DEREK GENE SMITH JR. (NPI# 1053726323) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1053726323 |
Entity Type | Individual |
Full Name | DEREK GENE SMITH JR. |
Credential | LMT |
Practice Address |
2801 Great Northern Loop Missoula MT 59808-1745 |
Practice Telephone | 4065499100 |
Practice Fax Number | 4065499151 |
Mailing Telephone | 4065499100 |
Mailing Fax Number | 4065499151 |
Enumeration Date | 2014-06-25 |
Last Update Date | 2014-06-25 |
Gender Code | M |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 225700000X | Massage Therapist | LMT-LMT-LIC-6151 | MT | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1407496110 | Derek Jenkins Smith | Home Health Aide | 2514 24th St Ne, Washington, DC 20018-2126 | 2020-01-10 |
1922511765 | Derek Smith | Counselor | 1317 Wilmer Ave Ste 102, Anniston, AL 36201-4600 | 2017-11-15 |
1871049437 | Derek Anthony Smith | Physical Therapist | 89135, 10550 W Park Run Dr, Las Vegas, NV 89144 | 2016-09-01 |
1518375682 | Derek Smith | Chiropractor | 809 Iroquois Cir, Baraboo, WI 53913-1248 | 2014-08-01 |
1386066082 | Derek Smith | Pharmacist | 727 E Main St, Havana, IL 62644-1530 | 2014-01-15 |
1730522863 | Derek K Smith | Student in an Organized Health Care Education/Training Program | 2025 Morse Avenue 1east Rm#6, Sacramento, CA 95825 | 2013-04-08 |
1346582525 | Derek Beeson Smith | Orthopaedic Surgery | 1140 Sw Simpson Ave Ste 100, Bend, OR 97702 | 2013-03-26 |
1780937961 | Derek Smith | Physical Therapist | 7405 W Arizona Pl, Lakewood, CO 80232-5416 | 2012-10-24 |
1407869019 | Derek R Smith | Psychiatry & Neurology | One Towne Park Plaza, Norwich, CT 06360 | 2006-08-14 |
1689298861 | Derek Nathaniel Smith | Nurse Anesthetist, Certified Registered | 1 Medical Village Dr, Edgewood, KY 41017-3403 | 2020-06-03 |
Street Address |
2801 GREAT NORTHERN LOOP |
City | MISSOULA |
State | MT |
Zip Code | 59808-1745 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1073605200 | Carl Edward Thornblade | Allergy & Immunology | 2801 Great Northern Loop, Suite 101, Missoula, MT 59808-1745 | 2006-09-28 |
1225685399 | Carly Keene | Massage Therapist | 2801 Great Northern Loop, Missoula, MT 59808-1745 | 2019-08-22 |
1205332582 | Cortney Alexandria Skinner | Massage Therapist | 2801 Great Northern Loop, Missoula, MT 59808-1745 | 2018-04-04 |
1912425794 | Sarah Jean Nelson | Massage Therapist | 2801 Great Northern Loop, Missoula, MT 59808-1745 | 2017-08-31 |
1477906808 | Tyler Rapke | Massage Therapist | 2801 Great Northern Loop, Missoula, MT 59808-1745 | 2016-07-21 |
1972960276 | Laura Elizabeth Gilhousen | Acupuncturist | 2801 Great Northern Loop, Missoula, MT 59801 | 2016-01-19 |
1689047391 | Randi Plouffe | Reflexologist | 2801 Great Northern Loop, Missoula, MT 59808-1745 | 2015-11-03 |
1649679408 | April Gragg | Chiropractor | 2801 Great Northern Loop, Missoula, MT 59808-1745 | 2014-08-18 |
1649694092 | Charles Vickrey | Massage Therapist | 2801 Great Northern Loop, Missoula, MT 59808-1745 | 2014-02-05 |
1740620830 | Eugene Statelen | Specialist | 2801 Great Northern Loop, Missoula, MT 59808-1745 | 2013-07-03 |
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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 | 225700000X |
Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Classification | Massage Therapist |
An individual trained in the manipulation of tissues (as by rubbing, stroking, kneading, or tapping) with the hand or an instrument for remedial or hygienic purposes. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1982216834 | Rosemary A Stoudt | Massage Therapist | 415 N Higgins Ave Ste 128, Missoula, MT 59802-4563 | 2020-08-21 |
1114549540 | Rozanne Smith | Massage Therapist | 700 South Ave W Ste C, Missoula, MT 59801-8011 | 2020-05-07 |
1215584719 | Shelby Riley | Massage Therapist | 2801 S Russell St Ste 39, Missoula, MT 59801-7922 | 2019-08-20 |
1588229686 | Kayla Hull | Massage Therapist | 1940 Harve Ave Ste B, Missoula, MT 59801-8332 | 2019-05-03 |
1063984078 | Sarah Jane Hanlon | Massage Therapist | 801 Sherwood St Ste 1, Missoula, MT 59802-2659 | 2019-01-02 |
1184195182 | Deep Tissue Massage Group, Inc. | Massage Therapist | 725 W Alder St Ste 20, Missoula, MT 59802-4099 | 2018-12-17 |
1518435940 | Marc Benjamin Gonzalez | Massage Therapist | 397 Brianna Ct, Missoula, MT 59804-1041 | 2018-11-03 |
1780169847 | Cindy Ardis Clippinger | Massage Therapist | 4708 Sage St, Missoula, MT 59808-1475 | 2018-09-25 |
1881181444 | Carol Anne Lesser | Massage Therapist | 1918 Birch St, Missoula, MT 59802 | 2018-04-19 |
1700383940 | Kelsey Hamilton | Massage Therapist | 6945 Linda Vista Blvd, Missoula, MT 59803 | 2018-04-12 |
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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.