Headwaters Palliative Services

Primary specialty

Home Health Clinical Nurse SpecialistTaxonomy code 364SH0200X

Legal business name

HEADWATERS PALLIATIVE SERVICES

Practice address

2625 Winne Ave Ste A1
Helena, MT 59601-4958

Phone

(406) 422-0114

Fax

(406) 324-9190

NPI assigned

Oct 30, 2024

Organization subpart

No

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

Authorized official

Name

Michael Brown

Title

Owner

Phone

(406) 422-0114

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MT

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Practitioners 6

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

• Carissa Taylor, NP

  • Family Nurse Practitioner
  • Helena, MT
  • NPI 1548659527
  Medicare reassignment Care Compare group NPD
• Emily Yelenich, NP

  • Family Nurse Practitioner
  • Butte, MT
  • NPI 1447737523
  Medicare reassignment Care Compare group NPD
• Richard McEwen, PA-C

  • Physician Assistant
  • Butte, MT
  • NPI 1548744295
  Medicare reassignment Care Compare group
• Jenifer Patricia Dodge, MD

  • Family Medicine Physician
  • Helena, MT
  • NPI 1295724292
  Medicare reassignment NPD
• Jasmine Gagnon, NP-C

  • Family Nurse Practitioner
  • Frenchtown, MT
  • NPI 1437991577
  Medicare reassignment NPD
• Karry Mikel Clos, LPN

  • Licensed Practical Nurse
  • Helena, MT
  • NPI 1356142574
  NPD

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

{
    "created_epoch": "1730246400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1730246400000",
    "number": "1245052299",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2625 WINNE AVE STE A1",
            "city": "HELENA",
            "state": "MT",
            "postal_code": "596014958",
            "telephone_number": "406-422-0114",
            "fax_number": "406-324-9190"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2625 WINNE AVE STE A1",
            "city": "HELENA",
            "state": "MT",
            "postal_code": "596014958",
            "telephone_number": "406-422-0114",
            "fax_number": "406-324-9190"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEADWATERS PALLIATIVE SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-10-30",
        "last_updated": "2024-10-30",
        "certification_date": "2024-10-30",
        "status": "A",
        "authorized_official_last_name": "BROWN",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "406-422-0114"
    },
    "taxonomies": [
        {
            "code": "364SH0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Clinical Nurse Specialist, Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael S Hay, M.D.
• Jessica Jean Hayes-Cook, LCPC
• Donovan Kristopher Hayes, D.C.
• Kyle Hayter, OD
• Headwaters Hospice and Palliative Care, LLC
• Healing Mountain Mental Health
• Health Care Service Corporation, a Mutual Legal Reserve Company
• Health Haus Mobile LLC
• Hearing Solutions of Montana LLC
• Heart & Mind Collaborative LLC

• Home Health Clinical Nurse Specialist in Helena, MT
• Providers in Helena, MT by specialty
• Home Health Clinical Nurse Specialist in Montana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.