PROVIDENCE HEALTH & SERVICES MT (NPI# 1952568735) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1952568735 |
| Entity Type | Organization |
| Organization Name | PROVIDENCE HEALTH & SERVICES MT |
| Other Organization Name | PMG MT IHI POLSON |
| Practice Address |
6 13th Ave E Polson MT 59860-5315 |
| Mailing Address |
Po Box 34439 Seattle WA 98124-1439 |
| Practice Telephone | 4068835680 |
| Practice Fax Number | 4063295606 |
| Mailing Telephone | 4063295615 |
| Mailing Fax Number | 4063295606 |
| Enumeration Date | 2008-05-20 |
| Last Update Date | 2011-06-22 |
| 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 Polson | 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 |
6 13TH AVE E |
| City | POLSON |
| State | MT |
| Zip Code | 59860-5315 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588669576 | Kenneth L. Galewyrick | Emergency Medicine | 6 13th Ave E, Polson, MT 59860-5315 | 2005-06-16 |
| 1982227443 | Sarah Elizabeth Anderson | Pharmacist | 6 13th Ave E, Polson, MT 59860-5315 | 2020-05-19 |
| 1932601796 | Elizabeth Nicole Bassler | Social Worker | 6 13th Ave E, Polson, MT 59860-5315 | 2018-03-07 |
| 1437661113 | Paige J Stone | Pharmacist | 6 13th Ave E, Polson, MT 59860-5315 | 2017-11-02 |
| 1992230239 | Corey Gaul | Emergency Medicine | 6 13th Ave E, Polson, MT 59860-5315 | 2017-04-24 |
| 1235679796 | Shana Eaglefeathers | Family Medicine | 6 13th Ave E, Polson, MT 59860-5315 | 2017-03-03 |
| 1306296249 | Susan Weaselhead | Counselor | 6 13th Ave E, Polson, MT 59860-5315 | 2016-06-21 |
| 1194191569 | Clint Tjelmeland | Pharmacist | 6 13th Ave E, Polson, MT 59860-5315 | 2015-08-19 |
| 1134501117 | Maria Mcneil Williams | Nurse Practitioner | 6 13th Ave E, Polson, MT 59860-5315 | 2015-06-25 |
| 1831581669 | Angelia Relph | Nurse Anesthetist, Certified Registered | 6 13th Ave E, Polson, MT 59860-5315 | 2015-03-03 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679095020 | Ashley J Gilham | Registered Nurse | #5 4th Ave E., Polson, MT 59860 | 2017-07-07 |
| 1225585532 | St. Luke Community Hospital | Clinic/Center | 107 Ridgewater Dr., Polson, MT 59860 | 2016-09-02 |
| 1306202163 | Western Montana Mental Health Center | Community Based Residential Treatment Facility, Mental Illness | 7 13th Ave East, Polson, MT 59860 | 2016-01-11 |
| 1154730364 | Wanda L King | Dietitian, Registered | 6 Thirteenth Avenue East, Poslon, MT 59860 | 2014-08-13 |
| 1104255637 | Dacia Lee Antiste-fisher | Counselor | #5 4th Ave. E., Polson, MT 59860 | 2013-11-05 |
| 1154758134 | Richard Pierre | Pharmacy Technician | 5 4th Ave E., Polson, MT 59860 | 2013-10-04 |
| 1154755197 | Wal-mart Stores, Inc | Durable Medical Equipment & Medical Supplies | 36318 Memory Lane, Polson, MT 59860 | 2013-08-27 |
| 1245582022 | Catherine D Addison | Registered Nurse | 5 4th Ave. East, Polson, MT 59860 | 2012-10-04 |
| 1114220787 | Erika Ann Weber | Social Worker | #5 4th Ave. E, Polson, MT 59860 | 2010-12-21 |
| 1942431473 | Lisa L. Scalpane | Counselor | 803 Main Street, Suite C, Polson, MT 59860 | 2009-07-31 |
| Find all providers in zip 59860 | ||||
| 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 |
|---|---|---|---|---|
| 1003157868 | Big Sky Heart Pllc | Internal Medicine | 2900 12th Ave N Ste 301e, Billings, MT 59101-7504 | 2013-03-04 |
| 1932460763 | Matthew Cortright Weiss | Internal Medicine | 2827 Fort Missoula Rd Bldg 5, Missoula, MT 59804-7408 | 2012-06-07 |
| 1417230855 | Puneet Victor Bansal | Internal Medicine | 1101 25th St S, Great Falls, MT 59405 | 2011-09-22 |
| 1538394267 | Providence Health & Services Mt | Internal Medicine | 435 S Crystal St Ste 240, Butte, MT 59701-1523 | 2009-05-26 |
| 1467657965 | Montana Cardiac Institute | Internal Medicine | 401 S Alabama St Ste 9, Butte, MT 59701-2358 | 2007-06-15 |
| 1700093846 | Richard Dean Tenney | Internal Medicine | 308 S Bozeman Ave, Bozeman, MT 59715-4809 | 2007-05-17 |
| 1710020029 | Glacier Cardiovascular Consultants | Internal Medicine | 711 E 13th Street, Whitefish, MT 59937 | 2007-02-15 |
| 1861540593 | Daniel R Walker | Internal Medicine | 2510 Bobcat Way, Great Falls, MT 59405-5169 | 2007-01-08 |
| 1972665503 | Caring Hearts of The Rockies PC | Internal Medicine | 350 Heritage Way Suite 2100, Kalispell, MT 59901 | 2006-12-13 |
| 1477581916 | Philip A. Roper | Internal Medicine | 601 W Spruce St Ste A, Missoula, MT 59802-4047 | 2006-06-30 |
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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.