NPIMap

Individual provider Active NPI

Mariah Kellam, RN

  • Family Nurse Practitioner
  • Chinook, MT
National Provider Identifier
1083230304
Registry record updated Dec 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
NUR-APRN-LIC-216413 Issued in MT
Practice address
419 Pennsylvania St
Chinook, MT 59523-9726
Phone
(406) 357-2294
NPI assigned
Jun 23, 2020
Reactivated
Jul 26, 2023
Last updated
Dec 8, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X NUR-APRN-LIC-216413 MT Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

419 Pennsylvania St
Chinook, MT 59523-9726

Mailing address

419 Pennsylvania St
Chinook, MT 59523-9726
Phone (406) 357-2294

Other practice location 1

736 Alfalfa Ln
Chinook, MT 59523-9402
Phone (406) 262-3361

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MT
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230908001267 MT Practitioner - Nurse Practitioner 7012371180 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

419 Pennsylvania St
Chinook, MT 59523-9726
Phone (406) 357-2294

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts, Nurse Practitioner, Registered Nurse

State licenses

LicenseStateTypeSpecialty
NUR-APRN-LIC-216413MTMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Bighorn Valley Health Center Incorporated Current Accepting new patients
Bighorn Valley Health Center, Incorporated CurrentSince Sep 5, 2023 Accepting new patients
Bighorn Valley Health Center Incorporated CurrentSince Sep 5, 2023 Accepting new patients
Bighorn Valley Health Center, Incorporated PastSince May 7, 2024 Accepting new patients
Bighorn Valley Health Center Incorporated Past Accepting new patients
Bighorn Valley Health Center, Incorporated Past Accepting new patients
Bighorn Valley Health Center, Incorporated Past Accepting new patients
Bighorn Valley Health Center, Incorporated Past Accepting new patients
Bighorn Valley Health Center, Incorporated Past Accepting new patients
Bighorn Valley Health Center, Incorporated Past Accepting new patients
Bighorn Valley Health Center, Incorporated Past Accepting new patients
Bighorn Valley Health Center, Incorporated Past Accepting new patients
Bighorn Valley Health Center Incorporated Past Accepting new patients
Bighorn Valley Health Center Incorporated Past Accepting new patients
Frances Mahon Deaconess Hospital Past Accepting new patients
Bighorn Valley Health Center, Incorporated Past Accepting new patients
Bighorn Valley Health Center, Incorporated PastSince Oct 24, 2021 Accepting new patients
Bighorn Valley Health Center, Incorporated Past Accepting new patients

Locations

112 St. Labre Campus Dr
Ashland, MT 59003
Phone (406) 784-2346

19 E Main St
Belgrade, MT 59714
Phone (406) 922-0820

410 Triple Crown St
Rm A108
Belgrade, MT 59714
Phone (406) 388-3311

1695 Tschache Ln
Bozeman, MT 59715
Phone (406) 585-1360

1515 W Bell St
Ste 15
Glendive, MT 59330
Phone (406) 815-5831

300 College Dr
Glendive, MT 59330
Phone (406) 377-9410

10 4th St W
Ste B
Hardin, MT 59034
Phone (406) 237-5845

1223 N Center Ave
Hardin, MT 59034
Phone (406) 665-4103

16 N Miles Ave
Ste 101
Hardin, MT 59034
Phone (406) 237-8270

721 N Miles Ave
Hardin, MT 59034
Phone (406) 665-4103

207 W Main St
Ste 5
Lewistown, MT 59457
Phone (406) 968-0172

311 W Main St
Lewistown, MT 59457
Phone (406) 535-6545

112 W Lewis St
Livingston, MT 59047
Phone (406) 222-1111

305 S 4th St
Miles City, MT 59301
Phone (406) 234-4724

601 Main St
Miles City, MT 59301
Phone (406) 874-8700

Interoperability endpoints

  • Direct secure messaging: mariah.kellam.1@16708.direct.athenahealth.com

Organizations & group practices 18

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.

View all 18

Hospital & facility affiliations 14

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1592870400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765152000000",
    "number": "1083230304",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "419 PENNSYLVANIA ST",
            "city": "CHINOOK",
            "state": "MT",
            "postal_code": "595239726",
            "telephone_number": "406-357-2294"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "419 PENNSYLVANIA ST",
            "city": "CHINOOK",
            "state": "MT",
            "postal_code": "595239726",
            "telephone_number": "406-357-2294"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "736 Alfalfa Ln",
            "address_purpose": "LOCATION",
            "city": "Chinook",
            "state": "MT",
            "postal_code": "595239402",
            "country_code": "US",
            "telephone_number": "406-262-3361",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KELLAM",
        "first_name": "MARIAH",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-23",
        "last_updated": "2025-12-08",
        "certification_date": "2025-12-08",
        "deactivation_date": "2023-06-19",
        "reactivation_date": "2023-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MT",
            "license": "NUR-APRN-LIC-216413",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chinook, MT

Sources for this page

Verify at the official NPI Registry.