Active NPI
Brooke Williamson Everest, MT
- Medical Technologist
- Harlem, MT
National Provider Identifier
1205058591
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Technologist
- License
- 1344
- Practice address
- RR1 Box 67
Harlem, MT 59526 - Phone
- (406) 353-3100
- Fax
- (406) 353-3229
- NPI assigned
- May 3, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Technologist | 246QM0706X | 1344 | MT | Primary |
Addresses
Primary practice location
RR1 Box 67
Harlem, MT 59526
Mailing address
15818 Skunk CRK Rd
Bozeman, MT 59715
Phone (406) 686-4878
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1344 | Other | MT | LICENSE |
| 150444 | Other | MT | ASCP LICENSE |
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
- Credentials
- Medical Technician
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1344 | MT | MD | Medical Technologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1178150400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1205058591",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15818 SKUNK CRK RD",
"city": "BOZEMAN",
"state": "MT",
"postal_code": "59715",
"telephone_number": "406-686-4878"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "RR1 BOX 67",
"city": "HARLEM",
"state": "MT",
"postal_code": "59526",
"telephone_number": "406-353-3100",
"fax_number": "406-353-3229"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EVEREST",
"first_name": "BROOKE",
"middle_name": "WILLIAMSON",
"credential": "MT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-05-03",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "246QM0706X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Pathology, Medical Technologist",
"state": "MT",
"license": "1344",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE",
"identifier": "1344",
"state": "MT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ASCP LICENSE",
"identifier": "150444",
"state": "MT"
}
],
"endpoints": [],
"other_names": []
}Other providers in Harlem, MT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.