Individual provider Active NPI

Mijah McLeod

  • Registered Nurse
  • Missoula, MT
National Provider Identifier
1174325773
Registry record updated Mar 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
NUR-RN-LIC-212367 Issued in MT
Practice address
345 W Sussex Ave
Missoula, MT 59801-6827
Phone
(406) 565-3028
NPI assigned
Mar 25, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X NUR-RN-LIC-212367 MT Primary

Addresses

Primary practice location

345 W Sussex Ave
Missoula, MT 59801-6827

Mailing address

345 W Sussex Ave
Missoula, MT 59801-6827
Phone (406) 565-3028

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
NUR-RN-LIC-212367MTMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1742860800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742860800000",
    "number": "1174325773",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "345 W SUSSEX AVE",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598016827",
            "telephone_number": "406-565-3028"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "345 W SUSSEX AVE",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598016827",
            "telephone_number": "406-565-3028"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCLEOD",
        "first_name": "MIJAH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-03-25",
        "last_updated": "2025-03-25",
        "certification_date": "2025-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MT",
            "license": "NUR-RN-LIC-212367",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Mar 25, 2025; 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.