Andrea M. Vannatta, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

12531 Issued in MT

Practice address

500 W Broadway St
Missoula, MT 59802-4008

Phone

(406) 721-5600

Fax

(406) 721-3907

NPI assigned

Jul 13, 2007

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

Electronic endpoints 1

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: avannatta255722@wm.providencedirect.org

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.

• Partnership Health Center Inc

  • Federally Qualified Health Center (FQHC)
  • Missoula, MT
  • NPI 1437196243
  Medicare reassignment NPD
• Partnership Health Center Inc

  dba PHC-Hellgate Elem 2-3 (BLDG 1)

  • Federally Qualified Health Center (FQHC)
  • Missoula, MT
  • NPI 1477439131
  NPD

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

{
    "created_epoch": "1184284800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636502400000",
    "number": "1164621769",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 W BROADWAY ST",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598024008",
            "telephone_number": "406-721-5600",
            "fax_number": "406-721-3907"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 W BROADWAY ST",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598024008",
            "telephone_number": "406-721-5600",
            "fax_number": "406-721-3907"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "401 Railroad St W",
            "address_purpose": "LOCATION",
            "city": "Missoula",
            "state": "MT",
            "postal_code": "598024178",
            "country_code": "US",
            "telephone_number": "406-258-4789",
            "fax_number": "406-258-4732",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VANNATTA",
        "first_name": "ANDREA",
        "middle_name": "M.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-13",
        "last_updated": "2021-11-10",
        "certification_date": "2021-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MT",
            "license": "12531",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "avannatta255722@wm.providencedirect.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "401 Railroad St W",
            "city": "Missoula",
            "state": "MT",
            "country_code": "US",
            "postal_code": "598024178",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Jennifer L Vanderburg, LMT
• Mike R. Vanderiet, BC-HIS
• Tammy Vanderwoude, APRN
• Jessica L Vanderziel, LMT
• Doua Vang
• Misty Vannice, R.N.
• Hannah Nicole Vasquez, SWLC
• Ned F Vasquez, MD
• Vast Sky Counseling, LLC
• Michael Ann Vaughn, DNP

• Pediatrics Physician in Missoula, MT
• Providers in Missoula, MT by specialty
• Pediatrics Physician in Montana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2021; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.