NPIMap

Individual provider Active NPI

Heather Kristine Thomasclark

  • Family Nurse Practitioner
  • Kalispell, MT
National Provider Identifier
1083670285
Registry record updated Nov 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
47021 Issued in MT
Practice address
343 Sunnyview LN
Kalispell, MT 59901-3156
Phone
(406) 752-1790
Fax
(406) 756-3529
NPI assigned
Apr 25, 2006
Last updated
Nov 27, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2023

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 732 HI
Family Nurse Practitioner 363LF0000X 47021 MT Primary

Addresses

Primary practice location

343 Sunnyview LN
Kalispell, MT 59901-3156

Mailing address

343 Sunnyview LN
Kalispell, MT 59901-3156
Phone (406) 752-1790

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address krmcmedicalrecords@krhdirect.org Kalispell Regional Medical Center Inc

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
I20130129000643 MT Practitioner - Nurse Practitioner 2860477650 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Glacier Medical AssociatesGroup PAC ID 7911981188, 23 clinicians

Practice addresses (Care Compare)

1111 Baker Ave
Whitefish, MT 59937-2901
Phone (406) 862-2515

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
732HIMDAcupuncturist
47021MTMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Glacier Medical Associates CurrentSince Apr 13, 2022 Accepting new patients
Glacier Medical Associates Past Accepting new patients

Locations

500 12th Ave W
Columbia Falls, MT 59912
Phone (406) 257-2020

500 12th Ave W
Ste 1B
Columbia Fls, MT 59912

2310 US Highway 2 E
Ste 4
Kalispell, MT 59901
Phone (406) 862-2515

Organizations & group practices 2

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.

Hospital & facility affiliations 9

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

NPI Registry JSON

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

{
    "created_epoch": "1145923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701043200000",
    "number": "1083670285",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "343 SUNNYVIEW LN",
            "city": "KALISPELL",
            "state": "MT",
            "postal_code": "599013156",
            "telephone_number": "406-752-1790",
            "fax_number": "406-756-3529"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "343 SUNNYVIEW LN",
            "city": "KALISPELL",
            "state": "MT",
            "postal_code": "599013156",
            "telephone_number": "406-752-1790",
            "fax_number": "406-756-3529"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMASCLARK",
        "first_name": "HEATHER",
        "middle_name": "KRISTINE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-25",
        "last_updated": "2023-11-27",
        "certification_date": "2020-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "HI",
            "license": "732",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MT",
            "license": "47021",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "krmcmedicalrecords@krhdirect.org",
            "affiliation": "Y",
            "affiliationName": "Kalispell Regional Medical Center Inc",
            "address_1": "343 Sunnyview Ln",
            "city": "Kalispell",
            "state": "MT",
            "country_code": "US",
            "postal_code": "599013156",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Kalispell, MT

Sources for this page

Verify at the official NPI Registry.