NPIMap

Organization Active NPI

Rocky Mountain Vein Clinic Bozeman, Inc

  • Specialist
  • Bozeman, MT
National Provider Identifier
1174962542
Registry record updated Oct 21, 2020
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Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
10772 Issued in MT
Legal business name
ROCKY MOUNTAIN VEIN CLINIC BOZEMAN, INC
Practice address
822 Stoneridge Dr Ste 2
Bozeman, MT 59718-7047
Phone
(406) 252-8346
Fax
(406) 656-8303
NPI assigned
Jun 19, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2020

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

Authorized official

Name
Lacy Bangert
Title
Administrator
Phone
(406) 252-8346

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X 10772 MT Primary

Addresses

Primary practice location

822 Stoneridge Dr Ste 2
Bozeman, MT 59718-7047

Mailing address

2820 Central Ave
Suite a
Billings, MT 59102-8624
Phone (406) 252-8346

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1371600000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1603238400000",
    "number": "1174962542",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2820 CENTRAL AVE",
            "address_2": "SUITE A",
            "city": "BILLINGS",
            "state": "MT",
            "postal_code": "591028624",
            "telephone_number": "406-252-8346",
            "fax_number": "406-656-8303"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "822 STONERIDGE DR STE 2",
            "city": "BOZEMAN",
            "state": "MT",
            "postal_code": "597187047",
            "telephone_number": "406-252-8346",
            "fax_number": "406-656-8303"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROCKY MOUNTAIN VEIN CLINIC BOZEMAN, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-06-19",
        "last_updated": "2020-10-21",
        "certification_date": "2020-10-21",
        "status": "A",
        "authorized_official_last_name": "BANGERT",
        "authorized_official_first_name": "LACY",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "406-252-8346"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "MT",
            "license": "10772",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bozeman, MT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2020; 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.