Active NPI
Park County
- Maternal Newborn Registered Nurse
- Livingston, MT
National Provider Identifier
1235294687
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Maternal Newborn Registered Nurse
- License
- RN013198
- 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
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Maternal Newborn Registered Nurse | 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 290316 | Medicaid | MT | |
| 290602 | Medicaid | MT | |
| 3501381 | Medicaid | MT |
Other names 1
- Park County
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MT
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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 Dept
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Land Ambulance
- Pray, MT
- NPI 1477712214
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.
-
- Registered Dietitian
- Livingston, MT
- NPI 1932700432
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
- Nicolle Bellerive LCSW LLC
- Taylor Nix, CRNA
- Nohl P.C. (Nohl Family Chiropractic)
- Northland Hearing Center (The Hearing Aid Institute)
- Grant Palm, CRNA
- Park County Special Education Cooperative
- Park Health Care PLLC
- Partnership for Health & Wellness, Inc. (Park County Chiropractic)
- Shawn Glenn Patrick, PHARM D
- PCRS 360 Dba Rural Resilience
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.