Active NPI
Theodore J Chase, P.A.
- Medical Physician Assistant
- Miles City, MT
National Provider Identifier
1013987312
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Physician Assistant
- License
- 469
- Practice address
- 2600 Wilson Street
Miles City, MT 59301 - Phone
- (406) 233-2600
- Fax
- (406) 233-2611
- NPI assigned
- Jan 26, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | PA-577 | ID | |
| Medical Physician Assistant | 363AM0700X | 469 | MT | Primary |
Addresses
Primary practice location
2600 Wilson Street
Miles City, MT 59301
Mailing address
PO Box 1412
Miles City, MT 59301
Phone (406) 459-6060
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 9970976 | Medicaid | MT |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 469 | MT | MD | Professional Counselor |
| PA-577 | ID | MD | Medical Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Frances Mahon Deaconess Hospital | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Critical Access Hospital
- Glasgow, MT
- NPI 1689685323
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1138233600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1194307200000",
"number": "1013987312",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1412",
"city": "MILES CITY",
"state": "MT",
"postal_code": "59301",
"telephone_number": "406-459-6060"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2600 WILSON STREET",
"city": "MILES CITY",
"state": "MT",
"postal_code": "59301",
"telephone_number": "406-233-2600",
"fax_number": "406-233-2611"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHASE",
"first_name": "THEODORE",
"middle_name": "J",
"credential": "P.A.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-01-26",
"last_updated": "2007-11-06",
"status": "A"
},
"taxonomies": [
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "ID",
"license": "PA-577",
"primary": false
},
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "MT",
"license": "469",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "9970976",
"state": "MT"
}
],
"endpoints": [],
"other_names": []
}Other providers in Miles City, MT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.