Individual provider Active NPI

Marion Ruth Bachra, RD, MS

  • Metabolic Nutrition Registered Dietitian
  • Bozeman, MT
National Provider Identifier
1205947819
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Metabolic Nutrition Registered DietitianTaxonomy code 133VN1006X
License
391 Issued in MT
Practice address
127 Sheridan Ave
Bozeman, MT 59718-6283
Phone
(406) 586-1833
Fax
(406) 586-1833
NPI assigned
Aug 31, 2006
Last updated
Jul 9, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Metabolic Nutrition Registered Dietitian 133VN1006X 391 MT Primary

Addresses

Primary practice location

127 Sheridan Ave
Bozeman, MT 59718-6283

Mailing address

127 Sheridan Ave
Bozeman, MT 59718-6283
Phone (406) 586-1833

Other identifiers 1

IdentifierTypeStateIssuer
0280143MedicaidMT

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081103000287 MT Practitioner - Registered Dietitian Or Nutrition Professional 6002975299 Practice locations: Bozeman, MT

Care Compare profile

Medicare Care Compare
Specialty
Registered Dietitian Or Nutrition Professional
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

127 Sheridan Ave
Bozeman, MT 59718-6283
Phone (406) 586-1833

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
391MTMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1205947819",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "127 SHERIDAN AVE",
            "city": "BOZEMAN",
            "state": "MT",
            "postal_code": "597186283",
            "telephone_number": "406-586-1833",
            "fax_number": "406-586-1833"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "127 SHERIDAN AVE",
            "city": "BOZEMAN",
            "state": "MT",
            "postal_code": "597186283",
            "telephone_number": "406-586-1833",
            "fax_number": "406-586-1833"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BACHRA",
        "first_name": "MARION",
        "middle_name": "RUTH",
        "name_prefix": "Ms.",
        "credential": "RD, MS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-31",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133VN1006X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered, Nutrition, Metabolic",
            "state": "MT",
            "license": "391",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0280143",
            "state": "MT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bozeman, MT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.