NPIMap

Individual provider Active NPI

Michelle Lynn Boltz, FNP

  • Family Nurse Practitioner
  • Libby, MT
National Provider Identifier
1194843870
Registry record updated Aug 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
40325 Issued in MT
Practice address
214 E 3Rd St
Libby, MT 59923-2056
Phone
(406) 293-9274
Fax
(406) 293-9280
NPI assigned
Mar 27, 2007
Last updated
Aug 21, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 21, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 957 AK
Family Nurse Practitioner 363LF0000X 40325 MT Primary

Addresses

Primary practice location

214 E 3Rd St
Libby, MT 59923-2056

Mailing address

214 E 3Rd St
Libby, MT 59923-2056
Phone (406) 293-9274

Other practice location 1

310 Sunnyview Ln
Kalispell, MT 59901-3129
Phone (406) 751-5310

Other practice location 2

600 Mt Highway 91 S
Dillon, MT 59725-7379
Phone (406) 683-3000

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address krmcmedicalrecords@krhdirect.org Kalispell Regional Medical Center Inc
Direct Messaging Address mboltz236485@wm.providencedirect.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, MT2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20090629000389 TX Practitioner - Nurse Practitioner 3274684451 Reassigns benefits to 1 organization
I20120803000715 MT Practitioner - Nurse Practitioner 3274684451 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Maniilaq AssociationGroup PAC ID 6103881792, 32 clinicians

Practice addresses (Care Compare)

436 5TH and Ted Stevens Way
Maniilaq Health Center
Kotzebue, AK 99752-0043
Phone (907) 442-3321

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
40325MTMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Liberty County Hospital and Nursing Home, Inc CurrentSince Apr 1, 2023 Accepting new patients
Kalispell Regional Medical Center Inc Current Accepting new patients
Marcus Daly Memorial Hospital Corporation CurrentSince Feb 26, 2020 Accepting new patients
Maniilaq Association CurrentSince Jul 6, 2023 Accepting new patients
Marcus Daly Memorial Hospital Corp CurrentSince Feb 26, 2020 Accepting new patients
Logan Health - Conrad Current Accepting new patients
Liberty County Hospital and Nursing Home, Inc CurrentSince Apr 1, 2023 Accepting new patients
Northern Rockies Medical Center, Inc. CurrentSince Apr 1, 2023 Accepting new patients
Marcus Daly Memorial Hospital Corporation Current Accepting new patients
Logan Health - Conrad CurrentSince Jun 17, 2023 Accepting new patients
Maniilaq Association CurrentSince Jul 6, 2023 Accepting new patients
Logan Health - Conrad CurrentSince Jun 17, 2023 Accepting new patients
Northern Rockies Medical Center, Inc. CurrentSince Apr 1, 2023 Accepting new patients
Maniilaq Association Current Accepting new patients
Maniilaq Association Past Accepting new patients
St. John's Lutheran Hospital, Inc. Past Accepting new patients

Locations

805 Sunset Blvd
Conrad, MT 59425
Phone (406) 271-3211

809 Sunset Blvd
Conrad, MT 59425
Phone (406) 271-3211

802 2nd St SE
Cut Bank, MT 59427
Phone (406) 873-2251

1200 Westwood Dr
Hamilton, MT 59840
Phone (406) 363-2211

1224 W Main St
Hamilton, MT 59840
Phone (406) 375-4823

310 Sunnyview Ln
Kalispell, MT 59901
Phone (406) 751-5310

350 Heritage Way
Ste 2100
Kalispell, MT 59901
Phone (406) 257-8992

Interoperability endpoints

  • Direct secure messaging: krmcmedicalrecords@krhdirect.org
  • Direct secure messaging: mboltz236485@wm.providencedirect.org

Organizations & group practices 17

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

View all 17

Hospital & facility affiliations 12

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1174953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692576000000",
    "number": "1194843870",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "214 E 3RD ST",
            "city": "LIBBY",
            "state": "MT",
            "postal_code": "599232056",
            "telephone_number": "406-293-9274",
            "fax_number": "406-293-9280"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "214 E 3RD ST",
            "city": "LIBBY",
            "state": "MT",
            "postal_code": "599232056",
            "telephone_number": "406-293-9274",
            "fax_number": "406-293-9280"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "310 Sunnyview Ln",
            "address_purpose": "LOCATION",
            "city": "Kalispell",
            "state": "MT",
            "postal_code": "599013129",
            "country_code": "US",
            "telephone_number": "406-751-5310",
            "fax_number": "406-751-3068",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "600 Mt Highway 91 S",
            "address_purpose": "LOCATION",
            "city": "Dillon",
            "state": "MT",
            "postal_code": "597257379",
            "country_code": "US",
            "telephone_number": "406-683-3000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOLTZ",
        "first_name": "MICHELLE",
        "middle_name": "LYNN",
        "name_prefix": "Ms.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-27",
        "last_updated": "2023-08-21",
        "certification_date": "2023-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AK",
            "license": "957",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MT",
            "license": "40325",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "krmcmedicalrecords@krhdirect.org",
            "affiliation": "Y",
            "affiliationName": "Kalispell Regional Medical Center Inc",
            "address_1": "310 Sunnyview Ln",
            "city": "Kalispell",
            "state": "MT",
            "country_code": "US",
            "postal_code": "599013129",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mboltz236485@wm.providencedirect.org",
            "affiliation": "N",
            "address_1": "600 Mt Highway 91 S",
            "city": "Dillon",
            "state": "MT",
            "country_code": "US",
            "postal_code": "597257379",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Libby, MT

Sources for this page

Verify at the official NPI Registry.