Active NPI
John Espy, LCSW
- Clinical Social Worker
- Missoula, MT
National Provider Identifier
1205958766
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 467
- Practice address
- 126 E Broadway St
Missoula, MT 59802-4511 - Phone
- (406) 549-7104
- Fax
- (406) 542-2785
- NPI assigned
- Apr 4, 2007
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 467 | MT | Primary |
Addresses
Primary practice location
126 E Broadway St
Missoula, MT 59802-4511
Mailing address
126 E Broadway St
Missoula, MT 59802-4511
Phone (406) 549-7104
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0501143 | Medicaid | MT | |
| 467 | Other | MT | STATE LICENSE |
| 70283 | Other | MT | BLUE CROSS BLUE SHIELD |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 467 | MT | MD | Medical Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1175644800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1205958766",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "126 E BROADWAY ST",
"city": "MISSOULA",
"state": "MT",
"postal_code": "598024511",
"telephone_number": "406-549-7104",
"fax_number": "406-542-2785"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "126 E BROADWAY ST",
"city": "MISSOULA",
"state": "MT",
"postal_code": "598024511",
"telephone_number": "406-549-7104",
"fax_number": "406-542-2785"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ESPY",
"first_name": "JOHN",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-04-04",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MT",
"license": "467",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0501143",
"state": "MT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE LICENSE",
"identifier": "467",
"state": "MT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "70283",
"state": "MT"
}
],
"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 Jul 9, 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.