NPIMap

Organization Active NPI

Glacier Medical Associates

  • Family Medicine Physician
  • Whitefish, MT
National Provider Identifier
1104882232
Registry record updated Mar 25, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
GLACIER MEDICAL ASSOCIATES
Practice address
1111 Baker Ave
Whitefish, MT 59937-2901
Phone
(406) 862-2515
Fax
(406) 862-4229
NPI assigned
Apr 26, 2006
Last updated
Mar 25, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2014

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

Authorized official

Name
Ms. Kelli D Meuchel
Title
Practice Administrator
Phone
(406) 862-2515

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X
Pediatrics PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208000000X

Addresses

Primary practice location

1111 Baker Ave
Whitefish, MT 59937-2901

Mailing address

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

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040615001387 MT Part B Supplier - Clinic/Group Practice 7911981188 Receives reassigned benefits from 28 practitioners
Practice locations: Whitefish, MT

National Provider Directory

National Provider Directory

Locations

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

2310 US Highway 2 E
Kalispell, MT 59901

Practitioners & affiliated clinicians

Practitioners 31

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 31

NPI Registry JSON

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

{
    "created_epoch": "1146009600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1395705600000",
    "number": "1104882232",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1111 BAKER AVE",
            "city": "WHITEFISH",
            "state": "MT",
            "postal_code": "599372901",
            "telephone_number": "406-862-2515",
            "fax_number": "406-862-4229"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 BAKER AVE",
            "city": "WHITEFISH",
            "state": "MT",
            "postal_code": "599372901",
            "telephone_number": "406-862-2515",
            "fax_number": "406-862-4229"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GLACIER MEDICAL ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-26",
        "last_updated": "2014-03-25",
        "status": "A",
        "authorized_official_last_name": "MEUCHEL",
        "authorized_official_first_name": "KELLI",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "PRACTICE ADMINISTRATOR",
        "authorized_official_telephone_number": "406-862-2515",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Whitefish, MT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2014; 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.