Organization Active NPI

Infectious Disease Specialists, PC

  • Infectious Disease Physician
  • Missoula, MT
National Provider Identifier
1144260514
Registry record updated May 27, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infectious Disease PhysicianTaxonomy code 207RI0200X
License
6638 Issued in MT
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

Updated by the provider on May 27, 2008

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)CodeLicenseStatePrimary
Infectious Disease PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 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

IdentifierTypeStateIssuer
0154581MedicaidMT
P00185637OtherRR MEDICARE
1073553491MedicaidMT
92275OtherBCBS

National Provider Directory

National Provider Directory

Locations

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.

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.

Verify at the official NPI Registry.