DOMINICK PETER TRIVISONNO (NPI# 1235303801) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1235303801 |
| Entity Type | Individual |
| Full Name | DOMINICK PETER TRIVISONNO |
| Credential | MD |
| Practice Address |
202 South 4th Street West Baker MT 59313-1119 |
| Mailing Address |
Po Box 1119 Baker MT 59313-1119 |
| Practice Telephone | 4067782833 |
| Practice Fax Number | 4067785131 |
| Mailing Telephone | 4067782833 |
| Mailing Fax Number | 4067785131 |
| Enumeration Date | 2008-04-15 |
| Last Update Date | 2012-01-30 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 208D00000X | General Practice | 11857 | MT | Allopathic & Osteopathic Physicians |
| Y | 208D00000X | General Practice | 173465 | NY | Allopathic & Osteopathic Physicians |
| Street Address |
202 SOUTH 4TH STREET WEST |
| City | BAKER |
| State | MT |
| Zip Code | 59313-1119 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093745572 | Darryl M Espeland | General Practice | 202 South 4th Street West, Baker, MT 59313-1119 | 2006-07-03 |
| 1689894800 | Fallon Medical Complex Inc | Durable Medical Equipment & Medical Supplies | 202 South 4th Street West, Baker, MT 59313-0820 | 2007-04-27 |
| 1194881698 | Fallon Medical Complex, Inc | Clinic/Center | 202 South 4th Street West, Baker, MT 59313-0820 | 2006-12-29 |
| 1023174521 | Fallon Medical Complex Inc | Clinical Medical Laboratory | 202 South 4th Street West, Baker, MT 59313-0820 | 2006-12-29 |
| 1861558330 | Fallon Medical Complex, Inc | Clinic/Center | 202 South 4th Street West, Baker, MT 59313-0820 | 2006-12-29 |
| 1386700763 | Fallon Medical Complex Inc | Clinic/Center | 202 South 4th Street West, Baker, MT 59313-1119 | 2006-12-29 |
| 1316013022 | Fallon Medical Complex Inc | Medicare Defined Swing Bed Unit | 202 South 4th Street West, Baker, MT 59313-0820 | 2006-11-27 |
| 1003982935 | Fallon Medical Complex Inc | Home Health | 202 South 4th Street West, Baker, MT 59313-0820 | 2006-11-24 |
| 1083624639 | Fallon Medical Complex Inc | Skilled Nursing Facility | 202 South 4th Street West, Baker, MT 59313-0820 | 2006-08-08 |
| 1700895752 | Fallon Medical Complex Inc | Clinic/Center | 202 South 4th Street West, Baker, MT 59313-1119 | 2006-08-07 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336293547 | James R Campbell Jr. | Dentist | 202 S 4th St W, Baker, MT 59313 | 2007-01-23 |
| 1871613703 | Todd Overton | Pharmacist | 103 South Main, Baker, MT 59313 | 2007-04-02 |
| 1598885410 | Eric S Sonsalla | Pharmacist | 103 South Main, Baker, MT 59313 | 2007-04-02 |
| 1508945502 | Baker Drug Co | Durable Medical Equipment & Medical Supplies | 103 S Main St, Baker, MT 59313 | 2006-11-02 |
| 1548314438 | Baker Drug Company | Pharmacy | 103 South Main, Baker, MT 59313-0459 | 2007-01-22 |
| 1073689915 | County of Fallon | Ambulance | 9 West Fallon Avenue, Baker, MT 59313-0638 | 2006-11-24 |
| 1902089550 | County of Fallon | Public Health or Welfare | 205 S 4th Street W, Baker, MT 59313-0820 | 2007-12-06 |
| 1700987690 | Gerald Elmo Gamrath | Pharmacist | 21 South Main, Baker, MT 59313-1018 | 2006-09-26 |
| 1134290950 | Gerald Gamrath | Durable Medical Equipment & Medical Supplies | 21 South Main Street, Baker, MT 59313-1518 | 2006-11-13 |
| 1134746605 | Baker Drug LLC | Durable Medical Equipment & Medical Supplies | 103 S Main St, Baker, MT 59313-9013 | 2020-07-01 |
| Find all providers in zip 59313 | ||||
| Taxonomy Code | 208D00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | General Practice |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093745572 | Darryl M Espeland | General Practice | 202 South 4th Street West, Baker, MT 59313-1119 | 2006-07-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124687876 | Edward Michael Uriell | General Practice | 1607 Avenue E Apt 2, Billings, MT 59102-3064 | 2019-06-06 |
| 1346654167 | Wally Jean | General Practice | 107 H St W, Poplar, MT 59255 | 2014-06-19 |
| 1396159240 | Pierrette Toussaint | General Practice | 107 H. Street, Verne E. Gibbs Clinic, Poplar, MT 59255 | 2014-06-19 |
| 1225479918 | Thu Tran | General Practice | 126 Indian Health Way, Harlem, MT 59526-9489 | 2013-07-10 |
| 1497012009 | Roland Sweatman | General Practice | 1410 Stanley St, Missoula, MT 59802-3312 | 2012-04-19 |
| 1902079965 | Molly Elizabeth Biehl | General Practice | 210 E Crofoot Ln, Sheridan, MT 59749-7714 | 2008-04-10 |
| 1639399009 | Sage Medical Clinic PC | General Practice | 820 N. Montana Ave, Helena, MT 59601 | 2007-04-26 |
| 1225252935 | Richard J Best | General Practice | 101 Arrow St Dba Garden Wall Clinic, St. Ignatius, MT 59865 | 2007-04-12 |
| 1215005335 | Steven Bradley Sonntag | General Practice | 100 Cheyenne Ave., Lame Deer, MT 59043-0070 | 2006-11-30 |
| 1336221613 | Reed L Yeater | General Practice | 5 4th Ave East, Poison, MT 59860 | 2006-10-19 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on DOMINICK PETER TRIVISONNO.
| 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.