Organization Active NPI

Western Montana Orthotics & Prosthetics, P.C.

  • Prosthetic/Orthotic Supplier
  • Missoula, MT
National Provider Identifier
1194771881
Registry record updated Feb 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Prosthetic/Orthotic SupplierTaxonomy code 335E00000X
Legal business name
WESTERN MONTANA ORTHOTICS & PROSTHETICS, P.C.
Practice address
1300 S Reserve St
Suite G
Missoula, MT 59801-4704
Phone
(406) 549-9667
Fax
(406) 721-9667
NPI assigned
May 25, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 26, 2025

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

Authorized official

Name
Jamie McCorkle
Title
Office Manager
Phone
(406) 549-9667

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Prosthetic/Orthotic Supplier 335E00000X Primary

Addresses

Primary practice location

1300 S Reserve St
Suite G
Missoula, MT 59801-4704

Mailing address

1300 S Reserve St
Suite G
Missoula, MT 59801-4704
Phone (406) 549-9667

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MT

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100930031400 MT DME Supplier - Medical Supply Company With Orthotic PersonnelDME Supplier - Medical Supply Company With Prosthetic PersonnelDME Supplier - Orthotic PersonnelDME Supplier - Prosthetic Personnel 8820290620 Practice locations: Missoula, MT

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Western Montana Orthotics1300 S Reserve St, Missoula, MT 59801-4704(406) 549-9667 Orthoses: Custom Fabricated|Orthoses: Prefabricated (Non-Custom Fabricated)|Orthoses: Off-The-Shelf|Limb Prostheses|Diabetic Shoes and Inserts|Diabetic Shoes/Inserts - Custom|Lymphedema Compression Treatment Items Does not accept assignmentParticipating since Apr 14, 2006

National Provider Directory

National Provider Directory

Locations

1300 S Reserve St
Ste G
Missoula, MT 59801
Phone (406) 549-9667

NPI Registry JSON

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

{
    "created_epoch": "1148515200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1740528000000",
    "number": "1194771881",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1300 S RESERVE ST",
            "address_2": "SUITE G",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598014704",
            "telephone_number": "406-549-9667",
            "fax_number": "406-721-9667"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 S RESERVE ST",
            "address_2": "SUITE G",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598014704",
            "telephone_number": "406-549-9667",
            "fax_number": "406-721-9667"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WESTERN MONTANA ORTHOTICS & PROSTHETICS, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-25",
        "last_updated": "2025-02-26",
        "certification_date": "2025-02-26",
        "status": "A",
        "authorized_official_last_name": "MCCORKLE",
        "authorized_official_first_name": "JAMIE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "406-549-9667"
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": null,
            "license": null,
            "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 Feb 26, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.