Organization Active NPI

Park County

  • Maternal Newborn Registered Nurse
  • Livingston, MT
National Provider Identifier
1235294687
Registry record updated Jun 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Maternal Newborn Registered NurseTaxonomy code 163WM0102X
License
RN013198 Issued in MT
Legal business name
PARK COUNTY
Practice address
414 E Callender St
Livingston, MT 59047-2746
Phone
(406) 222-4140
Fax
(406) 222-4138
NPI assigned
Dec 26, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 4, 2024

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

Authorized official

Name
Dr. Laurel Desnick, MD
Title
Health Officer
Phone
(406) 222-4145

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Maternal Newborn Registered NurseGroup: 193400000X SINGLE SPECIALTY GROUP 163WM0102X RN013198 MT Primary

Addresses

Primary practice location

414 E Callender St
Livingston, MT 59047-2746

Mailing address

414 E Callender St
Livingston, MT 59047-2746
Phone (406) 222-4145

Other identifiers 3

IdentifierTypeStateIssuer
290316MedicaidMT
290602MedicaidMT
3501381MedicaidMT

Other names 1

  • Park County Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MT

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240703001789 MT Part B Supplier - Mass Immunization (Roster Biller Only) 5597209346 Practice locations: Livingston, MT

National Provider Directory

National Provider Directory
Tax ID family
Park Co Health Dept2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1167091200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1717459200000",
    "number": "1235294687",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "414 E CALLENDER ST",
            "city": "LIVINGSTON",
            "state": "MT",
            "postal_code": "590472746",
            "telephone_number": "406-222-4145",
            "fax_number": "406-222-4763"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "414 E CALLENDER ST",
            "city": "LIVINGSTON",
            "state": "MT",
            "postal_code": "590472746",
            "telephone_number": "406-222-4140",
            "fax_number": "406-222-4138"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PARK COUNTY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-26",
        "last_updated": "2024-06-04",
        "certification_date": "2024-03-25",
        "status": "A",
        "authorized_official_last_name": "DESNICK",
        "authorized_official_first_name": "LAUREL",
        "authorized_official_title_or_position": "HEALTH OFFICER",
        "authorized_official_telephone_number": "406-222-4145",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "163WM0102X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Registered Nurse, Maternal Newborn",
            "state": "MT",
            "license": "RN013198",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "290316",
            "state": "MT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "290602",
            "state": "MT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3501381",
            "state": "MT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Park County",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Park County",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Livingston, MT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare 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.