NPIMap

Organization Active NPI

Mountain Mobile Wound Care

  • Family Nurse Practitioner
  • Missoula, MT
National Provider Identifier
1114050481
Registry record updated Sep 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
Legal business name
MOUNTAIN MOBILE WOUND CARE
Practice address
1801 Selway Dr
Missoula, MT 59808-9314
Phone
(406) 240-4593
NPI assigned
Mar 14, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 2, 2025

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

Authorized official

Name
Dr. John Kevin Beighle, FNP, DPMNPI 1386642577
Title
Pres.
Phone
(406) 240-4593

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 4

Specialty (taxonomy)CodeLicenseStatePrimary
PodiatristGroup: 193200000X MULTI-SPECIALTY GROUP 213E00000X
Foot & Ankle Surgery PodiatristGroup: 193200000X MULTI-SPECIALTY GROUP 213ES0103X
Clinic/Center 261Q00000X
Family Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LF0000X Primary

Addresses

Primary practice location

1801 Selway Dr
Missoula, MT 59808-9314

Mailing address

1801 Selway Dr
Missoula, MT 59808-9314
Phone (406) 240-4593

Other identifiers 1

IdentifierTypeStateIssuer
0390422MedicaidMT

Other names 1

  • Beighle and assoc PC Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20241218002708 MT Part B Supplier - Clinic/Group Practice 5597292359 Receives reassigned benefits from 3 practitioners
Practice locations: Missoula, MT

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1173830400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1756771200000",
    "number": "1114050481",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1801 SELWAY DR",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598089314",
            "telephone_number": "406-240-4593"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1801 SELWAY DR",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598089314",
            "telephone_number": "406-240-4593"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOUNTAIN MOBILE WOUND CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-14",
        "last_updated": "2025-09-02",
        "certification_date": "2025-01-06",
        "status": "A",
        "authorized_official_last_name": "BEIGHLE",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "KEVIN",
        "authorized_official_title_or_position": "PRES.",
        "authorized_official_telephone_number": "406-240-4593",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "FNP, DPM"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Podiatrist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0390422",
            "state": "MT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Beighle and assoc PC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Sep 2, 2025; 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.