MISSOULA BONE & JOINT SURGERY CENTER, LLC (NPI# 1639126303) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639126303 |
| Entity Type | Organization |
| Organization Name | MISSOULA BONE & JOINT SURGERY CENTER, LLC |
| Practice Address |
2360 Mullan Rd Suite B Missoula MT 59808-1811 |
| Practice Telephone | 4065429695 |
| Practice Fax Number | 4065429703 |
| Mailing Telephone | 4065429695 |
| Mailing Fax Number | 4065429703 |
| Enumeration Date | 2006-05-28 |
| Last Update Date | 2014-04-23 |
| Authorized Official Name | SAMANTHA SPENCER (CEO) |
| Authorized Official Telephone | 4067214436 |
| Authorized Official Credential | CEO |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QA1903X |
Clinic/Center Specialization: Ambulatory Surgical |
MT | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MT | 0000351084 | 05 |
| Street Address |
2360 MULLAN RD SUITE B |
| City | MISSOULA |
| State | MT |
| Zip Code | 59808-1811 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497747802 | Kay Lynn Kramer | Occupational Therapist | 2360 Mullan Rd, Ste D, Missoula, MT 59808-1811 | 2005-08-22 |
| 1891354684 | Tasha Nichole Kohlwes | Specialist/Technologist | 2360 Mullan Rd, Missoula, MT 59808-1811 | 2019-06-06 |
| 1306327317 | Sydney Williams | Physical Therapist | 2360 Mullan Rd, Missoula, MT 59808-1811 | 2018-08-27 |
| 1144754938 | University of Utah Adult Services | Orthopaedic Surgery | 2360 Mullan Rd, Suite C, Missoula, MT 59808-1811 | 2017-04-18 |
| 1023542388 | University of Utah Pediatric Services | Pediatrics | 2360 Mullan Rd, Sutie C, Missoula, MT 59808-1811 | 2017-04-13 |
| 1689117194 | Matea Michelle Depoe | Specialist/Technologist | 2360 Mullan Rd, Suite D, Missoula, MT 59808-1811 | 2016-12-01 |
| 1972900157 | Vincent Keeney | Physician Assistant | 2360 Mullan Rd, Ste C, Missoula, MT 59808-1811 | 2014-12-03 |
| 1497158208 | Emily Beatrice Smith | Dietitian, Registered | 2360 Mullan Rd, Suite C, Missoula, MT 59808-1811 | 2014-10-07 |
| 1588079016 | Cynthia Deann Cleveland | Physical Therapist | 2360 Mullan Rd, Suite C, Missoula, MT 59808-1811 | 2014-06-23 |
| 1427312438 | Jesse Jeffrey Doll | Physician Assistant | 2360 Mullan Rd, Ste C, Missoula, MT 59808-1811 | 2012-06-25 |
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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 |
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| Taxonomy Code | 261QA1903X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Ambulatory Surgical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154945921 | Montana Endoscopy Center, Pllc | Clinic/Center | 1930 W Broadway, Ste B, Missoula, MT 59802 | 2020-06-08 |
| 1639158645 | Big Sky Surgery Center, LLC | Clinic/Center | 2833 Fort Missoula Rd, Missoula, MT 59804-7408 | 2006-01-10 |
| 1407116338 | Facial Plastic and Reconstructive Surgery Montana PC | Clinic/Center | 805 S Reserve St, Missoula, MT 59801-2104 | 2012-05-25 |
| 1093726796 | Rocky Mountain Eye Surgery Center Inc | Clinic/Center | 700 West Kent, Missoula, MT 59801 | 2006-08-10 |
| 1407860745 | Providence Surgery Center | Clinic/Center | 902 N Orange St, Missoula, MT 59802-2916 | 2006-07-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285251132 | West Bozeman Surgery Center, LLC | Clinic/Center | 5031 S. Cottonwood Road, Suite 100, Bozeman, MT 59718 | 2020-06-26 |
| 1760836167 | Yellowstone Surgery Center LLC | Clinic/Center | 1739 Spring Creek Dr, Billings, MT 59102-6747 | 2016-04-21 |
| 1548626872 | Kalispell Regional Medical Center Inc | Clinic/Center | 106 Ridgewater Dr Ste B, Polson, MT 59860-8977 | 2015-12-31 |
| 1508163700 | Orthopaedic Neuro Institute Surgical Center, LLC | Clinic/Center | 1739 Spring Creek Lane, Suite 100, Billings, MT 59102 | 2011-02-24 |
| 1265645311 | Summit Surgery Center, LLC | Clinic/Center | 434 South Clark Street, Butte, MT 59701 | 2007-05-07 |
| 1770676447 | Summit Surgery Center LLC | Clinic/Center | 434 South Clark St., Butte, MT 59701-2836 | 2006-10-02 |
| 1487684213 | Same Day Surgery Center | Clinic/Center | 300 North Willson, Ste 600f, Bozeman, MT 59715 | 2006-07-04 |
| 1841275211 | Helena Surgicenter, LLC | Clinic/Center | 2440 Winne Ave, Suite 100, Helena, MT 59601-4905 | 2005-12-08 |
| 1447251327 | Great Falls Clinic Surgery Center LLC | Clinic/Center | 1509 29th St S, Great Falls, MT 59405-5363 | 2005-08-02 |
| 1497759955 | Yellowstone Surgery Center, LLC | Clinic/Center | 1144 N 28th St, Billings, MT 59101-0110 | 2005-06-10 |
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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.