Active NPI
Infectious Disease Specialists, PC
- Infectious Disease Physician
- Missoula, MT
National Provider Identifier
1144260514
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Infectious Disease Physician
- License
- 6638
- Legal business name
- INFECTIOUS DISEASE SPECIALISTS, PC
- Practice address
- 614 W Spruce St
Missoula, MT 59802-4002 - Phone
- (406) 327-1666
- Fax
- (406) 329-5606
- NPI assigned
- Jun 7, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Ms. Willa Craig, MBA
- Title
- Business Manager
- Phone
- (406) 721-6221
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Infectious Disease Physician | 207RI0200X | 6638 | MT | Primary |
Addresses
Primary practice location
614 W Spruce St
Missoula, MT 59802-4002
Mailing address
PO Box 8897
Missoula, MT 59807-8897
Phone (406) 721-6221
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0154581 | Medicaid | MT | |
| P00185637 | Other | RR MEDICARE | |
| 1073553491 | Medicaid | MT | |
| 92275 | Other | BCBS |
National Provider Directory
National Provider DirectoryLocations
554 W Broadway St
Missoula, MT 59802
Phone (406) 273-4923
500 W Broadway St
Ste 370
Missoula, MT 59802
Phone (406) 327-1666
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Infectious Disease Physician
- Billings, MT
- NPI 1689616914
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149638400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1211846400000",
"number": "1144260514",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 8897",
"city": "MISSOULA",
"state": "MT",
"postal_code": "598078897",
"telephone_number": "406-721-6221",
"fax_number": "406-721-6221"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "614 W SPRUCE ST",
"city": "MISSOULA",
"state": "MT",
"postal_code": "598024002",
"telephone_number": "406-327-1666",
"fax_number": "406-329-5606"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "INFECTIOUS DISEASE SPECIALISTS, PC",
"organizational_subpart": "NO",
"enumeration_date": "2006-06-07",
"last_updated": "2008-05-27",
"status": "A",
"authorized_official_last_name": "CRAIG",
"authorized_official_first_name": "WILLA",
"authorized_official_title_or_position": "BUSINESS MANAGER",
"authorized_official_telephone_number": "406-721-6221",
"authorized_official_name_prefix": "Ms.",
"authorized_official_credential": "MBA"
},
"taxonomies": [
{
"code": "207RI0200X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Internal Medicine, Infectious Disease",
"state": "MT",
"license": "6638",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0154581",
"state": "MT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RR MEDICARE",
"identifier": "P00185637",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1073553491",
"state": "MT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "92275",
"state": null
}
],
"endpoints": [],
"other_names": []
}
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 May 27, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.