Jennifer Lee Brunsdon, MD
Individual provider Active NPI Family Medicine Physician · White Sulphur Springs, MT
NPI 1003917618 · NPPES record last updated Oct 28, 2019
Key facts
- NPI
- 1003917618
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 10721 (MT)
- Practice address
- 16 W Main St
White Sulphur Springs, MT 59645-9036 - Phone
- (406) 547-3321
- Fax
- (406) 547-3298
- NPI assigned
- Sep 26, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 3
Hospital & facility affiliations 12
Medicare Care Compare profile
- Specialty
- Family Practice
- Education
- University of Washington School of Medicine, 1996
- Medicare assignment
- May accept Medicare assignment
- Group practices
- Helena Indian Alliance Inc
Practice addresses (Care Compare)
501 Euclid Ave
Helena, MT 59601-2865
Phone 4064429244109
Hospital & facility affiliations
- Billings Clinic Hospital
- St Peters Health
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MT
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20050603000856 | MT | Practitioner - Family Practice | 8921041674 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10721 | MT | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Helena Indian Alliance Inc | Current |
Accepting new patients | |
| Elkhorn Mountain Health Services Inc | Family Medicine | Past | Accepting new patients |
| Family Health Centers | Past | Accepting new patients |
Locations
501 Euclid Ave
Helena, MT 59601
Phone (406) 442-9244
Interoperability endpoints
- https://fhir4.healow.com/fhir/r4/FGAGDD/Endpoint/FGAGDD
- https://fhir4.healow.com/fhir/r4/FGAGDD
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 10721 | MT | Yes |
Addresses
Primary practice location
16 W Main St
White Sulphur Springs, MT 59645-9036
Mailing address
906 Dearborn Ave
Helena, MT 59601-2756
Phone (406) 461-5796
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0141908 | Medicaid | MT | |
| 99656 | Other | MT | BCBS OF MT |
Other providers in White Sulphur Springs, MT
All providers in White Sulphur Springs, MT · Family Medicine Physician in Montana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 28, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.