JACK STADDON (NPI# 1952500415) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1952500415 |
| Entity Type | Individual |
| Full Name | JACK STADDON |
| Credential | M.D., PH.D. |
| Practice Address |
2800 10th Ave N Billings MT 59101 |
| Mailing Address |
Po Box 35100 Billings MT 59107-5100 |
| Practice Telephone | 4062382500 |
| Mailing Telephone | 4062382500 |
| Enumeration Date | 2007-07-15 |
| Last Update Date | 2019-04-22 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2080P0207X |
Pediatrics Specialization: Pediatric Hematology-Oncology |
7766460-8905 | UT | Allopathic & Osteopathic Physicians |
| Y | 2080P0207X |
Pediatrics Specialization: Pediatric Hematology-Oncology |
7766460-1205 | UT | Allopathic & Osteopathic Physicians |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 601 John St, Suite M-005, Kalamazoo, MI 490075341 | 2693416350 | 2693418580 |
| Street Address |
2800 10TH AVE N |
| City | BILLINGS |
| State | MT |
| Zip Code | 59101 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235132978 | Michael Roy Moore | Physical Medicine & Rehabilitation | 2800 10th Ave N, Billings, MT 59101-0703 | 2005-05-25 |
| 1306472253 | Travis Bailey | Student in an Organized Health Care Education/Training Program | 2800 10th Ave N, Billings, MT 59101-0703 | 2020-03-22 |
| 1922648153 | Megan Joy Lehman | Nurse Practitioner | 2800 10th Ave N, Billings, MT 59101-0703 | 2020-01-15 |
| 1598304271 | Jacob Timothy Barnett | Dietitian, Registered | 2800 10th Ave N, Billings, MT 59101-0703 | 2019-12-30 |
| 1669022695 | Anna Katherine Weber | Nurse Practitioner | 2800 10th Ave N, Billings, MT 59101-0703 | 2019-09-11 |
| 1093372963 | Laura Forcella | Nurse Practitioner | 2800 10th Ave N, Billings, MT 59101-0703 | 2019-05-24 |
| 1598322935 | Dale Hansen Moller | Occupational Therapy Assistant | 2800 10th Ave N, Billings, MT 59101-0703 | 2019-05-21 |
| 1922663756 | Jessica Coffman | Occupational Therapist | 2800 10th Ave N, Billings, MT 59101-0703 | 2019-05-07 |
| 1083174601 | Barbara Celeste Mcmullan | Student in an Organized Health Care Education/Training Program | 2800 10th Ave N, Billings, MT 59101-0703 | 2019-03-20 |
| 1770042087 | Seth Heikkila | Student in an Organized Health Care Education/Training Program | 2800 10th Ave N, Billings, MT 59101-0703 | 2019-03-16 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356950927 | Rayola Carol Grant | Student in an Organized Health Care Education/Training Program | Montana State University College of Nursing, Billing Ce, Ap 306 1500 University Drive, Billings, MT 59101 | 2020-07-29 |
| 1225652001 | Johnny L Talawyma Jr. | Peer Specialist | 1230 N. 30th St. Suite 100, Billings, MT 59101 | 2020-06-08 |
| 1306487962 | Jeannine L. Walter | Technician | 26 Peters St, Billings, MT 59101 | 2019-10-04 |
| 1912470089 | Deidre Jenae Johnson | Student in an Organized Health Care Education/Training Program | 1500 University Drive, Rimrock 503, Billings, MT 59101 | 2019-01-10 |
| 1649743964 | Annika Stampfel | Behavior Technician | 780 Broadwater Avenue, Billings, MT 59101 | 2019-01-09 |
| 1215436092 | Yellowstone City-county Health Department | Clinic/Center | 515 N 27th St, Billings, MT 59101 | 2018-02-07 |
| 1902305790 | Yellowstone City-county Health Department | Clinic/Center | 3005 1st Ave S, Billings, MT 59101 | 2018-02-07 |
| 1720587512 | Yellowstone City-county Health Department | Clinic/Center | 120 Jackson Street, Billings, MT 59101 | 2018-02-07 |
| 1508385477 | Jkw & Jira Inc. | Pharmacy | 1245 N 29th St Ste 100, Billings, MT 59101 | 2017-09-12 |
| 1487198610 | Rebecca Webber | Counselor | 251 Rolling Meadow Dr, Billings, MT 59101 | 2016-12-07 |
| Find all providers in zip 59101 | ||||
| Taxonomy Code | 2080P0207X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| Specialization | Pediatric Hematology-Oncology |
| A pediatrician trained in the combination of pediatrics, hematology and oncology to recognize and manage pediatric blood disorders and cancerous diseases. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) was provided by the American Osteopathic Board of Pediatrics. The Certification is no longer offered. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043469513 | Benefis Medical Group | Pediatrics | 1117 29th Street South, Great Falls, MT 59405-5306 | 2008-09-09 |
| 1013164987 | Benefis Healthcare Practitioners, PC | Pediatrics | 40 13th St W, Havre, MT 59501-5215 | 2008-08-22 |
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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.