Individual provider Active NPI

Amber Coulter, P.T.

  • Physical Therapist
  • Stevensville, MT
National Provider Identifier
1023194776
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
1678PT Issued in MT
Practice address
3802 Eastside Hwy
Stevensville, MT 59870-2224
Phone
(406) 777-3523
NPI assigned
Oct 27, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 1678PT MT Primary

Addresses

Primary practice location

3802 Eastside Hwy
Stevensville, MT 59870-2224

Mailing address

5578 Bridlepath Lane
Florence, MT 59833
Phone (406) 721-3096

Other identifiers 1

IdentifierTypeStateIssuer
3400663MedicaidMT

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MT

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040611001421 MT Practitioner - Physical Therapist in Private Practice 9436132107 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Valley Physical Therapy PLLCGroup PAC ID 7618959495, 8 clinicians

Practice addresses (Care Compare)

3802 Eastside Hwy
Stevensville, MT 59870-2224
Phone (406) 777-3523

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1678PTMTMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Valley Physical Therapy, PLLC Physical Therapist CurrentSince Apr 26, 2004 Accepting new patients
Peak Performance Physical Therapy PC Physical Therapist PastSince Jul 19, 1996 Accepting new patients
Functional Performance Therapy, Inc. PastSince Apr 26, 2004 Accepting new patients

Locations

2105 Bow St
Missoula, MT 59801
Phone (406) 327-0706

1001 SW Higgins Ave
Ste 205
Missoula, MT 59803
Phone (406) 721-3096

3802 Eastside Hwy
Stevensville, MT 59870
Phone (406) 777-3523

Organizations & group practices 3

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": "1161907200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1023194776",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5578 BRIDLEPATH LANE",
            "city": "FLORENCE",
            "state": "MT",
            "postal_code": "59833",
            "telephone_number": "406-721-3096"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3802 EASTSIDE HWY",
            "city": "STEVENSVILLE",
            "state": "MT",
            "postal_code": "598702224",
            "telephone_number": "406-777-3523"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COULTER",
        "first_name": "AMBER",
        "name_prefix": "Mrs.",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MT",
            "license": "1678PT",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3400663",
            "state": "MT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Stevensville, MT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.