NPIMap

406 Recovery Inc

Organization Active NPI Addiction Medicine (Psychiatry & Neurology) Physician · Bozeman, MT

NPI 1023745247 · NPPES record last updated May 16, 2023

Key facts

NPI
1023745247
Entity type
Organization (NPI type 2)
Primary specialty
Addiction Medicine (Psychiatry & Neurology) Physician 2084A0401X
Legal business name
406 RECOVERY INC
Practice address
5 W Mendenhall St Ste 202
Bozeman, MT 59715-3566
Phone
(406) 219-7233
NPI assigned
Aug 7, 2022
Organization subpart
No

Authorized official

Name
Robert Sise, MD NPI 1053725937
Title
Ceo
Phone
(208) 810-2319

Authorized official NPPES reports the authorized official by name only; the link goes to the one practitioner connected to this organization with that name.

Practitioners 14

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in MT

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20221109002096 MT Part B Supplier - Clinic/Group Practice 0042687717 Receives reassigned benefits from 13 practitioners
Practice locations: Billings, MT; Bozeman, MT; Missoula, MT

National Provider Directory

Locations

96 N Weaver St
Unit 440
Belgrade, MT 59714
Phone (406) 219-7233

100 N 27th St
Ste 200
Billings, MT 59101
Phone (406) 219-7233

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction Medicine (Psychiatry & Neurology) Physician
Group: 193200000X MULTI-SPECIALTY GROUP		 2084A0401X Yes
Addiction Psychiatry Physician
Group: 193200000X MULTI-SPECIALTY GROUP		 2084P0802X

Addresses

Primary practice location

5 W Mendenhall St Ste 202
Bozeman, MT 59715-3566

Mailing address

96 N Weaver St Unit 440
Belgrade, MT 59714-7018
Phone (406) 219-7233

Other names

  • 406 RECOVERY Doing business as

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on May 16, 2023.

{
    "created_epoch": "1659830400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1684195200000",
    "number": "1023745247",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "96 N WEAVER ST UNIT 440",
            "city": "BELGRADE",
            "state": "MT",
            "postal_code": "597147018",
            "telephone_number": "406-219-7233",
            "fax_number": "888-798-0145"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 W MENDENHALL ST STE 202",
            "city": "BOZEMAN",
            "state": "MT",
            "postal_code": "597153566",
            "telephone_number": "406-219-7233"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "406 RECOVERY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-08-07",
        "last_updated": "2023-05-16",
        "certification_date": "2023-05-16",
        "status": "A",
        "authorized_official_last_name": "SISE",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "208-810-2319",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084A0401X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Addiction Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2084P0802X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Addiction Psychiatry",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "406 RECOVERY",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "406 RECOVERY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bozeman, MT

All providers in Bozeman, MT · Addiction Medicine (Psychiatry & Neurology) Physician in Montana

Sources for this page

Verify at the official NPI Registry.