Glendive Medical Center, Inc
Organization Active NPI Emergency Care Clinic/Center · Glendive, MT
NPI 1124038716 · NPPES record last updated Mar 4, 2021
Key facts
- NPI
- 1124038716
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Emergency Care Clinic/Center 261QE0002X
- Legal business name
- GLENDIVE MEDICAL CENTER, INC
- Practice address
- 202 Prospect Dr
Glendive, MT 59330-1943 - Phone
- (406) 345-3306
- Fax
- (406) 345-3358
- NPI assigned
- Aug 8, 2006
- Organization subpart
- No
Authorized official
- Name
- William Robinson
- Title
- VP of Financial Services
- Phone
- (406) 345-8924
Other NPIs on the same Medicare enrollment 3
Practitioners 30
-
Travis C Blackhurst, CRNA
-
Christina Culver, FNP-BC
-
Laura Fuhrman, FNP-C
-
Emma Anne Jackson, PA-C
-
Audrey J. Kerr, PA-C
-
Thomas Eugene Schultz, CRNA
-
John C Sillery, M.D.
-
Edna M Streit, PA-C
-
Amanda Torgerson, FNP
-
Erin P Butler, PA C
-
Janet Lee Gorham, APRN-CNP
-
Troy B Graybeal, MD
-
Michael Ryan Johnson, C.R.N.A.
-
Eric A Sadler, PA
-
Adam W Smith, PA
-
Dale Darwin Diede, PAC
-
Sherry Sue Gairrett, FNP-BC
-
Michael T Kidd, M.D.
-
Joe Leal, M.D.
-
Jessica Miller, MD
-
Teresea Olson, PA-C
-
Chrystal Lynn Potter, M.D.
-
April Dawn Price, NURSE PRACTITIONER
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MT
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20031103000338 | MT | Part B Supplier - Clinic/Group Practice | 7214846823 |
Receives reassigned benefits from 55 practitioners 3 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Glendive, MT |
National Provider Directory
Locations
202 Prospect Dr
Glendive, MT 59330
Phone (406) 345-3306
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician |
207P00000X | |||
| Emergency Care Clinic/Center | 261QE0002X | Yes |
Addresses
Primary practice location
202 Prospect Dr
Glendive, MT 59330-1943
Mailing address
202 Prospect Dr
Glendive, MT 59330-1943
Phone (406) 345-3306
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 9903 | Other | MT | BLUE CROSS HBP |
| 359476 | Medicaid | MT |
Other providers in Glendive, MT
- George R. Carson D.D.S. P.C.
- Glendive Counseling Center
- Glendive Eyecare
- Glendive Medical Center, Inc
- Glendive Medical Center, Inc
- Glendive Medical Center, Inc
- Glendive Medical Center, Inc
- Glendive Medical Center, Inc
- Glendive Medical Center, Inc
- Glendive Medical Center, Inc
All providers in Glendive, MT · Emergency Care Clinic/Center in Montana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 4, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.