MOMENTUM PROSTHETIC CLINIC (NPI# 1952797243) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1952797243 |
| Entity Type | Organization |
| Organization Name | MOMENTUM PROSTHETIC CLINIC |
| Practice Address |
120 South Ave W Missoula MT 59801-8116 |
| Practice Telephone | 4069261321 |
| Practice Fax Number | 4069261327 |
| Mailing Telephone | 4069261321 |
| Mailing Fax Number | 4069261327 |
| Enumeration Date | 2015-04-13 |
| Last Update Date | 2015-11-24 |
| Authorized Official Name | CLIFFORD HENRY CREEKMORE (PRACTITIONER/MANAGING MEMBER) |
| Authorized Official Telephone | 4065290474 |
| Authorized Official Credential | CPO |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 335E00000X | Prosthetic/Orthotic Supplier | 2015-MSS-GEN-000 | MT | Suppliers |
| Street Address |
120 SOUTH AVE W |
| City | MISSOULA |
| State | MT |
| Zip Code | 59801-8116 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346353521 | Missoula Orthotics & Prosthetics Laboratory, Inc | Durable Medical Equipment & Medical Supplies | 120 South Ave W, Missoula, MT 59801-8116 | 2006-08-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629681010 | Time To Thrive Pllc | Social Worker | 1836 South Ave. West, Missoula, MT 59801 | 2020-08-26 |
| 1740815653 | Yuzo Fujiki | Specialist/Technologist | 210 N California St 104, Missoula, MT 59801 | 2020-03-11 |
| 1407346596 | Stepping Stones Counseling, Pllc | Counselor | 202 Brooks St Ste 300, Missoula, MT 59801 | 2018-05-14 |
| 1437668530 | Rejuve Care Clinic, Inc | Plastic Surgery | 715 Kensingten, Ste 1, Missoula, Missoula, MT 59801 | 2017-09-21 |
| 1619499555 | Beatrice Elise Powers | Specialist/Technologist | 410 B Stephens Ave, Missoula, MT 59801 | 2017-07-12 |
| 1770012197 | Hannah Lepiane | Massage Therapist | 1313 S. 4th W., Missoula, MT 59801 | 2017-06-08 |
| 1811420227 | Celeste Willis | Social Worker | 1055 W. Sussex, Missoula, MT 59801 | 2017-04-04 |
| 1073050498 | Rina Kasuga | Specialist/Technologist | 913 Rimini Ct, Missoula, MT 59801 | 2017-01-24 |
| 1043756919 | Heather Bartz | Specialist/Technologist | 831 Hastings Ave, Missoula, MT 59801 | 2017-01-16 |
| 1255874517 | Sarabeth Haddad | Social Worker | 1055 W Sussex Ave, Missoula, MT 59801 | 2016-11-18 |
| Find all providers in zip 59801 | ||||
| Taxonomy Code | 335E00000X |
| Grouping | Suppliers |
| Classification | Prosthetic/Orthotic Supplier |
| An organization that provides prosthetic and orthotic care which may include, but is not limited to, patient evaluation, prosthesis or orthosis design, fabrication, fitting and modification to treat limb loss for purposes of restoring physiological function and/or cosmesis or to treat a neuromusculoskeletal disorder or acquired condition. |
| Notes: Source: American Board for Certification in Orthotics, Prosthetics, and Pedorthics, Inc. [7/1/2010: modified, 7/1/2013: modified] Additional Resources: American Board for Certification in Orthotics, Prosthetics and Pedorthics, Inc., www.abcop.org and Board of Certification/Accreditation, International, www.bocusa.org. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205126794 | Pacific Medical, Inc. | Prosthetic/Orthotic Supplier | 2732 South Ave West, Suite 202, Missoula, MT 59804 | 2011-04-18 |
| 1740438696 | Recreate Mastectomy Products & Boutique | Prosthetic/Orthotic Supplier | 116 South Ave W, Missoula, MT 59801-8116 | 2008-09-04 |
| 1427141324 | Hanger Prosthetics & Orthotics, Inc. | Prosthetic/Orthotic Supplier | 1505 S Russell St, Missoula, MT 59801-3629 | 2006-10-02 |
| 1396739793 | Hands In Motion Ot LLC | Prosthetic/Orthotic Supplier | 2360 Mullan Rd, Ste D, Missoula, MT 59808-1811 | 2005-08-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457860389 | Treasure State Orthotic & Prosthetic Clinic, Inc | Prosthetic/Orthotic Supplier | 436 W Porphyry St, Butte, MT 59701-2312 | 2017-09-22 |
| 1821539909 | Survivors Boutique | Prosthetic/Orthotic Supplier | 1054 Helena Ave, Helena, MT 59601 | 2017-03-09 |
| 1558816272 | Michelle Kunnary | Prosthetic/Orthotic Supplier | 1054 Helena Avenue, Helena, MT 59601 | 2016-08-23 |
| 1578603239 | Timothy Roy Chaffin | Prosthetic/Orthotic Supplier | 3025 10th Ave S, Great Falls, MT 59405-3444 | 2007-02-08 |
| 1811046303 | Glacier Prosthetic Care Inc | Prosthetic/Orthotic Supplier | 985 N Meridian Rd, Kalispell, MT 59901-3539 | 2007-01-10 |
| 1932121829 | Tlc Lingerie Inc | Prosthetic/Orthotic Supplier | 1402 Broadwater Ave, Billings, MT 59102-5324 | 2006-07-23 |
| 1689602716 | Benefis Spectrum Medical, Inc. | Prosthetic/Orthotic Supplier | 1117 29th St S, Great Falls, MT 59405-5306 | 2006-06-29 |
| 1881680577 | Northern Care, Inc. | Prosthetic/Orthotic Supplier | 210 Windward Way, Kalispell, MT 59901-3132 | 2005-09-27 |
| 1548587702 | Treasure State Orthotic and Prosthetic Clinic, Inc. | Prosthetic/Orthotic Supplier | 2110 Euclid Ave, Helena, MT 59601-1506 | 2010-04-28 |
| 1174767024 | Missoula Orthotics & Prosthetics Laboratory Inc | Prosthetic/Orthotic Supplier | 400 W Main St, Suite #203, Hamilton, MT 59840-2439 | 2009-04-22 |
| Find all providers with the same taxonomy | ||||
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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.