Individual provider Active NPI

Rolf H O Holle, M.D.

  • Sleep Medicine (Internal Medicine) Physician
  • Missoula, MT
National Provider Identifier
1013963958
Registry record updated Mar 2, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sleep Medicine (Internal Medicine) PhysicianTaxonomy code 207RS0012X
License
10654 Issued in MT
Practice address
1782 Elison LN Unit 3
Missoula, MT 59802-3684
Phone
(406) 544-1871
NPI assigned
May 25, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 2, 2018

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Medicine (Internal Medicine) Physician 207RC0200X 10654 MT
Pulmonary Disease Physician 207RP1001X 10654 MT
Sleep Medicine (Internal Medicine) Physician 207RS0012X 10654 MT Primary

Addresses

Primary practice location

1782 Elison LN Unit 3
Missoula, MT 59802-3684

Mailing address

1782 Elison LN Unit 3
Missoula, MT 59802-3684
Phone (406) 544-1871

Other practice location 1

500 West Broadway
Missoula, MT 59802-4008
Phone (406) 721-5600

Other identifiers 1

IdentifierTypeStateIssuer
0082280MedicaidMT

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041007000332 MT Practitioner - Pulmonary DiseasePractitioner - Critical Care (Intensivists) 2961461744 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
10654MTMDPulmonary Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Marcus Daly Memorial Hospital Corporation CurrentSince Apr 10, 2011 Accepting new patients
Marcus Daly Memorial Hospital Corporation CurrentSince Apr 10, 2011 Accepting new patients

Locations

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

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

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

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

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1148515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1519948800000",
    "number": "1013963958",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1782 ELISON LN UNIT 3",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598023684",
            "telephone_number": "406-544-1871"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1782 ELISON LN UNIT 3",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598023684",
            "telephone_number": "406-544-1871"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "500 West Broadway",
            "address_purpose": "LOCATION",
            "city": "Missoula",
            "state": "MT",
            "postal_code": "598024008",
            "country_code": "US",
            "telephone_number": "406-721-5600",
            "fax_number": "406-721-3907",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HOLLE",
        "first_name": "ROLF",
        "middle_name": "H O",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-25",
        "last_updated": "2018-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "MT",
            "license": "10654",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "MT",
            "license": "10654",
            "primary": false
        },
        {
            "code": "207RS0012X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Sleep Medicine",
            "state": "MT",
            "license": "10654",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0082280",
            "state": "MT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Missoula, MT

Sources for this page

Verify at the official NPI Registry.