Blue Goddess LLC

Primary specialty

Prosthetic/Orthotic SupplierTaxonomy code 335E00000X

Legal business name

BLUE GODDESS LLC

Practice address

1001 S Main St Ste 600
Kalispell, MT 59901-5635

Phone

(410) 989-7661

NPI assigned

Aug 10, 2024

Organization subpart

No

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

Authorized official

Name

Janaya Holmes

Title

President

Phone

(410) 989-7661

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1723248000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1723248000000",
    "number": "1235960378",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 S MAIN ST STE 600",
            "city": "KALISPELL",
            "state": "MT",
            "postal_code": "599015635"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 S MAIN ST STE 600",
            "city": "KALISPELL",
            "state": "MT",
            "postal_code": "599015635",
            "telephone_number": "410-989-7661"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLUE GODDESS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-08-10",
        "last_updated": "2024-08-10",
        "certification_date": "2024-08-09",
        "status": "A",
        "authorized_official_last_name": "HOLMES",
        "authorized_official_first_name": "JANAYA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "410-989-7661"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joshua Blanton-Dickens, DMD
• James P Blasingame, MD
• Rheanna Blasius, LPN
• Deborah Blauvelt, RDH, LAP
• Lottie Lucille Block, FNP
• Bluebird Health Imaging, PLLC
• Bluebird Health, PLLC
• Gabor Bodonyi-Kovacs, MD
• Susan E Bodurtha, RN, CNS
• Body Balance Health and Wellness Clinic LLC

• Prosthetic/Orthotic Supplier in Kalispell, MT
• Providers in Kalispell, MT by specialty
• Prosthetic/Orthotic Supplier in Montana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2024; 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.