Kathryn Ross Walicki, DO

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

MED-PHYS-LIC-116218 Issued in MT

Practice address

3975 US Hwy 93 N
Stevensville, MT 59870-6474

Phone

(406) 777-6002

Fax

(406) 206-2965

NPI assigned

Apr 9, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Family Practice

Education

Michigan State University College of Osteopathic Medicine, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Marcus Daly Memorial Hospital CorporationGroup PAC ID 5597664474, 97 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Bitterroot Health - Daly Hospital Hospital, Hamilton, MT, CCN 271340
• Community Medical Center Hospital, Missoula, MT, CCN 270023

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

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

• Marcus Daly Memorial Hospital Corporation

  • Critical Access Hospital
  • Hamilton, MT
  • NPI 1659475846
  Medicare reassignment Care Compare group NPD
• Marcus Daly Memorial Hospital Corp

  • Surgery Physician
  • Hamilton, MT
  • NPI 1023576956
  NPD
• Marcus Daly Memorial Hospital Corporation

  • Nephrology Physician
  • Hamilton, MT
  • NPI 1235997958
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Marcus Daly Memorial Hospital Corporation

  • Critical Access Hospital
  • Hamilton, MT
  • NPI 1659475846
  Care Compare affiliation
• RCHP Billings - Missoula LLC

  • General Acute Care Hospital
  • Missoula, MT
  • NPI 1346642899
  Care Compare affiliation

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

{
    "created_epoch": "1554768000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731369600000",
    "number": "1144783929",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 WESTWOOD DR",
            "city": "HAMILTON",
            "state": "MT",
            "postal_code": "598402345"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3975 US HWY 93 N",
            "city": "STEVENSVILLE",
            "state": "MT",
            "postal_code": "598706474",
            "telephone_number": "406-777-6002",
            "fax_number": "406-206-2965"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALICKI",
        "first_name": "KATHRYN",
        "middle_name": "ROSS",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-09",
        "last_updated": "2024-11-12",
        "certification_date": "2024-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MT",
            "license": "MED-PHYS-LIC-116218",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200014749",
            "state": "MT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1144783929",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Arayna Nicole Tucker, DPT
• Valley Drug Inc
• Valor Home Care LLC
• VDV Inc
• VDV, Inc
• Debbie Welch, NP-C
• Well Kneaded Massage, Inc
• Western Health Care Inc.
• Wilson Integrated Psychiatry LLC
• Sarina Sue Wilson, APRN

• Family Medicine Physician in Stevensville, MT
• Providers in Stevensville, MT by specialty
• Family Medicine Physician in Montana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.