NPIMap

Organization Active NPI

Lewis and Clark Emergency Physicians P C

  • Emergency Medicine Physician
  • Helena, MT
National Provider Identifier
1083668651
Registry record updated May 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
Legal business name
LEWIS AND CLARK EMERGENCY PHYSICIANS P C
Practice address
2475 E Broadway St
Emergency Department
Helena, MT 59601-4928
Phone
(406) 442-2480
NPI assigned
May 19, 2006
Last updated
May 2, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 2, 2024

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

Authorized official

Name
Trent Jensen, MDNPI 1386934271
Title
President
Phone
(781) 280-9381

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
Emergency Medicine Physician 207P00000X Primary

Addresses

Primary practice location

2475 E Broadway St
Emergency Department
Helena, MT 59601-4928

Mailing address

PO Box 947951
Atlanta, GA 30394-7951
Phone (556) 919-8908

Other identifiers 3

IdentifierTypeStateIssuer
1083668651MedicaidMT
187223500OtherMTUS DEPT OF LABOR
CE8304OtherMTRRMCR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MT

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040223001126 MT Part B Supplier - Clinic/Group Practice 0941196497 Receives reassigned benefits from 47 practitioners
Practice locations: Helena, MT

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 65

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.

View all 65

NPI Registry JSON

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

{
    "created_epoch": "1147996800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1714608000000",
    "number": "1083668651",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 947951",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303947951",
            "telephone_number": "556-919-8908"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2475 E BROADWAY ST",
            "address_2": "EMERGENCY DEPARTMENT",
            "city": "HELENA",
            "state": "MT",
            "postal_code": "596014928",
            "telephone_number": "406-442-2480"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEWIS AND CLARK EMERGENCY PHYSICIANS P C",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-19",
        "last_updated": "2024-05-02",
        "certification_date": "2024-05-02",
        "status": "A",
        "authorized_official_last_name": "JENSEN",
        "authorized_official_first_name": "TRENT",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "781-280-9381",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1083668651",
            "state": "MT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "US DEPT OF LABOR",
            "identifier": "187223500",
            "state": "MT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RRMCR",
            "identifier": "CE8304",
            "state": "MT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Helena, MT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.