Individual provider Active NPI

Karen A. Boone, RN, MS, PMHCNS

  • Psychiatric/Mental Health Clinical Nurse Specialist
  • Havre, MT
National Provider Identifier
1144464082
Registry record updated Nov 6, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Clinical Nurse SpecialistTaxonomy code 364SP0808X
License
99997 Issued in MT
Practice address
521 4TH St
Havre, MT 59501-3649
Phone
(406) 395-4305
Fax
(406) 395-5997
NPI assigned
Apr 22, 2009
Last updated
Nov 6, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 6, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Clinical Nurse Specialist 364SP0808X 99997 MT Primary
Adult Psychiatric/Mental Health Clinical Nurse Specialist 364SP0809X 209.006636 IL

Addresses

Primary practice location

521 4TH St
Havre, MT 59501-3649

Mailing address

521 4TH St
Havre, MT 59501-3649
Phone (406) 395-4305

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MT
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140409001491 MT Practitioner - Certified Clinical Nurse Specialist (CNS) 4385876168 Practice locations: Butte, MT

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Specialist, Master of Science, Registered Nurse

State licenses

LicenseStateTypeSpecialty
99997MTMDPsychiatric/Mental Health Clinical Nurse Specialist
209.006636ILMDAdult Psychiatric/Mental Health Clinical Nurse Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
State of Montana CurrentSince Jan 6, 2014 Accepting new patients
Tommie L Perusich, PC PastSince Apr 1, 2020 Accepting new patients

Locations

400 Veterans Dr
Columbia Fls, MT 59912
Phone (406) 892-3256

111 N Sanders St
#30
Helena, MT 59601

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1240358400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604620800000",
    "number": "1144464082",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "521 4TH ST",
            "city": "HAVRE",
            "state": "MT",
            "postal_code": "595013649",
            "telephone_number": "406-395-4305",
            "fax_number": "406-395-5643"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "521 4TH ST",
            "city": "HAVRE",
            "state": "MT",
            "postal_code": "595013649",
            "telephone_number": "406-395-4305",
            "fax_number": "406-395-5997"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOONE",
        "first_name": "KAREN",
        "middle_name": "A.",
        "name_prefix": "Ms.",
        "credential": "RN, MS, PMHCNS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-04-22",
        "last_updated": "2020-11-06",
        "certification_date": "2020-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364SP0808X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Psychiatric/Mental Health",
            "state": "MT",
            "license": "99997",
            "primary": true
        },
        {
            "code": "364SP0809X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Psychiatric/Mental Health, Adult",
            "state": "IL",
            "license": "209.006636",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Havre, MT

Sources for this page

Verify at the official NPI Registry.