NPIMap

Individual provider Active NPI

Phillip A Gardner, MD

  • Otolaryngology Physician
  • Missoula, MT
National Provider Identifier
1003843897
Registry record updated Aug 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
8225 Issued in MT
Practice address
700 W Kent Ave
Missoula, MT 59801-6772
Phone
(406) 541-3277
Fax
(406) 541-3811
NPI assigned
Jun 27, 2006
Last updated
Aug 28, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X 8225 MT Primary

Addresses

Primary practice location

700 W Kent Ave
Missoula, MT 59801-6772

Mailing address

PO Box 4907
Missoula, MT 59806-4907
Phone (406) 541-3277

Other practice location 1

120 S 5th St Ste 104
Hamilton, MT 59840-2798
Phone (406) 363-3366

Other practice location 2

2760 Elizabeth Warren Ave Ste B
Butte, MT 59701-3979
Phone (406) 792-1250

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
I20041122001102 MT Practitioner - Otolaryngology 1850356569 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
Indiana University School of Medicine, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Rocky Mountain Ear Nose and Throat Center PCGroup PAC ID 3678472099, 20 clinicians

Practice addresses (Care Compare)

700 W Kent Ave
Missoula, MT 59801-6772
Phone (406) 541-3937

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
8225MTMDOtolaryngology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Marcus Daly Memorial Hospital Corp CurrentSince Mar 1, 2022 Accepting new patients
Community Hospital of Anaconda CurrentSince Aug 1, 2019 Accepting new patients
Credena Health LLC CurrentSince Jan 1, 2017 Accepting new patients
Marcus Daly Memorial Hospital Corporation CurrentSince Mar 1, 2022 Accepting new patients
Rocky Mountain Ear Nose & Throat Center PC Otolaryngology CurrentSince Aug 4, 2008 Accepting new patients
Community Hospital of Anaconda Current Accepting new patients
Community Hospital of Anaconda CurrentSince Aug 1, 2019 Accepting new patients
Marcus Daly Memorial Hospital Corporation Current Accepting new patients
Providence St Joseph Medical Center CurrentSince Jan 1, 2017 Accepting new patients
Rocky Mountain Eye Center PC Past Accepting new patients

Locations

305 W Pennsylvania Ave
Anaconda, MT 59711
Phone (406) 563-8571

401 W Pennsylvania Ave
Anaconda, MT 59711
Phone (406) 563-5261

2760 Elizabeth Warren Ave
Ste B
Butte, MT 59701
Phone (406) 792-1250

120 S 5th St
Ste 104
Hamilton, MT 59840
Phone (406) 363-3366

1200 Westwood Dr
Hamilton, MT 59840
Phone (406) 363-2211

1200 Westwood Dr
Ste F
Hamilton, MT 59840
Phone (406) 375-2930

1224 W Main St
Hamilton, MT 59840
Phone (406) 375-4823

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

700 W Kent Ave
Missoula, MT 59801
Phone (406) 541-3277

6 13th Ave E
Polson, MT 59860
Phone (406) 883-5377

Interoperability endpoints

  • Direct secure messaging: pgardner207212@wm.providencedirect.org

Organizations & group practices 10

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 8

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": "1151366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724803200000",
    "number": "1003843897",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4907",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598064907",
            "telephone_number": "406-541-3277",
            "fax_number": "406-541-3950"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 W KENT AVE",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598016772",
            "telephone_number": "406-541-3277",
            "fax_number": "406-541-3811"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "120 S 5th St Ste 104",
            "address_purpose": "LOCATION",
            "city": "Hamilton",
            "state": "MT",
            "postal_code": "598402798",
            "country_code": "US",
            "telephone_number": "406-363-3366",
            "fax_number": "406-541-3811",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2760 Elizabeth Warren Ave Ste B",
            "address_purpose": "LOCATION",
            "city": "Butte",
            "state": "MT",
            "postal_code": "597013979",
            "country_code": "US",
            "telephone_number": "406-792-1250",
            "fax_number": "406-541-3811",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GARDNER",
        "first_name": "PHILLIP",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-27",
        "last_updated": "2024-08-28",
        "certification_date": "2024-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "MT",
            "license": "8225",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Missoula, MT

Sources for this page

Verify at the official NPI Registry.