NPIMap

Individual provider Active NPI

Kevin Matthew Chin, D.O.

  • Family Medicine Physician
  • Missoula, MT
National Provider Identifier
1003047960
Registry record updated Dec 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MED-PHYS-LIC-12053 Issued in MT
Practice address
601 W Spruce St Ste a
Missoula, MT 59802-4047
Phone
(406) 728-3111
Fax
(406) 728-3116
NPI assigned
Jul 27, 2009
Last updated
Dec 22, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 22, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MED-PHYS-LIC-12053 MT Primary

Addresses

Primary practice location

601 W Spruce St Ste a
Missoula, MT 59802-4047

Mailing address

PO Box 12
Liberty Lake, WA 99019-0012
Phone (406) 728-3111

Other practice location 1

323 W Alder St
Missoula, MT 59802-4123
Phone (406) 258-4195

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MT
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100322000842 MT Practitioner - Family Practice 1052446572 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
At Still University of Health Sciences, College of Osteo Med, Kirksville, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Providence Health and Services MtGroup PAC ID 6608786306, 358 clinicians

Practice addresses (Care Compare)

601 W Spruce St
Suite a
Missoula, MT 59802-4047
Phone (406) 329-2945

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy, Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MED-PHYS-LIC-12053MTMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Health & Services Mt Current Accepting new patients
Providence Health & Services Mt Family Medicine CurrentSince Jan 30, 2023 Accepting new patients
Partnership Health Center Inc Family Medicine Current Accepting new patients
Partnership Health Center Inc CurrentSince Jan 18, 2010 Accepting new patients
Partnership Health Center Inc CurrentSince Jan 18, 2010 Accepting new patients
Providence Health & Services Mt CurrentSince Jan 30, 2023 Accepting new patients
Frances Mahon Deaconess Hospital Past Accepting new patients

Locations

323 W Alder St
Missoula, MT 59802
Phone (406) 258-4195

401 Railroad St W
Missoula, MT 59802
Phone (406) 258-4183

500 W Broadway St
Missoula, MT 59802
Phone (406) 327-1918

500 W Broadway St
Ste 320
Missoula, MT 59802
Phone (406) 329-2945

601 W Spruce St
Ste A
Missoula, MT 59802
Phone (406) 329-2945

405 Brooklyn Ave
Superior, MT 59872
Phone (406) 532-9150

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/57e9b20b-351b-4b85-8ec7-ce273f1da74c/
  • Direct secure messaging: kchin285775@wm.providencedirect.org

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1248652800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671667200000",
    "number": "1003047960",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 12",
            "city": "LIBERTY LAKE",
            "state": "WA",
            "postal_code": "990190012",
            "telephone_number": "406-728-3111",
            "fax_number": "406-728-3116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 W SPRUCE ST STE A",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598024047",
            "telephone_number": "406-728-3111",
            "fax_number": "406-728-3116"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "323 W Alder St",
            "address_purpose": "LOCATION",
            "city": "Missoula",
            "state": "MT",
            "postal_code": "598024123",
            "country_code": "US",
            "telephone_number": "406-258-4195",
            "fax_number": "406-258-4180",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHIN",
        "first_name": "KEVIN",
        "middle_name": "MATTHEW",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-07-27",
        "last_updated": "2022-12-22",
        "certification_date": "2022-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MT",
            "license": "MED-PHYS-LIC-12053",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Missoula, MT

Sources for this page

Verify at the official NPI Registry.