Individual provider Active NPI

Tommie Lynn Perusich, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Butte, MT
National Provider Identifier
1194364091
Registry record updated Oct 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
155842 Issued in MT
Practice address
2210 Silver Bow Blvd
Butte, MT 59701-4940
Phone
(406) 491-9282
NPI assigned
Dec 26, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 22, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 155842 MT Primary

Addresses

Primary practice location

2210 Silver Bow Blvd
Butte, MT 59701-4940

Mailing address

2210 Silver Bow Blvd
Butte, MT 59701-4940
Phone (406) 491-9282

Other identifiers 1

IdentifierTypeStateIssuer
0290819MedicaidMT

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
I20200123001321 MT Practitioner - Nurse Practitioner 7113352014 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
155842MTMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mercury Street Medical Group PLLC CurrentSince Apr 3, 2020 Accepting new patients
Tommie L Perusich, PC Psychiatric/Mental Health CurrentSince Mar 31, 2020 Accepting new patients
HKJ Inc CurrentSince Dec 30, 2019 Accepting new patients
HKJ Inc CurrentSince Dec 30, 2019 Accepting new patients

Locations

300 W Mercury St
Butte, MT 59701
Phone (406) 723-1300

3000 Palmer St
Missoula, MT 59808
Phone (406) 541-4673

1120 Cedar St
Missoula, MT 59802
Phone (406) 541-4673

Interoperability endpoints

  • Direct secure messaging: mountainwestpsychologicalresources.tommieperusich@139040.advancedmd-direct.com

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1577318400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761091200000",
    "number": "1194364091",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2210 SILVER BOW BLVD",
            "city": "BUTTE",
            "state": "MT",
            "postal_code": "597014940",
            "telephone_number": "406-491-9282"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2210 SILVER BOW BLVD",
            "city": "BUTTE",
            "state": "MT",
            "postal_code": "597014940",
            "telephone_number": "406-491-9282"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERUSICH",
        "first_name": "TOMMIE",
        "middle_name": "LYNN",
        "name_prefix": "Ms.",
        "credential": "PMHNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-12-26",
        "last_updated": "2025-10-22",
        "certification_date": "2025-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MT",
            "license": "155842",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0290819",
            "state": "MT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Butte, MT

Sources for this page

Verify at the official NPI Registry.