Individual provider Active NPI

Kelli Gibbs

  • Physician Assistant
  • Missoula, MT
National Provider Identifier
1225279227
Registry record updated Jul 21, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
MED-PAC-LIC-573 Issued in MT
Practice address
902 N Orange St
Missoula, MT 59802-2928
Phone
(406) 329-5736
Fax
(406) 329-2941
NPI assigned
Mar 20, 2009
Last updated
Jul 21, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X MED-PAC-LIC-573 MT Primary
Medical Physician Assistant 363AM0700X

Addresses

Primary practice location

902 N Orange St
Missoula, MT 59802-2928

Mailing address

PO Box 31001
4114
Pasadena, CA 91110-4114
Phone (406) 329-5736

Other practice location 1

3017 Paxson St
Missoula, MT 59801-8325
Phone (406) 519-3422

Other practice location 2

715 Main St
Stevensville, MT 59870-2846
Phone (406) 777-5522

Other practice location 3

5549 Old Highway 93
Florence, MT 59833-6845
Phone (406) 327-4923

Other practice location 4

3075 N Reserve St Ste Q
Missoula, MT 59808-1390
Phone (406) 327-1750

Other practice location 5

500 W Broadway St Fl 4
Missoula, MT 59802-4008
Phone (406) 327-1900

Other practice location 6

1211 S Reserve St Ste 101
Missoula, MT 59801-3103
Phone (406) 327-3057

Other practice location 7

601 W Spruce St Ste A
Missoula, MT 59802-4047
Phone (406) 728-3111

Other identifiers 1

IdentifierTypeStateIssuer
M011004293OtherMTMEDICARE PTAN -

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
I20090513000332 MT Practitioner - Physician Assistant 7719036284 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cogent Healthcare of Montana P CGroup PAC ID 4486712833, 82 clinicians
Providence Health and Services MtGroup PAC ID 6608786306, 358 clinicians

Practice addresses (Care Compare)

1101 26TH St S
Great Falls, MT 59405-5161
Phone (406) 455-4690

2827 Fort Missoula Rd
Missoula, MT 59804-7408
Phone (406) 728-4100

500 W Broadway St
Missoula, MT 59802-4003

500 W Broadway St
Missoula, MT 59802-4096

500 W Broadway St 3Rd FL
Missoula, MT 59802-4096

902 N Orange St
Missoula, MT 59802-2928

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Health & Services Mt CurrentSince Apr 14, 2009 Accepting new patients
Providence Health & Services Mt CurrentSince Apr 14, 2009 Accepting new patients
RCHP Billings - Missoula LLC CurrentSince Apr 1, 2018 Accepting new patients
Providence Health & Services Mt Past Accepting new patients

Locations

5549 Old US Highway 93
Florence, MT 59833
Phone (406) 273-4923

2230 N Reserve St
Ste 402
Missoula, MT 59808
Phone (406) 327-3850

2827 Fort Missoula Rd
Missoula, MT 59804
Phone (406) 327-4202

2835 Fort Missoula Rd
Ste 204
Missoula, MT 59804
Phone (406) 327-3935

3075 N Reserve St
Ste Q
Missoula, MT 59808
Phone (406) 327-1750

500 W Broadway St
Missoula, MT 59802
Phone (406) 327-1918

500 W Broadway St
Ste 320
Missoula, MT 59802
Phone (406) 329-2945

902 N Orange St
Missoula, MT 59802
Phone (406) 327-3300

Interoperability endpoints

  • Direct secure messaging: kgibbs@direct.communitymed.org
  • Direct secure messaging: missoulavalleypmr.kelligibbs@154771.advancedmd-direct.com

Organizations & group practices 9

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 6

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": "1237507200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784592000000",
    "number": "1225279227",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 31001",
            "address_2": "4114",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911104114",
            "telephone_number": "406-329-5736",
            "fax_number": "406-329-2941"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "902 N ORANGE ST",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598022928",
            "telephone_number": "406-329-5736",
            "fax_number": "406-329-2941"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3017 Paxson St",
            "address_purpose": "LOCATION",
            "city": "Missoula",
            "state": "MT",
            "postal_code": "598018325",
            "country_code": "US",
            "telephone_number": "406-519-3422",
            "fax_number": "406-203-5110",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "715 Main St",
            "address_purpose": "LOCATION",
            "city": "Stevensville",
            "state": "MT",
            "postal_code": "598702846",
            "country_code": "US",
            "telephone_number": "406-777-5522",
            "fax_number": "406-777-1175",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5549 Old Highway 93",
            "address_purpose": "LOCATION",
            "city": "Florence",
            "state": "MT",
            "postal_code": "598336845",
            "country_code": "US",
            "telephone_number": "406-327-4923",
            "fax_number": "406-329-4174",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3075 N Reserve St Ste Q",
            "address_purpose": "LOCATION",
            "city": "Missoula",
            "state": "MT",
            "postal_code": "598081390",
            "country_code": "US",
            "telephone_number": "406-327-1750",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "500 W Broadway St Fl 4",
            "address_purpose": "LOCATION",
            "city": "Missoula",
            "state": "MT",
            "postal_code": "598024008",
            "country_code": "US",
            "telephone_number": "406-327-1900",
            "fax_number": "406-327-1974",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1211 S Reserve St Ste 101",
            "address_purpose": "LOCATION",
            "city": "Missoula",
            "state": "MT",
            "postal_code": "598013103",
            "country_code": "US",
            "telephone_number": "406-327-3057",
            "fax_number": "406-327-3231",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "601 W Spruce St Ste A",
            "address_purpose": "LOCATION",
            "city": "Missoula",
            "state": "MT",
            "postal_code": "598024047",
            "country_code": "US",
            "telephone_number": "406-728-3111",
            "fax_number": "406-728-3116",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GIBBS",
        "first_name": "KELLI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-03-20",
        "last_updated": "2026-07-21",
        "certification_date": "2026-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MT",
            "license": "MED-PAC-LIC-573",
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN -",
            "identifier": "M011004293",
            "state": "MT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Missoula, MT

Sources for this page

Verify at the official NPI Registry.