Pangea Health Services LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

PANGEA HEALTH SERVICES LLC

Practice address

4254 Bordeaux Blvd
Missoula, MT 59808-9686

Phone

(406) 871-5814

Fax

(406) 214-6334

NPI assigned

Mar 4, 2019

Organization subpart

No

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

Authorized official

Name

Ashley Gummer

Title

Owner

Phone

(406) 871-5814

Specialties & licenses 3

Addresses

Other identifiers 1

Other names 1

• Pangea Health Services Doing business as

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

{
    "created_epoch": "1551657600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1551657600000",
    "number": "1124586607",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4254 BORDEAUX BLVD",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598089686",
            "telephone_number": "406-871-5814",
            "fax_number": "406-214-6334"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4254 BORDEAUX BLVD",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598089686",
            "telephone_number": "406-871-5814",
            "fax_number": "406-214-6334"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PANGEA HEALTH SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-03-04",
        "last_updated": "2019-03-04",
        "status": "A",
        "authorized_official_last_name": "GUMMER",
        "authorized_official_first_name": "ASHLEY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "406-871-5814"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "347C00000X",
            "taxonomy_group": "",
            "desc": "Private Vehicle",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0553189",
            "state": "MT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pangea Health Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Matthew Jude Pall, AUD
• Jay Richard Palmatier, PHD
• Meghan Rose Palmer, PA-C
• Marlon Jay Pamiwulf
• Sara Maria Panczyk
• Kimberly Wallis Panko, MA
• Holly Anne Pantaloni, RDH
• Denelle Pappier, R.N., M.S.
• Paradyme Enterprises, LLC
• Paula Parcheta, LMT

• Community/Behavioral Health Agency in Missoula, MT
• Providers in Missoula, MT by specialty
• Community/Behavioral Health Agency in Montana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.