PROVIDENCE HEALTH & SERVICES MT (NPI# 1336380161) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1336380161 |
| Entity Type | Organization |
| Organization Name | PROVIDENCE HEALTH & SERVICES MT |
| Other Organization Name | PMG MT INFECTION DISEASE |
| Practice Address |
902 N Orange St Missoula MT 59802-2928 |
| Mailing Address |
Po Box 12 Liberty Lake WA 99019-0012 |
| Practice Telephone | 4063211732 |
| Practice Fax Number | 4256873615 |
| Mailing Fax Number | 4256873615 |
| Enumeration Date | 2009-03-06 |
| Last Update Date | 2019-04-01 |
| Authorized Official Name | DONALD WAYNE ANDERSON JR. (ASST SEC OF ENROLLMENT/DIR REIMB) |
| Authorized Official Telephone | 4255255392 |
| Is Organization Subpart | Y |
| Parent Organization Name | PROVIDENCE HEALTH & SERVICES |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RI0200X |
Internal Medicine Specialization: Infectious Disease |
Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| PMG MT Infection Disease | Doing Business As Name - 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 |
902 N ORANGE ST |
| City | MISSOULA |
| State | MT |
| Zip Code | 59802-2928 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003821976 | Brooks William Baer | Counselor | 902 N Orange St, Suite 102, Missoula, MT 59802-2928 | 2006-07-29 |
| 1689804239 | Barbara Ann Jacobson | Nurse Practitioner | 902 N Orange St, Missoula, MT 59802-2928 | 2009-07-16 |
| 1699916429 | Providence Health & Services Mt | Physical Medicine & Rehabilitation | 902 N Orange St, 4th Floor, Missoula, MT 59802-2928 | 2009-03-06 |
| 1093830515 | Robert C. Munjal | Psychiatry & Neurology | 902 N Orange St, Suite 206, Missoula, MT 59802-2928 | 2007-03-21 |
| 1619058302 | Providence Health & Services Mt | Psychiatric Unit | 902 N Orange St, Missoula, MT 59802-2928 | 2006-10-18 |
| 1407860745 | Providence Surgery Center | Clinic/Center | 902 N Orange St, Missoula, MT 59802-2916 | 2006-07-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154945921 | Montana Endoscopy Center, Pllc | Clinic/Center | 1930 W Broadway, Ste B, Missoula, MT 59802 | 2020-06-08 |
| 1194364091 | Tommie Lynn Perusich | Nurse Practitioner | 1120 Cedar St., Missoula, MT 59802 | 2019-12-26 |
| 1386122752 | The Hope Health Alliance, Inc. | Case Management | 314 White House Ln, Missoula, MT 59802 | 2018-07-30 |
| 1881181444 | Carol Anne Lesser | Massage Therapist | 1918 Birch St, Missoula, MT 59802 | 2018-04-19 |
| 1528587581 | Missoula Aids Fund, Inc. | Clinic/Center | 1500 W. Broadway Suite A, Missoula, MT 59802 | 2017-09-11 |
| 1942740667 | Gabrielle Shulman | Counselor | 415 N Higgins Ave Ste 14, Missoula, MT 59802 | 2017-02-28 |
| 1053798736 | Endurance Physio | Clinic/Center | 214 E. Main St, Missoula, MT 59802 | 2015-05-01 |
| 1720481971 | Anna Golding | Counselor | 1325 Wyoming Street, Missoula, MONTANA 59802 | 2014-10-02 |
| 1003255803 | Jennifer Dawn Danielson | Speech-Language Pathologist | 2408 Duncan Drive, Missoula, MT 59802 | 2013-06-14 |
| 1437595725 | Partnership Health Center Inc | Clinic/Center | 1150 Sherwood St, Missoula, MT 59802 | 2013-05-14 |
| Find all providers in zip 59802 | ||||
| Taxonomy Code | 207RI0200X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Infectious Disease |
| An internist who deals with infectious diseases of all types and in all organ systems. Conditions requiring selective use of antibiotics call for this special skill. This physician often diagnoses and treats AIDS patients and patients with fevers which have not been explained. Infectious disease specialists may also have expertise in preventive medicine and travel medicine. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://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 |
|---|---|---|---|---|
| 1073553491 | George Franklin Risi Jr. | Internal Medicine | 614 W Spruce St, Missoula, MT 59802-3652 | 2006-06-07 |
| 1215222617 | Providence Health & Services Mt | Internal Medicine | 500 W Broadway St, Missoula, MT 59802-4008 | 2011-06-14 |
| 1811056336 | David Charles Christiansen | Internal Medicine | 500 W Broadway St, Missoula, MT 59802-4008 | 2006-12-08 |
| 1780758714 | Leslie Field Whitney | Internal Medicine | 2831 Fort Missoula Rd, Suite 301, Missoula, MT 59804 | 2006-11-20 |
| 1144260514 | Infectious Disease Specialists, PC | Internal Medicine | 614 W Spruce St, Missoula, MT 59802-4002 | 2006-06-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518290923 | David Neely Taylor | Internal Medicine | 2155 Analysis Dr, Bozeman, MT 59718-6830 | 2009-09-16 |
| 1376842567 | Anne Michal Stevens | Internal Medicine | 1101 26th St S, Great Falls, MT 59405-5161 | 2011-03-28 |
| 1851624514 | Martin Prager-sanchez | Internal Medicine | 801 N 29th St, Billings, MT 59101-0905 | 2009-09-14 |
| 1427237965 | Ronald H Smith | Internal Medicine | 2825 8th Ave N, Billings, MT 59101-0909 | 2007-11-01 |
| 1164583373 | Jeffrey Allen Tjaden | Internal Medicine | 430 Windward Way Ste 100, Kalispell, MT 59901-2619 | 2006-12-12 |
| 1962425868 | David M. Graham | Internal Medicine | 2900 12th Ave N, 300e, Billings, MT 59101-7506 | 2006-07-25 |
| 1487680534 | Anne Maura Anglim | Internal Medicine | 2475 E Broadway St, Helena, MT 59601-4928 | 2006-06-23 |
| 1689616914 | Camilla M Reese | Internal Medicine | 801 N 29th St, Billings, MT 59101-0905 | 2006-06-12 |
| 1114915360 | Donald Roland Skillman | Internal Medicine | 2475 E Broadway St, Helena, MT 59601-4928 | 2005-10-12 |
| 1851392732 | Raymond A Geyer | Internal Medicine | 1400 29th St S, Great Falls, MT 59405-5353 | 2005-08-02 |
| 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.