NPIMap

Organization Active NPI

Livingston Healthcare

Doing business as LHC Shields Valley Therapy

  • Rehabilitation Clinic/Center
  • Wilsall, MT
National Provider Identifier
1124660279
Registry record updated Dec 12, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation Clinic/CenterTaxonomy code 261QR0400X
Legal business name
LIVINGSTON HEALTHCARE
Doing business as
LHC Shields Valley Therapy
Practice address
309 Elliot St N
Wilsall, MT 59086-8501
Phone
(406) 578-2222
NPI assigned
Oct 10, 2019
Last updated
Dec 12, 2019By the provider in NPPES
Organization subpart
Yes
Parent organization
LIVINGSTON HEALTHCAREAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 12, 2019

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

Authorized official

Name
Debra Anczak
Title
Ceo
Phone
(406) 823-6411

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X
Rehabilitation Clinic/Center 261QR0400X Primary

Addresses

Primary practice location

309 Elliot St N
Wilsall, MT 59086-8501

Mailing address

320 Alpenglow LN
Livingston, MT 59047-8506
Phone (406) 823-6419

Other names 1

  • LHC Shields Valley Therapy Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20061104000158 MT Part A Provider - Critical Access Hospital 5991613598 Receives reassigned benefits from 63 practitioners
3 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Livingston, MT; Gardiner, MT; Wilsall, MT

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1124660279. Details of each certification follow.

Hospital certification: CCN 271317

Legal name
LIVINGSTON HEALTHCARE
Certification status
Active
Provider type (POS)
Hospital – Critical access hospital
Participating since
Mar 1, 2001
Last certification
Sep 14, 2023
Beds
25
Ownership / control type
Physician ownership
Organization structure
CorporationNon-profit
Incorporated
Dec 24, 1946 in MT
Enrollment address
320 Alpenglow LN
Livingston, MT 59047-8506

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs on the same Medicare enrollment 3

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Care Compare: Hospital

Medicare Care Compare
Listed as
Livingston HealthcareCCN 271317 · All quality measures
Overall star rating
3 of 5
Type
Critical Access Hospitals
Ownership
Physician
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory
Tax ID family
Livingston Mem Hospital17 organizations share this tax ID, including this one
Part of
Livingston Mem Hospital

Other organizations with this tax ID 16

Organizations that report the same tax identification number in the National Provider Directory.

View all 16

Ownership & related parties

All disclosed owners & managing parties 11

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Bruce E Whitfield Individual Corporate OfficerChief Executive Officer Mar 1, 2023
W-2 Managing Employee Mar 1, 2023
Courtney Konop Individual Corporate Director Nov 12, 2025
Steven W Caldwell Individual Corporate Director Jul 1, 2023
Jennifer Carmody Individual Corporate Director Jul 1, 2023
Matthew Groenig Individual W-2 Managing EmployeeChief Financial Officer Nov 3, 2025
William Lee Kinsey Individual Corporate Director Jul 1, 2021
Michael Atkinson Individual Corporate Director Oct 2, 2024
Elizabeth Lewis Individual Corporate Officer Jul 1, 2021
Henry Pinango Individual Corporate Director Jul 1, 2024
Justin K Roberts Individual Corporate Director Jul 1, 2022
Molly Ballard Individual Corporate Director Nov 12, 2025

Owners & managing parties with NPI records 2

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Practitioners & affiliated clinicians

Affiliated clinicians 260

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 260

NPI Registry JSON

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

{
    "created_epoch": "1570665600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1576108800000",
    "number": "1124660279",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "320 ALPENGLOW LN",
            "city": "LIVINGSTON",
            "state": "MT",
            "postal_code": "590478506",
            "telephone_number": "406-823-6419"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "309 ELLIOT ST N",
            "city": "WILSALL",
            "state": "MT",
            "postal_code": "590868501",
            "telephone_number": "406-578-2222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIVINGSTON HEALTHCARE",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "LIVINGSTON HEALTHCARE",
        "enumeration_date": "2019-10-10",
        "last_updated": "2019-12-12",
        "certification_date": "2019-12-12",
        "status": "A",
        "authorized_official_last_name": "ANCZAK",
        "authorized_official_first_name": "DEBRA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "406-823-6411"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "LHC Shields Valley Therapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Wilsall, MT

Sources for this page

Verify at the official NPI Registry.