NPIMap

Organization Active NPI

Frances Mahon Deaconess Hospital

Doing business as Glasgow Clinic Inc

  • Rural Health Clinic/Center
  • Glasgow, MT
National Provider Identifier
1043266356
Registry record updated Feb 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
FRANCES MAHON DEACONESS HOSPITAL
Doing business as
Glasgow Clinic Inc
Practice address
221 5TH Ave S
Glasgow, MT 59230-2600
Phone
(406) 228-3400
NPI assigned
May 26, 2006
Last updated
Feb 6, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
FRANCES MAHON DEACONESS HOSPITALAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 6, 2024

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

Authorized official

Name
Connie Brunelle
Title
Director of Physician Recruitment
Phone
(406) 228-3609

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X 10542 MT
Rural Health Clinic/Center 261QR1300X NU Primary

Addresses

Primary practice location

221 5TH Ave S
Glasgow, MT 59230-2600

Mailing address

221 5TH Ave S
Glasgow, MT 59230-2600
Phone (406) 228-3400

Other identifiers 2

IdentifierTypeStateIssuer
DC8692OtherMTMEDICARE RAILROAD
0720486MedicaidMT

Other names 1

  • Glasgow Clinic Inc Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address glasgowclinicpc@direct-address.net Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MT2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20020918000025 MT Part A Provider - Rural Health Clinic 3173430949 Practice locations: Glasgow, MT
O20031111000918 MT Part B Supplier - Clinic/Group Practice 3173430949 Receives reassigned benefits from 42 practitioners
2 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Glasgow, MT

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1043266356. Details of each certification follow.

Rural health clinic certification: CCN 273406

Legal name
FRANCES MAHON DEACONESS HOSPITAL
Doing business as
GLASGOW CLINIC INC.
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Jul 1, 2003
Last certification
Mar 13, 2024
Ownership / control type
2B
Organization structure
CorporationNon-profit
Incorporated
Apr 20, 1914 in MT
Enrollment address
221 5TH S Ave
Glasgow, MT 59230-2600
Related CCNs
271316

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs with the same Medicare PAC ID 4

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
27D0409795FMDH Dba Glasgow Clinic Inc221 5TH Avenue South, Glasgow, MT 59230Certificate of waiverAug 31, 2026

National Provider Directory

National Provider Directory
Part of
Lawrence D Bockar MD

Interoperability endpoints

  • Direct secure messaging: glasgowclinicpc@direct-address.net

Ownership & related parties

All disclosed owners & managing parties 13

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Angela Page Individual Corporate Director Jul 1, 2025
Nichole Bergtoll Individual Corporate Director Jul 1, 2025
Camilia Kalinski Individual W-2 Managing EmployeeCfo Oct 28, 2002
Brianne Capdeville Individual Corporate Director Jul 1, 2020
Dirk Markle Individual Corporate Director Jul 1, 2024
Connie Brunelle Individual W-2 Managing Employee Feb 1, 2015
Susan Johnson Individual W-2 Managing Employee Nov 1, 2019
Gordon L Bell Individual Corporate Director Jul 1, 2023
Nickolas Dirkes Individual Corporate Officer Oct 1, 2022
W-2 Managing EmployeeCeo Oct 1, 2022
Cami Graham Individual Corporate Director Jul 1, 2021
Marisa Sather Individual Corporate Director Jan 29, 2020
Stanley Ozark Individual Corporate Director Nov 29, 2017
Patrick Menge Individual Corporate Director Nov 29, 2017

Practitioners & affiliated clinicians

Practitioners 30

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 30

NPI Registry JSON

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

{
    "created_epoch": "1148601600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1707177600000",
    "number": "1043266356",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "221 5TH AVE S",
            "city": "GLASGOW",
            "state": "MT",
            "postal_code": "592302600",
            "telephone_number": "406-228-3400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "221 5TH AVE S",
            "city": "GLASGOW",
            "state": "MT",
            "postal_code": "592302600",
            "telephone_number": "406-228-3400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FRANCES MAHON DEACONESS HOSPITAL",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "FRANCES MAHON DEACONESS HOSPITAL",
        "enumeration_date": "2006-05-26",
        "last_updated": "2024-02-06",
        "certification_date": "2024-02-06",
        "status": "A",
        "authorized_official_last_name": "BRUNELLE",
        "authorized_official_first_name": "CONNIE",
        "authorized_official_title_or_position": "DIRECTOR OF PHYSICIAN RECRUITMENT",
        "authorized_official_telephone_number": "406-228-3609"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "MT",
            "license": "10542",
            "primary": false
        },
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "DC8692",
            "state": "MT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0720486",
            "state": "MT"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "glasgowclinicpc@direct-address.net",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "221 5th Ave S",
            "city": "Glasgow",
            "state": "MT",
            "country_code": "US",
            "postal_code": "592302600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Glasgow Clinic Inc",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Glasgow Clinic Inc",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Glasgow, MT

Sources for this page

Verify at the official NPI Registry.