MAE O BERENTSON (NPI# 1972558120) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1972558120 |
| Entity Type | Individual |
| Full Name | MAE O BERENTSON |
| Credential | NP |
| Practice Address |
160 Heritage Way Ste 202 Kalispell MT 59901-3127 |
| Practice Telephone | (406) 752-8433 |
| Practice Fax Number | 4067566768 |
| Mailing Telephone | 4067528433 |
| Mailing Fax Number | 4067566768 |
| Enumeration Date | 2006-05-24 |
| Last Update Date | 2020-06-26 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363L00000X | Nurse Practitioner | 100419 | MT | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363L00000X | Nurse Practitioner | RN26212 | MT | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MT | BCBS | 1972558120 | 01 |
| MT | 1972558120 | 05 |
| Street Address |
160 HERITAGE WAY STE 202 |
| City | KALISPELL |
| State | MT |
| Zip Code | 59901-3127 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467446773 | John Mark Tollerson | Family Medicine | 160 Heritage Way Ste 202, Kalispell, MT 59901-3127 | 2005-09-01 |
| 1720554488 | Julia Marie Tikka | Nurse Practitioner | 160 Heritage Way Ste 202, Kalispell, MT 59901 | 2018-10-22 |
| 1265916589 | Rachael Marie Alsbury | Nurse Practitioner | 160 Heritage Way Ste 202, Kalispell, MT 59901-3127 | 2018-09-21 |
| 1720490907 | Brendon Patrick Smith | Family Medicine | 160 Heritage Way Ste 202, Kalispell, MT 59901-3127 | 2014-05-22 |
| 1093082638 | Kaycee L Mcintosh | Physician Assistant | 160 Heritage Way Ste 202, Kalispell, MT 59901-3127 | 2011-11-28 |
| 1760787766 | Jesse A Mumm | Physician Assistant | 160 Heritage Way Ste 202, Kalispell, MT 59901-3127 | 2011-01-21 |
| 1275862625 | Jessica Colleen Glover | Nurse Practitioner | 160 Heritage Way Ste 202, Kalispell, MT 59901-3127 | 2009-12-14 |
| 1114252327 | Douglas S Marbarger | Physician Assistant | 160 Heritage Way Ste 202, Kalispell, MT 59901-3127 | 2009-10-05 |
| 1194984039 | Ivory D Drendel | Family Medicine | 160 Heritage Way Ste 202, Kalispell, MT 59901-3127 | 2008-06-05 |
| 1932262052 | Marci Rae Mangold | Physician Assistant | 160 Heritage Way Ste 202, Kalispell, MT 59901-3127 | 2006-12-19 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982226650 | Mountain Physical Therapy and Fitness Center LLC | Physical Medicine & Rehabilitation | 2593 Highway 2 East, Suite 6, Kalispell, MT 59901 | 2020-05-15 |
| 1164058350 | Jessica Leeann Abell | Physical Therapist | 1825 Highway 93 S. Suite C, Kalispell, MT 59901 | 2020-03-19 |
| 1588216535 | Diversified Therapeutic Services, Pllc | Clinic/Center | 30 E Washinton St, Suite A, Kalispell, MT 59901 | 2019-07-10 |
| 1467986216 | Jill Shaver | Counselor | 285 2nd Avenue Wn, Suite #100, Kalispell, MT 59901 | 2017-04-19 |
| 1003270810 | Angela Otto | Counselor | 17 2nd St E Ste 204, Kalispell, MT 59901 | 2016-04-07 |
| 1548626989 | Pamela Greskowiak | Counselor | 2282 Hwy 93 South, Suite #1, Kalispell, MT 59901 | 2016-01-14 |
| 1063894921 | Joel Booth | Dentist | 690 N Meridian Rd Ste 106, Kalispell, MT 59901 | 2015-06-26 |
| 1982085841 | Heather Reddig | Specialist | 751 Snowberry Trail, Kalispell, MT 59901 | 2015-06-16 |
| 1497147193 | Patricia Greene Hall | Psychologist | 1035 1st Ave W Fl 3, Kalispell, MT 59901 | 2015-03-04 |
| 1720478886 | Lori Mariani | Social Worker | 1605 Danielson Road, Kalispell, MT 59901 | 2015-01-28 |
| Find all providers in zip 59901 | ||||
| Taxonomy Code | 363L00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners. |
| Notes: Source: (1) American Nurses’ Association, American Nurses Credentialing Center, 1996 Certification Catalogue. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 549. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285002923 | Rejuvecare Clinic | Nurse Practitioner | 77 3rd Avenue West N, Kalispell, MT 59901-4049 | 2015-09-11 |
| 1144785916 | Kirsten Svennungsen | Nurse Practitioner | 175 Commons Loop, Kalispell, MT 59901-1904 | 2019-02-06 |
| 1699292615 | Kira Kitchens | Nurse Practitioner | 350 Heritage Way Ste 2100, Kalispell, MT 59901-3167 | 2017-08-30 |
| 1861843039 | Janae Harper | Nurse Practitioner | 75 Claremont St Ste H, Kalispell, MT 59901-3500 | 2016-06-28 |
| 1891159109 | Kelly Marie Gregory | Nurse Practitioner | 2316 Us Highway 93 N, Kalispell, MT 59901-2547 | 2016-04-12 |
| 1104295211 | Jaimee Gribben | Nurse Practitioner | 1333 Surgical Services Way, Kalispell, MT 59901-4844 | 2015-09-18 |
| 1225350879 | Christianne D Jaffe | Nurse Practitioner | 320 Sunnyview Ln, Kalispell, MT 59901 | 2010-02-24 |
| 1285889519 | Erica L. Case | Nurse Practitioner | 310 Sunnyview Ln, Kalispell, MT 59901 | 2008-12-01 |
| 1568669877 | John L Willcut | Nurse Practitioner | 350 Heritage Way Ste 1200, Kalispell, MT 59901-3160 | 2007-06-29 |
| 1841493350 | Carrie A Thompson | Nurse Practitioner | 320 Sunnyview Ln, Kalispell, MT 59901-3129 | 2007-06-11 |
| Find all providers in KALISPELL | ||||
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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.