Active NPI
Robert Owen McGinnis, M.D.
- Family Medicine Physician
- Bozeman, MT
National Provider Identifier
1063621985
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 10123
- Practice address
- 1575 W Kagy Blvd
Bozeman, MT 59715-6509 - Phone
- (406) 522-9355
- NPI assigned
- May 21, 2007
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 10123 | MT | Primary |
Addresses
Primary practice location
1575 W Kagy Blvd
Bozeman, MT 59715-6509
Mailing address
1575 W Kagy Blvd
Bozeman, MT 59715-6509
Phone (406) 522-9355
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 10123 | Other | MT | STATE MEDICAL LICENSE |
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 Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10123 | MT | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179705600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1063621985",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1575 W KAGY BLVD",
"city": "BOZEMAN",
"state": "MT",
"postal_code": "597156509",
"telephone_number": "406-522-9355"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1575 W KAGY BLVD",
"city": "BOZEMAN",
"state": "MT",
"postal_code": "597156509",
"telephone_number": "406-522-9355"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCGINNIS",
"first_name": "ROBERT",
"middle_name": "OWEN",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-05-21",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "MT",
"license": "10123",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE MEDICAL LICENSE",
"identifier": "10123",
"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 Jul 8, 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.