Individual provider Active NPI

Mary Hannon

  • Registered Nurse
  • Bozeman, MT
National Provider Identifier
1043176282
Registry record updated Dec 31, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
NUR-RN-LIC-219475 Issued in MT
Practice address
1288 N 14TH Ave Ste 201
Bozeman, MT 59715-8535
Phone
(406) 587-0681
Fax
(406) 587-9011
NPI assigned
Dec 31, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 31, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X NUR-RN-LIC-219475 MT Primary

Addresses

Primary practice location

1288 N 14TH Ave Ste 201
Bozeman, MT 59715-8535

Mailing address

210 W Arnold St
Bozeman, MT 59715-6131
Phone (208) 201-4933

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
NUR-RN-LIC-219475MTMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Bridgercare CurrentSince Jan 4, 2026 Accepting new patients

Locations

1288 N 14th Ave
Ste 201
Bozeman, MT 59715
Phone (406) 587-0681

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.

NPI Registry JSON

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

{
    "created_epoch": "1767139200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1767139200000",
    "number": "1043176282",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 W ARNOLD ST",
            "city": "BOZEMAN",
            "state": "MT",
            "postal_code": "597156131",
            "telephone_number": "208-201-4933"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1288 N 14TH AVE STE 201",
            "city": "BOZEMAN",
            "state": "MT",
            "postal_code": "597158535",
            "telephone_number": "406-587-0681",
            "fax_number": "406-587-9011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANNON",
        "first_name": "MARY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-12-31",
        "last_updated": "2025-12-31",
        "certification_date": "2025-12-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MT",
            "license": "NUR-RN-LIC-219475",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bozeman, MT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 2025; 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.