NPIMap

Organization Active NPI

Great Falls Surgical Associates

  • Surgery Physician
  • Great Falls, MT
National Provider Identifier
1073658084
Registry record updated Apr 8, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
Legal business name
GREAT FALLS SURGICAL ASSOCIATES
Practice address
400 13TH Ave S
Ste 102
Great Falls, MT 59405
Phone
(406) 452-0877
Fax
(406) 452-2989
NPI assigned
Feb 20, 2007
Last updated
Apr 8, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2010

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

Authorized official

Name
Dr. Dale R Mortenson, MDNPI 1801949722
Title
Partner
Phone
(406) 452-0877

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208600000X Primary

Addresses

Primary practice location

400 13TH Ave S
Ste 102
Great Falls, MT 59405

Mailing address

400 13TH Ave S
Ste 102
Great Falls, MT 59405
Phone (406) 452-0877

Other identifiers 1

IdentifierTypeStateIssuer
CK4565OtherMTRR MEDICARE GROUP NO.

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 6

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": "1171929600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1270684800000",
    "number": "1073658084",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 13TH AVE S",
            "address_2": "STE 102",
            "city": "GREAT FALLS",
            "state": "MT",
            "postal_code": "59405",
            "telephone_number": "406-452-0877",
            "fax_number": "406-452-2989"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 13TH AVE S",
            "address_2": "STE 102",
            "city": "GREAT FALLS",
            "state": "MT",
            "postal_code": "59405",
            "telephone_number": "406-452-0877",
            "fax_number": "406-452-2989"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREAT FALLS SURGICAL ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-20",
        "last_updated": "2010-04-08",
        "status": "A",
        "authorized_official_last_name": "MORTENSON",
        "authorized_official_first_name": "DALE",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "406-452-0877",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE GROUP NO.",
            "identifier": "CK4565",
            "state": "MT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Great Falls, MT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2010; 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.