NPIMap

Organization Active NPI

Kalispell Regional Medical Center, Inc

Doing business as Logan Health Plastic & Reconstructive Surgery

  • Plastic and Reconstructive Surgery Physician
  • Kalispell, MT
National Provider Identifier
1033709225
Registry record updated Jan 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic and Reconstructive Surgery PhysicianTaxonomy code 2086S0122X
Legal business name
KALISPELL REGIONAL MEDICAL CENTER, INC
Doing business as
Logan Health Plastic & Reconstructive Surgery
Practice address
60 Four Mile Dr Ste 10
Kalispell, MT 59901-2663
Phone
(406) 756-2241
Fax
(406) 758-7062
NPI assigned
Jan 21, 2021
Last updated
Jan 21, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 21, 2021

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

Authorized official

Name
William D Gibson
Title
General Counsel
Phone
(406) 752-1724

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic and Reconstructive Surgery Physician 2086S0122X NU Primary

Addresses

Primary practice location

60 Four Mile Dr Ste 10
Kalispell, MT 59901-2663

Mailing address

60 Four Mile Dr Ste 10
Kalispell, MT 59901-2663
Phone (406) 756-2241

Other practice location 1

40 Four Mile Dr Ste 5
Kalispell, MT 59901-2655
Phone (406) 756-2241

Other names 1

  • Logan Health Plastic & Reconstructive Surgery Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Kalispell Reg Hosp58 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 13

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 13

Locations

40 Four Mile Dr
Ste 5
Kalispell, MT 59901
Phone (406) 756-2241

NPI Registry JSON

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

{
    "created_epoch": "1611187200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1611187200000",
    "number": "1033709225",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "60 FOUR MILE DR STE 10",
            "city": "KALISPELL",
            "state": "MT",
            "postal_code": "599012663",
            "telephone_number": "406-756-2241",
            "fax_number": "406-758-7062"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "60 FOUR MILE DR STE 10",
            "city": "KALISPELL",
            "state": "MT",
            "postal_code": "599012663",
            "telephone_number": "406-756-2241",
            "fax_number": "406-758-7062"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "40 Four Mile Dr Ste 5",
            "address_purpose": "LOCATION",
            "city": "Kalispell",
            "state": "MT",
            "postal_code": "599012655",
            "country_code": "US",
            "telephone_number": "406-756-2241",
            "fax_number": "406-758-7062",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "KALISPELL REGIONAL MEDICAL CENTER, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-01-21",
        "last_updated": "2021-01-21",
        "certification_date": "2021-01-11",
        "status": "A",
        "authorized_official_last_name": "GIBSON",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "GENERAL COUNSEL",
        "authorized_official_telephone_number": "406-752-1724"
    },
    "taxonomies": [
        {
            "code": "2086S0122X",
            "taxonomy_group": "",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Logan Health Plastic & Reconstructive Surgery",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Kalispell, MT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.