Jordan McLaine Icenoggle, MD

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

MED-PHYS-LIC-148113 Issued in MT

Practice address

1200 Westwood Dr Ste G
Hamilton, MT 59840-2345

Phone

(406) 375-4777

Fax

(406) 375-4778

NPI assigned

Mar 30, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Jordan McLain Albrecht Former name

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

Specialty

Obstetrics/Gynecology

Education

Creighton University School of Medicine, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Marcus Daly Memorial Hospital CorporationGroup PAC ID 5597664474, 97 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Bitterroot Health - Daly Hospital Hospital, Hamilton, MT, CCN 271340
• Community Medical Center Hospital, Missoula, MT, CCN 270023

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jordan.albrecht.1@15558.direct.athenahealth.com

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.

• Marcus Daly Memorial Hospital Corporation

  • Critical Access Hospital
  • Hamilton, MT
  • NPI 1659475846
  Medicare reassignment Care Compare group NPD
• Marcus Daly Memorial Hospital Corporation

  • Nephrology Physician
  • Hamilton, MT
  • NPI 1235997958
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Marcus Daly Memorial Hospital Corporation

  • Critical Access Hospital
  • Hamilton, MT
  • NPI 1659475846
  Care Compare affiliation
• RCHP Billings - Missoula LLC

  • General Acute Care Hospital
  • Missoula, MT
  • NPI 1346642899
  Care Compare affiliation

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

{
    "created_epoch": "1617062400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759449600000",
    "number": "1023696218",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1224 W MAIN ST",
            "city": "HAMILTON",
            "state": "MT",
            "postal_code": "598402338"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 WESTWOOD DR STE G",
            "city": "HAMILTON",
            "state": "MT",
            "postal_code": "598402345",
            "telephone_number": "406-375-4777",
            "fax_number": "406-375-4778"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3975 US Highway 93 N",
            "address_purpose": "LOCATION",
            "city": "Stevensville",
            "state": "MT",
            "postal_code": "598706474",
            "country_code": "US",
            "telephone_number": "406-777-6002",
            "fax_number": "406-206-2965",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ICENOGGLE",
        "first_name": "JORDAN",
        "middle_name": "MCLAINE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-03-30",
        "last_updated": "2025-10-03",
        "certification_date": "2025-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "MT",
            "license": "MED-PHYS-LIC-148113",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200034207",
            "state": "MT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JORDAN",
            "last_name": "ALBRECHT",
            "middle_name": "MCLAIN",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Erin Christine Hurst, FNP-BC
• Fred Michael Huskey, M.DIV., M.S., LCPC
• Rebecca Kanady Huston, LPC, LCPC
• Jennifer Michelle Huttie, ARNP
• Amy Catherin Hutton, PCLC
• Treve Michael Icenoggle, MD
• Frederick M Ilgenfritz, M.D.
• Ilhc of Hamilton, LLC
• Infinity Health Physical Therapy and Wellness
• Lawrence J. Ingvalson, PTA

• Obstetrics & Gynecology Physician in Hamilton, MT
• Providers in Hamilton, MT by specialty
• Obstetrics & Gynecology Physician in Montana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.