DR. JACK HENSOLD (NPI# 1851309421) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1851309421 |
| Entity Type | Individual |
| Full Name | DR. JACK HENSOLD |
| Credential | MD |
| Practice Address |
931 Highland Blvd Ste 3130 Bozeman MT 59715-6914 |
| Practice Telephone | 4065855070 |
| Enumeration Date | 2006-08-03 |
| Last Update Date | 2007-10-11 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RH0003X |
Internal Medicine Specialization: Hematology & Oncology |
10576 | MT | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MT | BLUE CROSS OF MT | 97535 | 01 |
| MT | 0140624 | 05 | |
| MEDICARE RAILROAD | P00225963 | 01 |
| Street Address |
931 HIGHLAND BLVD STE 3130 |
| City | BOZEMAN |
| State | MT |
| Zip Code | 59715-6914 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730161027 | Patrick Bunkley Gaylor | Internal Medicine | 931 Highland Blvd Ste 3130, Bozeman, MT 59715 | 2005-11-14 |
| 1962950923 | Jessica Story Pope | Nurse Practitioner | 931 Highland Blvd Ste 3130, Bozeman, MT 59715-6914 | 2016-09-19 |
| 1174935688 | Amy Wagner | Nurse Practitioner | 931 Highland Blvd Ste 3130, Bozeman, MT 59715-6914 | 2014-06-02 |
| 1205092400 | Courtney Regan Wagner | Internal Medicine | 931 Highland Blvd Ste 3130, Bozeman, MT 59715-6914 | 2008-08-06 |
| 1104002195 | Justin Daniel Thomas | Internal Medicine | 931 Highland Blvd Ste 3130, Bozeman, MT 59715-6914 | 2008-01-21 |
| 1942499645 | Charlotte A Weiss | Nurse Practitioner | 931 Highland Blvd Ste 3130, Bozeman, MT 59715-6914 | 2007-10-18 |
| 1881602498 | Rebecca Kane | Nurse Practitioner | 931 Highland Blvd Ste 3130, Bozeman, MT 59715-6914 | 2006-08-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477152288 | Ch Mh Services (il), LLC | Clinic/Center | 233 E Main St Suite 401, Bozeman, MT 59715 | 2020-10-22 |
| 1134735269 | Montana Therapy and Consulting Pllc | Social Worker | 110 S Grand Ave, Floor 2, Bozeman, MT 59715 | 2020-09-23 |
| 1831715994 | Alyson Raph | Student in an Organized Health Care Education/Training Program | 1 Anna Pearl Sherrick Hal, Bozeman, MT 59715 | 2020-06-24 |
| 1639702780 | Miranda Shields | Massage Therapist | 1001 W. Oak St. Bldg C Ste 210, Bozeman, MT 59715 | 2020-02-18 |
| 1154988590 | Christina Yancy | Massage Therapist | Bldg C, Ste 210, 1001 W Oak St, Bozeman, MT 59715 | 2019-05-21 |
| 1962068767 | Julie A Hisey | Physical Therapist | 1700 W. Koch, Suite 12, Bozeman, MT 59715 | 2019-05-16 |
| 1639631633 | Joshua Wallace | Massage Therapist | 1001 W Oak St, Bldg. C Ste. 210, Bozeman, MT 59715 | 2019-04-01 |
| 1528523388 | Judith Margaret Firehammer | Psychologist | 37 East Main St, Suite 7, Bozeman, MT 59715 | 2019-02-06 |
| 1194280875 | Erica Kotick | Counselor | 2246 Boot Hill Court, Suite 4, Bozeman, MT 59715 | 2019-02-06 |
| 1194291609 | Providence Mental Health Pllc | Social Worker | 2246 Boot Hill Ct. Unit #4, Bozeman, MT 59715 | 2018-10-23 |
| Find all providers in zip 59715 | ||||
| Taxonomy Code | 207RH0003X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Hematology & Oncology |
| An internist doctor of osteopathy that specializes in the treatment of the combination of hematology and oncology disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine WAS able to obtain a Certificate of Special Qualifications in the field of Hematology and Oncology. The Certificate is NO longer offered. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2007. [7/1/2008: definiton added, source added; 7/1/2011: modified source] - Additional Resources: http://www.osteopathic.org/certification |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902820483 | Annie L Castillo | Internal Medicine | 915 Highland Blvd # 3220, Bozeman, MT 59715-6902 | 2006-07-27 |
| 1205092400 | Courtney Regan Wagner | Internal Medicine | 931 Highland Blvd Ste 3130, Bozeman, MT 59715-6914 | 2008-08-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457543340 | Siobhan P Lynch | Internal Medicine | 2837 Fort Missoula Rd, Missoula, MT 59804-7408 | 2007-08-14 |
| 1871672428 | Judy L Schmidt, Md/pc | Internal Medicine | 2835 Fort Missoula Rd., Suite 301, Missoula, MT 59804-7424 | 2006-11-03 |
| 1275541559 | Donald H Berdeaux Md Facp PC | Internal Medicine | 1117 29th St S Ste 400, Great Falls, MT 59405-5309 | 2006-08-03 |
| 1245286970 | Grant W Harrer | Internal Medicine | 1117 29th St. S, Suite 500, Great Falls, MT 59405 | 2006-05-25 |
| 1891151122 | Kalispell Regional Medical Center Inc | Internal Medicine | 75 Claremont St, Suite E, Kalispell, MT 59901-3585 | 2015-12-31 |
| 1659629822 | Le Min Lee | Internal Medicine | 801 N 29th St, Billings, MT 59101 | 2012-08-20 |
| 1063788677 | Cesar Ochoa Perez | Internal Medicine | 801 N 29th St, Billings, MT 59101 | 2012-03-28 |
| 1962705376 | Kalispell Regional Medical Center Inc | Internal Medicine | 350 Heritage Way, Suite 1100, Kalispell, MT 59901-3158 | 2010-12-08 |
| 1568776771 | Carlos Silva Rondon | Internal Medicine | 801 N 29th St, Billings, MT 59101 | 2010-07-29 |
| 1467681833 | Jesus Carlos Fabregas Mercado | Internal Medicine | 801 N 29th St, Billings, MT 59101-0905 | 2009-07-07 |
| 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.