316 | Kevin Oberholser | Physician Assistant | 1287 Burns Way, Kalispell, MT 59901-3109 | 2014-09-22 |
| 1790021434 | Randy W Dugan | Physician Assistant | 111 Sunnyview Ln, Kalispell, MT 59901-3164 | 2012-12-28 |
| 1063796597 | Caleb R Ambrose | Physician Assistant | 1287 Burns Way, Kalispell, MT 59901-3109 | 2011-10-03 |
| Find all providers in KALISPELL | ||||
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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.