Organization Active NPI

Intermountain Spine and Wellness LLC

Doing business as Intermountain Spine and Wellness

  • Chiropractor
  • Helena, MT
National Provider Identifier
1104422088
Registry record updated Dec 7, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
INTERMOUNTAIN SPINE AND WELLNESS LLC
Doing business as
Intermountain Spine and Wellness
Practice address
62 S Last Chance Gulch Ste a
Helena, MT 59601-4149
Phone
(406) 449-0814
NPI assigned
Dec 7, 2020
Last updated
Dec 7, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 7, 2020

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

Authorized official

Name
Dr. Nolan Plocek, DCNPI 1326385204
Title
Owner
Phone
(605) 641-1456

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
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X Primary

Addresses

Primary practice location

62 S Last Chance Gulch Ste a
Helena, MT 59601-4149

Mailing address

827 5TH Ave
Helena, MT 59601-4441
Phone (605) 641-1456

Other practice location 1

308 Milwaukee Ave
Deer Lodge, MT 59722-1069
Phone (406) 846-9545

Other names 1

  • Intermountain Spine and Wellness Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220801002805 MT Part B Supplier - Clinic/Group Practice 0345622700 Receives reassigned benefits from 2 practitioners
Practice locations: Helena, MT

National Provider Directory

National Provider Directory

Locations

308 Milwaukee Ave
Deer Lodge, MT 59722
Phone (406) 442-2032

1101 E Lyndale Ave
Helena, MT 59601
Phone (406) 449-0814

Practitioners & affiliated clinicians

Practitioners 3

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": "1607299200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1607299200000",
    "number": "1104422088",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "827 5TH AVE",
            "city": "HELENA",
            "state": "MT",
            "postal_code": "596014441",
            "telephone_number": "605-641-1456"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "62 S LAST CHANCE GULCH STE A",
            "city": "HELENA",
            "state": "MT",
            "postal_code": "596014149",
            "telephone_number": "406-449-0814"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "308 Milwaukee Ave",
            "address_purpose": "LOCATION",
            "city": "Deer Lodge",
            "state": "MT",
            "postal_code": "597221069",
            "country_code": "US",
            "telephone_number": "406-846-9545",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "INTERMOUNTAIN SPINE AND WELLNESS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-12-07",
        "last_updated": "2020-12-07",
        "certification_date": "2020-12-07",
        "status": "A",
        "authorized_official_last_name": "PLOCEK",
        "authorized_official_first_name": "NOLAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "605-641-1456",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Intermountain Spine and Wellness",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Dec 7, 2020; 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.