Ravalli County

Primary specialty

Public Health or Welfare AgencyTaxonomy code 251K00000X

License

MS0194958 Issued in MT

Legal business name

RAVALLI COUNTY

Practice address

205 Bedford St
Suite L
Hamilton, MT 59840-2853

Phone

(406) 375-6670

Fax

(406) 375-6680

NPI assigned

Aug 2, 2006

Organization subpart

Yes

Parent organization

RAVALLI COUNTYAs reported in NPPES

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

Authorized official

Name

Ms. Kim A Squires, FNP/C

Title

Family Nurse Practitioner

Phone

(406) 375-6670

Specialties & licenses 1

Addresses

Other identifiers 5

Other names 1

• Ravalli County Public Health Doing business as

Tax ID family

County of Ravalli2 organizations share this tax ID, including this one

Part of

County of Ravalli

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• County of Ravalli

  • Public Health or Welfare Agency
  • Hamilton, MT
  • NPI 1386194785
  NPD tax ID

Locations

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

{
    "created_epoch": "1154476800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1205280000000",
    "number": "1225045370",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205 BEDFORD ST",
            "address_2": "SUITE L",
            "city": "HAMILTON",
            "state": "MT",
            "postal_code": "598402853",
            "telephone_number": "406-375-6670",
            "fax_number": "406-375-6680"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 BEDFORD ST",
            "address_2": "SUITE L",
            "city": "HAMILTON",
            "state": "MT",
            "postal_code": "598402853",
            "telephone_number": "406-375-6670",
            "fax_number": "406-375-6680"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RAVALLI COUNTY",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "RAVALLI COUNTY",
        "enumeration_date": "2006-08-02",
        "last_updated": "2008-03-12",
        "status": "A",
        "authorized_official_last_name": "SQUIRES",
        "authorized_official_first_name": "KIM",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "FAMILY NURSE PRACTITIONER",
        "authorized_official_telephone_number": "406-375-6670",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "FNP/C"
    },
    "taxonomies": [
        {
            "code": "251K00000X",
            "taxonomy_group": "",
            "desc": "Public Health or Welfare",
            "state": "MT",
            "license": "MS0194958",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "350-0952",
            "state": "MT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "13561",
            "state": "MT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS IZ'S",
            "identifier": "31388",
            "state": "MT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CHIP",
            "identifier": "31388",
            "state": "MT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MBCHP",
            "identifier": "94450094",
            "state": "MT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ravalli County Public Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Christopher Chisholm Qualls, OD
• Niki Qualm, RN
• Mona Liane Quintieri, LMT
• Jessica Randazzo, LCSW
• Amy Rau, LCSW
• Ravalli County Council on Aging
• Ravalli Family Medicine, LLC
• Ravalli Orthopedics & Sports Medicine PC
• Ravalli Services Corporation
• Scott Michael Raveling

• Public Health or Welfare Agency in Hamilton, MT
• Providers in Hamilton, MT by specialty
• Public Health or Welfare Agency in Montana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.