SCL Health Medical Group - Billings, LLC

Key facts

NPI: 1235170705
Entity type: Organization (NPI type 2)
Primary specialty: Rural Health Clinic/Center 261QR1300X
Legal business name: SCL HEALTH MEDICAL GROUP - BILLINGS, LLC
Practice address: 424 Yellowstone Ave Ste 310
Cody, WY 82414-9310
Phone: (307) 578-1800
Fax: (307) 578-1814
NPI assigned: Jun 8, 2006
Organization subpart: Yes
Parent organization (as reported): SISTERS OF CHARITY OF LEAVENWORTH HEALTH SYSTEM INC

Authorized official

Name: Jon McDaniel
Title: VP of Finance
Phone: (303) 272-0231

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

SCL Health Medical Group - Billings LLC Clinic/Center · Billings, MT · NPI 1508289703

Same enrollment O20150220002318

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Sisters of Charity of Leavenworth Health System Inc Institutional Pharmacy · Wheat Ridge, CO · NPI 1629515028

NPD member Member Of

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Claire Buckingham, NP Nurse Practitioner · Billings, MT · NPI 1598230724

NPD
Elizabeth V Connor, MD Gynecologic Oncology Physician · Billings, MT · NPI 1003179581

NPD
Janice Marie Fordham, M.D. Family Medicine Physician · Laurel, MT · NPI 1609197433

NPD
Marcus Nicola, NP Nurse Practitioner · Billings, MT · NPI 1730672866

NPD
Megan Marie Clute Petersen, M.D. Gynecologic Oncology Physician · Billings, MT · NPI 1215181029

NPD
Robert Michael Simonds Jr. Dermatology Physician · Cleveland, OH · NPI 1952806317

NPD
Erica Lynn Smith, M.D. Maternal & Fetal Medicine Physician · Murray, UT · NPI 1932355468

NPD
Brooke Elizabeth Yates, MS PAC Physician Assistant · Billings, MT · NPI 1215921838

NPD

Medicare participation

Medicare fee-for-service enrollment: Enrolled in WY

Medicare enrollment records

Enrollment ID	State	Provider type	PAC ID	Details
O20150220002318	WY	Part B Supplier - Clinic/Group Practice	9638491574	Receives reassigned benefits from 20 practitioners 1 other NPI on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Sheridan, WY; Cody, WY

National Provider Directory

Part of: Sisters of Charity of Leavenworth Health System Inc

Locations

1333 W 5th St
Ste 210
Sheridan, WY 82801
Phone (307) 672-2522

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Primary Care Clinic/Center	261QP2300X	13258	MT
Rural Health Clinic/Center	261QR1300X			Yes

Addresses

Primary practice location

424 Yellowstone Ave Ste 310
Cody, WY 82414-9310

Mailing address

424 Yellowstone Ave Ste 310
Cody, WY 82414-9310
Phone (307) 578-1800

Other names

Intermountain Health Cody Clinic Doing business as

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Aug 10, 2023.

{
    "created_epoch": "1149724800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1691625600000",
    "number": "1235170705",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "424 YELLOWSTONE AVE STE 310",
            "city": "CODY",
            "state": "WY",
            "postal_code": "824149310",
            "telephone_number": "307-578-1800",
            "fax_number": "307-578-1814"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "424 YELLOWSTONE AVE STE 310",
            "city": "CODY",
            "state": "WY",
            "postal_code": "824149310",
            "telephone_number": "307-578-1800",
            "fax_number": "307-578-1814"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SCL HEALTH MEDICAL GROUP - BILLINGS, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SISTERS OF CHARITY OF LEAVENWORTH HEALTH SYSTEM INC",
        "enumeration_date": "2006-06-08",
        "last_updated": "2023-08-10",
        "certification_date": "2023-08-10",
        "status": "A",
        "authorized_official_last_name": "MCDANIEL",
        "authorized_official_first_name": "JON",
        "authorized_official_title_or_position": "VP OF FINANCE",
        "authorized_official_telephone_number": "303-272-0231"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "MT",
            "license": "13258",
            "primary": false
        },
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Intermountain Health Cody Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Cody, WY

All providers in Cody, WY · Rural Health Clinic/Center in Wyoming

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 10, 2023. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.