Individual provider Active NPI

Michelle Weaver Knowles, FNP

  • Family Nurse Practitioner
  • Missoula, MT
National Provider Identifier
1205313590
Registry record updated Jul 19, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
131528 Issued in MT
Practice address
2825 Fort Missoula Rd Ste 113
Missoula, MT 59804-7403
Phone
(406) 544-3168
NPI assigned
Jul 19, 2018
Last updated
Jul 19, 2018By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 19, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 131528 MT Primary

Addresses

Primary practice location

2825 Fort Missoula Rd Ste 113
Missoula, MT 59804-7403

Mailing address

1001 E Broadway #2
PMB 217
Missoula, MT 59801

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
I20181022001228 MT Practitioner - Nurse Practitioner 9032462056 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

2875 Tina Ave
Suite 102a
Missoula, MT 59808-1582
Phone (406) 544-0628

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
131528MTMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Ava Health LLC Family CurrentSince Aug 27, 2018 Accepting new patients

Locations

1001 E Broadway St
#2
Missoula, MT 59802

1200 S Reserve St
Ste H
Missoula, MT 59801
Phone (406) 543-9200

2825 Fort Missoula Rd
Ste 113
Missoula, MT 59804
Phone (406) 542-2116

2875 Tina Ave
Ste 102A
Missoula, MT 59808

2875 Tina Ave
Ste 107
Missoula, MT 59808
Phone (406) 544-0628

Interoperability endpoints

  • Direct secure messaging: avahealth.michelleweaverknowles@139998.advancedmd-direct.com

Organizations & group practices 1

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.

Hospital & facility affiliations 5

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": "1531958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1531958400000",
    "number": "1205313590",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 E BROADWAY #2",
            "address_2": "PMB 217",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "59801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2825 FORT MISSOULA RD STE 113",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598047403",
            "telephone_number": "406-544-3168"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEAVER KNOWLES",
        "first_name": "MICHELLE",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-07-19",
        "last_updated": "2018-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MT",
            "license": "131528",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Missoula, MT

Sources for this page

Verify at the official NPI Registry.