DR. BRENT MUIR ROSTER (NPI# 1720222508) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1720222508 |
| Entity Type | Individual |
| Full Name | DR. BRENT MUIR ROSTER |
| Credential | M.D. |
| Practice Address |
2360 Mullan Rd Ste C Missoula MT 59808-1811 |
| Mailing Address |
2360 Mullan Rd, Ste C Missoula MT 59808-1811 |
| Practice Telephone | (406) 721-4436 |
| Practice Fax Number | 4067216053 |
| Mailing Telephone | (406) 721-4436 |
| Mailing Fax Number | 4067216053 |
| Enumeration Date | 2009-04-24 |
| Last Update Date | 2017-09-06 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207XX0004X |
Orthopaedic Surgery Specialization: Foot and Ankle Surgery |
MED-PHYS-LIC-367 | MT | Allopathic & Osteopathic Physicians |
| N | 207XX0004X |
Orthopaedic Surgery Specialization: Foot and Ankle Surgery |
MD158161 | OR | Allopathic & Osteopathic Physicians |
| N | 207XX0004X |
Orthopaedic Surgery Specialization: Foot and Ankle Surgery |
A130888 | CA | Allopathic & Osteopathic Physicians |
| N | 207XX0004X |
Orthopaedic Surgery Specialization: Foot and Ankle Surgery |
15371 | NV | Allopathic & Osteopathic Physicians |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NV | 1720222508 | 05 |
| Street Address |
2360 MULLAN RD STE C |
| City | MISSOULA |
| State | MT |
| Zip Code | 59808-1811 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548255540 | Jeffrey Mariano Laporte | Orthopaedic Surgery | 2360 Mullan Rd Ste C, Missoula, MT 59808-1811 | 2005-09-15 |
| 1245855030 | Cayden Napierala | Physical Therapist | 2360 Mullan Rd Ste C, Missoula, MT 59808-1811 | 2020-06-08 |
| 1629617956 | Kathryn Diane Fisette | Physical Therapist | 2360 Mullan Rd Ste C, Missoula, MT 59808-1811 | 2020-01-03 |
| 1245889484 | Mitchell Mayfield | Physician Assistant | 2360 Mullan Rd Ste C, Missoula, MT 59808-1811 | 2019-09-10 |
| 1750876041 | Samantha Rose Gunderson Morton | Physical Therapist | 2360 Mullan Rd Ste C, Missoula, MT 59808-1811 | 2018-06-28 |
| 1790207090 | Taylor Danielle Manning | Specialist/Technologist | 2360 Mullan Rd Ste C, Missoula, MT 59808-1811 | 2017-07-09 |
| 1871048801 | Jessica Paske | Specialist/Technologist | 2360 Mullan Rd Ste C, Missoula, MT 59808-1811 | 2016-08-19 |
| 1013365386 | Matthew Schumacher | Physical Therapist | 2360 Mullan Rd Ste C, Missoula, MT 59808-1811 | 2016-05-27 |
| 1710361175 | Lindsey Marie Ross | Specialist/Technologist | 2360 Mullan Rd Ste C, Missoula, MT 59808-1811 | 2015-07-16 |
| 1144669912 | James Joseph Gholson | Orthopaedic Surgery | 2360 Mullan Rd Ste C, Missoula, MT 59808 | 2013-06-14 |
| Find all providers in the same location | ||||
| 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 |
| Find all providers in zip 59808 | ||||
| Taxonomy Code | 207XX0004X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Orthopaedic Surgery |
| Specialization | Foot and Ankle Surgery |
| Recognized by several state medical boards as a fellowship subspecialty program of orthopaedic surgery, foot and ankle surgeons deal with adult reconstructive foot and ankle surgery, adult foot and ankle trauma, sports medicine foot and ankle, and children's foot and ankle reconstructive surgery. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: title modified, definiton added, source added] Additional Resources: American Board of Orthopaedic Surgery, 2007. http://www.abos.org/. Separate board certification is not currently offered. ACGME Accredited Residency Program Requirements: 1 year of training with 5 years Orthopedic Surgery for a total of 6 years. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962402123 | Emily E. Heid | Orthopaedic Surgery | 2831 Fort Missoula Rd, Suite 232, Missoula, MT 59804-7419 | 2005-07-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134345580 | Giselle Joan Tan | Orthopaedic Surgery | 2702 8th Ave N, Billings, MT 59101-1107 | 2007-04-17 |
| 1760418636 | Michael R Yorgason | Orthopaedic Surgery | 2900 12th Ave N, #100e, Billings, MT 59101-7506 | 2006-06-23 |
| 1538103502 | Patrick J Thomas | Orthopaedic Surgery | 1401 25th St S, Great Falls, MT 59405-5183 | 2006-06-16 |
| 1760464275 | Jon F. Robinson | Orthopaedic Surgery | 1450 Ellis St, Suite 201, Bozeman, MT 59715-8812 | 2005-11-18 |
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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.