Individual provider Active NPI

Kristin Ann Rauch, M.D.

  • Obstetrics & Gynecology Physician
  • Missoula, MT
National Provider Identifier
1104876887
Registry record updated May 25, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
6338 Issued in MT
Practice address
2825 Fort Missoula Rd
#115
Missoula, MT 59804-7420
Phone
(406) 728-4292
Fax
(406) 728-5770
NPI assigned
May 11, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 25, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 6338 MT Primary

Addresses

Primary practice location

2825 Fort Missoula Rd
#115
Missoula, MT 59804-7420

Mailing address

2825 Fort Missoula Rd
#115
Missoula, MT 59804-7420
Phone (406) 728-4292

Other identifiers 2

IdentifierTypeStateIssuer
000096350OtherMTBLUE CROSS BLUE SHIELD
0100711MedicaidMT

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
6338MTMDObstetrics & Gynecology Physician

NPI Registry JSON

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

{
    "created_epoch": "1147305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1337904000000",
    "number": "1104876887",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2825 FORT MISSOULA RD",
            "address_2": "#115",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598047420",
            "telephone_number": "406-728-4292",
            "fax_number": "406-728-5770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2825 FORT MISSOULA RD",
            "address_2": "#115",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598047420",
            "telephone_number": "406-728-4292",
            "fax_number": "406-728-5770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAUCH",
        "first_name": "KRISTIN",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-05-11",
        "last_updated": "2012-05-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "MT",
            "license": "6338",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "000096350",
            "state": "MT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0100711",
            "state": "MT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Missoula, MT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.