PROVIDENCE HEALTH & SERVICES MT (NPI# 1669791786) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1669791786 |
| Entity Type | Organization |
| Organization Name | PROVIDENCE HEALTH & SERVICES MT |
| Other Organization Name | PMG WMT FLORENCE FAMILY MED |
| Practice Address |
5549 Old Hwy 93 Florence MT 59833-6545 |
| Mailing Address |
Po Box 12 Liberty Lake WA 99019-0012 |
| Practice Telephone | 4062734923 |
| Mailing Telephone | 4062734923 |
| Enumeration Date | 2010-05-28 |
| Last Update Date | 2019-04-05 |
| Authorized Official Name | DONALD WAYNE ANDERSON (ASST SEC ENROLLMENT/DIR REIMB ADMIN) |
| Authorized Official Telephone | 4255255392 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| PMG WMT Florence Family Med | 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 |
5549 OLD HWY 93 |
| City | FLORENCE |
| State | MT |
| Zip Code | 59833-6545 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679574131 | Laura K Shelton | Family Medicine | 5549 Old Hwy 93, Florence, MT 59833-6545 | 2005-08-09 |
| 1770778144 | Florence Family Practice | Psychologist | 5549 Old Hwy 93, Florence, MT 59833-6545 | 2007-09-10 |
| 1023203650 | Jeffrey L Schroeder | Psychologist | 5549 Old Hwy 93, Florence, MT 59833-6545 | 2007-09-06 |
| 1134155534 | Georgia A Milan | Family Medicine | 5549 Old Hwy 93, Florence, MT 59833-6845 | 2006-06-25 |
| 1326020066 | Paul Edward Brand | Pharmacist | 5549 Old Hwy 93, Florence, MT 59833-6564 | 2005-11-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245604057 | Frederick Carl Guenzler | Massage Therapist | 201 Luby Lane, Florence, MT 59833 | 2015-11-17 |
| 1669894119 | Rachel J Evens | Nurse Practitioner | 1803 Eastside Hwy, Stevensville, MT 59833 | 2014-01-16 |
| 1851739551 | Lee Richard Hayne | Specialist | 660 Sweeney Cr. Lp., Florence, MT 59833 | 2013-06-05 |
| 1811221179 | Simone Alicia Larson | Massage Therapist | 5537 Old Us 93, Suite A, Florence, MT 59833 | 2009-09-18 |
| 1114062809 | Robert S Hart | Family Medicine | 5549 Old Highway 93, Florence, MT 59833 | 2007-02-20 |
| 1639221559 | Edward Andrew Boniecki | Occupational Therapist | 5633 Highway 93, Florence, MT 59833 | 2007-01-18 |
| 1891807046 | Carl Richard Shepp | Dentist | 5460 Hwy 93, Florence, MT 59833 | 2006-08-31 |
| 1265825434 | Terrence Austin | Physician Assistant | 5549 Us Highway 93 N, Florence, MT 59833 | 2015-03-12 |
| 1811141914 | Functional Performance Therapy, Inc. | Home Health | 5563 Old Hiway 93, Florence, MT 59833-0171 | 2008-11-17 |
| 1679087357 | Heather Marie Lodwig | Counselor | 20075 Old Us Highway 93, Florence, MT 59833-6000 | 2017-11-17 |
| Find all providers in zip 59833 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164046991 | Open Hands Nursing Telehealth Care LLC | Family Medicine | 1951 Pisgah Rd Rm 104, Florence, SC 29501-6705 | 2020-06-08 |
| 1326672361 | Mcleod Physician Associates II | Family Medicine | 800 E Cheves St Ste 240, Florence, SC 29506-2652 | 2020-02-28 |
| 1356988984 | Family Medicine and Mohr | Family Medicine | 1505a Heritage Ln, Florence, SC 29505-3141 | 2019-12-02 |
| 1841756731 | Sonya Whatley | Family Medicine | 3091 Highway 49 S Ste F, Florence, MS 39073-9446 | 2019-02-15 |
| 1922589704 | Mekesha Shaw | Family Medicine | 1196 Waxwing Dr Unit A, Florence, SC 29505-3846 | 2018-08-28 |
| 1043797723 | Richard Sloan Moon | Family Medicine | 202 W Caskey, Florence, TX 76527 | 2018-07-25 |
| 1568902864 | Summit Medical Group Inc | Family Medicine | 8200 Dixie Hwy, Florence, KY 41042-3225 | 2017-03-06 |
| 1801292396 | Stacey Spence | Family Medicine | 3327 Stockton Dr, Florence, SC 29501-7361 | 2014-11-10 |
| 1063828135 | Kevon Mccarty | Family Medicine | 3235 N Hunt Hwy Ste 103, Florence, AZ 85132-6898 | 2014-07-09 |
| 1023447943 | Advantage Family Care Inc | Family Medicine | 202 Cox Creek Pkwy, Florence, AL 35630-1536 | 2013-11-02 |
| Find all providers in FLORENCE | ||||
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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.