Landon Ray Heavyrunner, MSW, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

BBH-LCSW-LIC-72934 Issued in MT

Practice address

1511 S Russell St
Missoula, MT 59801-3629

Phone

(406) 829-9515

NPI assigned

Oct 25, 2024

Last updated

Oct 25, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

All Nations Health Center, Inc.Group PAC ID 5294025680, 4 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• All Nations Health Center, Inc.

  • Federally Qualified Health Center (FQHC)
  • Missoula, MT
  • NPI 1649663923

  TX

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1729814400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729814400000",
    "number": "1215759832",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1309 S 2ND ST W APT 3",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598012386",
            "telephone_number": "406-529-0913"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1511 S RUSSELL ST",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598013629",
            "telephone_number": "406-829-9515"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEAVYRUNNER",
        "first_name": "LANDON",
        "middle_name": "RAY",
        "credential": "MSW, LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-10-25",
        "last_updated": "2024-10-25",
        "certification_date": "2024-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MT",
            "license": "BBH-LCSW-LIC-72934",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hearing Aid Institute of Missoula
• Rodney Glen Heaton, D.O.
• Louella Kelly Heavy Runner, LAC
• Aimee Lee Heavyrunner
• Andrew C Heavyrunner
• Jeanne Hebl, CNM
• Alexa Megan Heckman, RPH
• Riley Hector
• Tiffany Heeren
• Heffernan Drug Inc (Palmer's Drug Co)

• Clinical Social Worker in Missoula, MT
• Providers in Missoula, MT by specialty
• Clinical Social Worker in Montana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.