Active NPI
Douglas R Elson, DO
- Emergency Medicine Physician
- Bozeman, MT
National Provider Identifier
1063422889
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medicine Physician
- License
- 6960
- Practice address
- 915 Highland Blvd
Bozeman, MT 59715-6902 - Phone
- (406) 585-5000
- NPI assigned
- Aug 8, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | 6960 | MT | Primary |
Addresses
Primary practice location
915 Highland Blvd
Bozeman, MT 59715-6902
Mailing address
915 Highland Blvd
Bozeman, MT 59715-6902
Phone (406) 585-5000
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3502642 | Medicaid | MT |
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)
- Enrolled
- Credentials
- Doctor of Osteopathy, Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6960 | MT | MD | Emergency Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Frances Mahon Deaconess Hospital | Past | Accepting new patients |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
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NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154995200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1192060800000",
"number": "1063422889",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "915 HIGHLAND BLVD",
"city": "BOZEMAN",
"state": "MT",
"postal_code": "597156902",
"telephone_number": "406-585-5000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "915 HIGHLAND BLVD",
"city": "BOZEMAN",
"state": "MT",
"postal_code": "597156902",
"telephone_number": "406-585-5000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ELSON",
"first_name": "DOUGLAS",
"middle_name": "R",
"name_prefix": "Dr.",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-08",
"last_updated": "2007-10-11",
"status": "A"
},
"taxonomies": [
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "MT",
"license": "6960",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3502642",
"state": "MT"
}
],
"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 Oct 11, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.