MRS. KENDALL PARKS (NPI# 1780781500) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1780781500 |
| Entity Type | Individual |
| Full Name | MRS. KENDALL PARKS |
| Credential | PAC |
| Practice Address |
937 Highland Blvd Ste 5510 Bozeman MT 59715-6916 |
| Mailing Address |
915 Highland Blvd Attn Pfs Credentialing Bozeman MT 59715-6902 |
| Practice Telephone | 4064143959 |
| Mailing Telephone | 4064141826 |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2020-03-12 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
532 | MT | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363AM0700X |
Physician Assistant Specialization: Medical |
PA10004623 | WA | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MT | 1780781500 | 05 |
| Street Address |
937 HIGHLAND BLVD STE 5510 |
| City | BOZEMAN |
| State | MT |
| Zip Code | 59715-6916 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053372821 | Mozelle M Soule | Physician Assistant | 937 Highland Blvd Ste 5510, Bozeman, MT 59715-6916 | 2006-03-31 |
| 1609927607 | Nathaniel John Madsen | Internal Medicine | 937 Highland Blvd Ste 5510, Bozeman, MT 59715-6916 | 2007-01-16 |
| 1154412799 | Andrew K Sullivan | Internal Medicine | 937 Highland Blvd Ste 5510, Bozeman, MT 59715-6916 | 2006-09-27 |
| 1770691842 | Shauna L Bethel | Internal Medicine | 937 Highland Blvd Ste 5510, Bozeman, MT 59715-6916 | 2006-08-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477152288 | Ch Mh Services (il), LLC | Clinic/Center | 233 E Main St Suite 401, Bozeman, MT 59715 | 2020-10-22 |
| 1134735269 | Montana Therapy and Consulting Pllc | Social Worker | 110 S Grand Ave, Floor 2, Bozeman, MT 59715 | 2020-09-23 |
| 1831715994 | Alyson Raph | Student in an Organized Health Care Education/Training Program | 1 Anna Pearl Sherrick Hal, Bozeman, MT 59715 | 2020-06-24 |
| 1639702780 | Miranda Shields | Massage Therapist | 1001 W. Oak St. Bldg C Ste 210, Bozeman, MT 59715 | 2020-02-18 |
| 1154988590 | Christina Yancy | Massage Therapist | Bldg C, Ste 210, 1001 W Oak St, Bozeman, MT 59715 | 2019-05-21 |
| 1962068767 | Julie A Hisey | Physical Therapist | 1700 W. Koch, Suite 12, Bozeman, MT 59715 | 2019-05-16 |
| 1639631633 | Joshua Wallace | Massage Therapist | 1001 W Oak St, Bldg. C Ste. 210, Bozeman, MT 59715 | 2019-04-01 |
| 1528523388 | Judith Margaret Firehammer | Psychologist | 37 East Main St, Suite 7, Bozeman, MT 59715 | 2019-02-06 |
| 1194280875 | Erica Kotick | Counselor | 2246 Boot Hill Court, Suite 4, Bozeman, MT 59715 | 2019-02-06 |
| 1194291609 | Providence Mental Health Pllc | Social Worker | 2246 Boot Hill Ct. Unit #4, Bozeman, MT 59715 | 2018-10-23 |
| Find all providers in zip 59715 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649365271 | Blythe Lindsay | Physician Assistant | 1648 Ellis Street, Suite 301, Bozeman, MT 59715-8811 | 2006-10-03 |
| 1972972180 | Susan J Dolan | Physician Assistant | 300 N Willson Ave, Ste 2001, Bozeman, MT 59715-3572 | 2015-09-17 |
| 1073851812 | Stephanie Kehoe Pitcairn | Physician Assistant | 1006 W Main St, Bozeman, MT 59715-3219 | 2013-01-29 |
| 1215205182 | Jessica Ann Pelton | Physician Assistant | 536 Cottonwood Rd, #100, Bozeman, MT 59718 | 2011-12-07 |
| 1508145582 | Melissa Pew | Physician Assistant | 931 Highland Blvd Ste 3350, Bozeman, MT 59715-6914 | 2011-08-09 |
| 1073823845 | Elizabeth A Ansley | Physician Assistant | 2233 W Kagy Blvd Ste 2, Bozeman, MT 59718-5938 | 2010-10-14 |
| 1205074648 | Cynthia M Carter | Physician Assistant | 905 Highland Blvd, Suite 4100, Bozeman, MT 59715-6901 | 2009-01-22 |
| 1629267521 | Laura Sherer Pace | Physician Assistant | 2233 W Kagy Blvd Ste 2, Bozeman, MT 59718-5938 | 2007-10-17 |
| 1528193265 | Theodore R Preiss | Physician Assistant | 937 Highland Blvd Ste 5410, Bozeman, MT 59715-6916 | 2007-02-22 |
| 1134278716 | Susan G Whittinghill | Physician Assistant | 935 Highland Blvd Ste 2180, Bozeman, MT 59715-6904 | 2007-01-10 |
| Find all providers in BOZEMAN | ||||
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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.