Active NPI
Del Bremer Coolidge, M.D.
- Family Medicine Physician
- Cut Bank, MT
National Provider Identifier
1104963610
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 3569MD
- Practice address
- 519 E Main St
Cut Bank, MT 59427-3015 - Phone
- (406) 873-5670
- Fax
- (406) 873-5675
- NPI assigned
- Jan 31, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 3569MD | MT | Primary |
Addresses
Primary practice location
519 E Main St
Cut Bank, MT 59427-3015
Mailing address
1850 Four Wheel Dr
Whitefish, MT 59937-8021
Phone (406) 862-7606
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
| License | State | Type | Specialty |
|---|---|---|---|
| 3569MD | MT | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170201600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1104963610",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1850 FOUR WHEEL DR",
"city": "WHITEFISH",
"state": "MT",
"postal_code": "599378021",
"telephone_number": "406-862-7606",
"fax_number": "406-873-5675"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "519 E MAIN ST",
"city": "CUT BANK",
"state": "MT",
"postal_code": "594273015",
"telephone_number": "406-873-5670",
"fax_number": "406-873-5675"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COOLIDGE",
"first_name": "DEL",
"middle_name": "BREMER",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-01-31",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "MT",
"license": "3569MD",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cut Bank, MT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.