MIKE MONDLOCH, CRNA, INC (NPI# 1295768448) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1295768448 |
| Entity Type | Organization |
| Organization Name | MIKE MONDLOCH, CRNA, INC |
| Practice Address |
700 W Kent Ave Missoula MT 59801-6772 |
| Mailing Address |
Po Box 24251 Seattle WA 98124-0251 |
| Practice Telephone | 4067283501 |
| Mailing Telephone | 5033722740 |
| Mailing Fax Number | 5033722754 |
| Enumeration Date | 2006-07-09 |
| Last Update Date | 2013-09-19 |
| Authorized Official Name | EDWARD MICHAEL MONDLOCH (PRESIDENT) |
| Authorized Official Telephone | 5033722740 |
| Authorized Official Credential | CRNA |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 367500000X | Nurse Anesthetist, Certified Registered | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| RAILROAD MEDICARE | DD4998 | 01 |
| Street Address |
700 W KENT AVE |
| City | MISSOULA |
| State | MT |
| Zip Code | 59801-6772 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164416038 | Roger Furlong | Ophthalmology | 700 W Kent Ave, Missoula, MT 59801-6772 | 2005-09-07 |
| 1073028213 | Ty William Felton | Optometrist | 700 W Kent Ave, Missoula, MT 59801-6772 | 2017-12-11 |
| 1245756253 | Kevin David Duffy | Audiologist | 700 W Kent Ave, Missoula, MT 59801-6772 | 2017-08-21 |
| 1003292277 | Kasey Brickey | Audiologist | 700 W Kent Ave, Missoula, MT 59801-6772 | 2015-08-10 |
| 1760814404 | Wade A Everett | Technician/Technologist | 700 W Kent Ave, Missoula, MT 59801-6772 | 2013-08-05 |
| 1720346844 | Jonathan William Fowlkes | Otolaryngology | 700 W Kent Ave, Missoula, MT 59801-6772 | 2012-04-26 |
| 1205106234 | Thomas Clark Hoshaw | Otolaryngology | 700 W Kent Ave, Missoula, MT 59801-6772 | 2012-01-06 |
| 1134451487 | Jacek Kotowski | Ophthalmology | 700 W Kent Ave, Missoula, MT 59801-6772 | 2010-02-10 |
| 1023229762 | Chad Michael Nedrud | Ophthalmology | 700 W Kent Ave, Missoula, MT 59801-6772 | 2007-05-24 |
| 1134281876 | Joy Lee Frantz | Audiologist | 700 W Kent Ave, Missoula, MT 59801-6772 | 2006-12-15 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629681010 | Time To Thrive Pllc | Social Worker | 1836 South Ave. West, Missoula, MT 59801 | 2020-08-26 |
| 1740815653 | Yuzo Fujiki | Specialist/Technologist | 210 N California St 104, Missoula, MT 59801 | 2020-03-11 |
| 1407346596 | Stepping Stones Counseling, Pllc | Counselor | 202 Brooks St Ste 300, Missoula, MT 59801 | 2018-05-14 |
| 1437668530 | Rejuve Care Clinic, Inc | Plastic Surgery | 715 Kensingten, Ste 1, Missoula, Missoula, MT 59801 | 2017-09-21 |
| 1619499555 | Beatrice Elise Powers | Specialist/Technologist | 410 B Stephens Ave, Missoula, MT 59801 | 2017-07-12 |
| 1770012197 | Hannah Lepiane | Massage Therapist | 1313 S. 4th W., Missoula, MT 59801 | 2017-06-08 |
| 1811420227 | Celeste Willis | Social Worker | 1055 W. Sussex, Missoula, MT 59801 | 2017-04-04 |
| 1073050498 | Rina Kasuga | Specialist/Technologist | 913 Rimini Ct, Missoula, MT 59801 | 2017-01-24 |
| 1043756919 | Heather Bartz | Specialist/Technologist | 831 Hastings Ave, Missoula, MT 59801 | 2017-01-16 |
| 1255874517 | Sarabeth Haddad | Social Worker | 1055 W Sussex Ave, Missoula, MT 59801 | 2016-11-18 |
| Find all providers in zip 59801 | ||||
| Taxonomy Code | 367500000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Anesthetist, Certified Registered |
| (1) A licensed registered nurse with advanced specialty education in anesthesia who, in collaboration with appropriate health care professionals, provides preoperative, intraoperative, and postoperative care to patients and assists in management and resuscitation of critical patients in intensive care, coronary care, and emergency situations. Nurse anesthetists are certified following successful completion of credentials and state licensure review and a national examination directed by the Council on Certification of Nurse Anesthetists. (2) A registered nurse who is qualified by special training to administer anesthesia in collaboration with a physician or dentist and who can assist in the care of patients who are in critical condition. |
| Notes: Sources: (1) Council on Certification of Nurse Anesthetists, Park Ridge, IL, and Rhea, Ott, and Shafritz, The Facts On File Dictionary of Health Care Management, New York: Facts On File Publications, 1988. (2) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 548. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013940261 | Edward Michael Mondloch | Nurse Anesthetist, Certified Registered | 700 W Kent Ave, Missoula, MT 59801-6772 | 2006-07-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558733709 | M & M Anesthesia Services, LLC | Nurse Anesthetist, Certified Registered | 3207 Augusta Ave, Butte, MT 59701-4405 | 2015-10-28 |
| 1316374820 | Marcus Jay Wilsey | Nurse Anesthetist, Certified Registered | 9589 Highway 2 East, Martin City, MT 59926 | 2013-09-28 |
| 1205103306 | Spectrum Anesthesia & Pain Management Services, S.c. | Nurse Anesthetist, Certified Registered | 1739 Spring Creek Lane Suite 100, Billings, MT 59102 | 2011-11-18 |
| 1750601423 | Tana M Taylor | Nurse Anesthetist, Certified Registered | 2111 Garfield St, Anaconda, MT 59711-1719 | 2010-06-04 |
| 1194907543 | Tara Munroe | Nurse Anesthetist, Certified Registered | 925 Highland Blvd Ste 1180, Bozeman, MT 59715-6905 | 2007-11-28 |
| 1922147693 | William Mark Higgs | Nurse Anesthetist, Certified Registered | 430 Fleshman Creek Rd, Livingston, MT 59047-1536 | 2007-02-06 |
| 1437266632 | Mark Alan Edwards | Nurse Anesthetist, Certified Registered | 350 Louisiana Ave, Libby, MT 59923-2130 | 2006-08-24 |
| 1811918998 | Tobacco Root Anesthesiology, LLC | Nurse Anesthetist, Certified Registered | 7 Vandolah Rd, Three Forks, MT 59752-8673 | 2006-07-22 |
| 1710903554 | Daniel Richard Mattson | Nurse Anesthetist, Certified Registered | 3111 Avenue E, Billings, MT 59102-6548 | 2006-07-14 |
| 1396778569 | Grant Palm | Nurse Anesthetist, Certified Registered | 320 Alpenglow Lane, Livingston, MT 59047 | 2006-07-09 |
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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.