Active NPI
Michael H Hamblock, P.T.
- Physical Therapist
- Butte, MT
National Provider Identifier
1114089059
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 374PT
- Practice address
- 3718 E Lake Dr
Suite a
Butte, MT 59701-4314 - Phone
- (406) 494-7050
- Fax
- (406) 494-1424
- NPI assigned
- Dec 15, 2006
- Last updated
- Jul 8, 2007
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 374PT | MT | Primary |
Addresses
Primary practice location
3718 E Lake Dr
Suite a
Butte, MT 59701-4314
Mailing address
2901 Edwards St
Butte, MT 59701-4109
Phone (406) 494-7050
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0346112 | Medicaid | MT | |
| MSF1151174 | Other | MT | STATE FUND |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 374 | MT | MD | Clinical Psychologist |
| 374PT | MT | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Michael Hamblock | Physical Therapist | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1166140800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1114089059",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2901 EDWARDS ST",
"city": "BUTTE",
"state": "MT",
"postal_code": "597014109",
"telephone_number": "406-494-7050",
"fax_number": "406-494-1424"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3718 E LAKE DR",
"address_2": "SUITE A",
"city": "BUTTE",
"state": "MT",
"postal_code": "597014314",
"telephone_number": "406-494-7050",
"fax_number": "406-494-1424"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HAMBLOCK",
"first_name": "MICHAEL",
"middle_name": "H",
"credential": "P.T.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-12-15",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MT",
"license": "374PT",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0346112",
"state": "MT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE FUND",
"identifier": "MSF1151174",
"state": "MT"
}
],
"endpoints": [],
"other_names": []
}Other providers in Butte, 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.