NPIMap

Organization Active NPI

Lakeside Clinic P.C.

  • Primary Care Clinic/Center
  • Somers, MT
National Provider Identifier
1053665091
Registry record updated May 9, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
LAKESIDE CLINIC P.C.
Practice address
77 Deer Creek Rd
Somers, MT 59932-8000
Phone
(406) 857-2997
Fax
(406) 857-2044
NPI assigned
Oct 30, 2012
Last updated
May 9, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 9, 2013

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

Authorized official

Name
Ms. Jill B Ripley, FNP
Title
Owner
Phone
(406) 857-2997

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X Primary

Addresses

Primary practice location

77 Deer Creek Rd
Somers, MT 59932-8000

Mailing address

PO Box 649
Lakeside, MT 59922-0649
Phone (406) 857-2997

National Provider Directory

National Provider Directory

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1351555200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1368057600000",
    "number": "1053665091",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 649",
            "city": "LAKESIDE",
            "state": "MT",
            "postal_code": "599220649",
            "telephone_number": "406-857-2997",
            "fax_number": "406-857-2044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "77 DEER CREEK RD",
            "city": "SOMERS",
            "state": "MT",
            "postal_code": "599328000",
            "telephone_number": "406-857-2997",
            "fax_number": "406-857-2044"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKESIDE CLINIC P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-10-30",
        "last_updated": "2013-05-09",
        "status": "A",
        "authorized_official_last_name": "RIPLEY",
        "authorized_official_first_name": "JILL",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "406-857-2997",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "FNP"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Somers, MT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2013; 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.