Erica L Kepner, DPT
Individual provider Active NPI Physical Therapist · Eureka, MT
NPI 1104187574 · NPPES record last updated Dec 20, 2024
Key facts
- NPI
- 1104187574
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- 4383 (MT)
- Practice address
- 604 1St Ave. E
Eureka, MT 59917 - Phone
- (406) 855-6439
- NPI assigned
- Jun 1, 2012
- Sex
- Female
- Sole proprietor
- Yes
Medicare Care Compare profile
- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2012
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
604 1St Ave E
Eureka, MT 59917-9998
Phone (406) 855-6439
PO Box
Suite 2396
Eureka, MT 59917-2396
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MT
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20121012000807 | MT | Practitioner - Physical Therapist in Private Practice | 9335398007 | Practice locations: Eureka, MT |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4383 | MT | MD | Physical Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 4383 | MT | Yes |
Addresses
Primary practice location
604 1St Ave. E
Eureka, MT 59917
Mailing address
PO Box 2396
Eureka, MT 59917-2396
Phone (406) 855-6439
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104187574 | Medicaid | MT |
Other providers in Eureka, MT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 20, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.