Active NPI
Four Corners Health Care Inc
- Pediatric Nurse Practitioner
- Bozeman, MT
National Provider Identifier
1245312644
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Nurse Practitioner
- License
- RN20521
- Legal business name
- FOUR CORNERS HEALTH CARE INC
- Practice address
- 7720 Shedhorn Dr Ste D
Bozeman, MT 59718 - Phone
- (406) 556-8300
- Fax
- (406) 556-8304
- NPI assigned
- Oct 19, 2006
- Last updated
- Sep 11, 2025
- 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
- Marie Sills Mitchell, CNP PNP FNP
- Title
- President Health Care Provider
- Phone
- (406) 556-8300
Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | RN20521 | MT | |
| Pediatric Nurse Practitioner | 363LP0200X | RN20521 | MT | Primary |
Addresses
Primary practice location
7720 Shedhorn Dr Ste D
Bozeman, MT 59718
Mailing address
7720 Shedhorn Dr Ste D
Bozeman, MT 59718
Phone (406) 556-8300
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4307043 | Medicaid | MT |
National Provider Directory
National Provider DirectoryLocations
7720 Shedhorn Dr
Ste D
Bozeman, MT 59718
Phone (406) 556-8300
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.
-
- Pediatric Nurse Practitioner
- Bozeman, MT
- NPI 1639382179
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161216000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1757548800000",
"number": "1245312644",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7720 SHEDHORN DR STE D",
"city": "BOZEMAN",
"state": "MT",
"postal_code": "59718",
"telephone_number": "406-556-8300",
"fax_number": "406-556-8304"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7720 SHEDHORN DR STE D",
"city": "BOZEMAN",
"state": "MT",
"postal_code": "59718",
"telephone_number": "406-556-8300",
"fax_number": "406-556-8304"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "FOUR CORNERS HEALTH CARE INC",
"organizational_subpart": "NO",
"enumeration_date": "2006-10-19",
"last_updated": "2025-09-11",
"status": "A",
"authorized_official_last_name": "MITCHELL",
"authorized_official_first_name": "MARIE",
"authorized_official_middle_name": "SILLS",
"authorized_official_title_or_position": "PRESIDENT HEALTH CARE PROVIDER",
"authorized_official_telephone_number": "406-556-8300",
"authorized_official_credential": "CNP PNP FNP"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Nurse Practitioner, Family",
"state": "MT",
"license": "RN20521",
"primary": false
},
{
"code": "363LP0200X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Nurse Practitioner, Pediatrics",
"state": "MT",
"license": "RN20521",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "4307043",
"state": "MT"
}
],
"endpoints": [],
"other_names": []
}Other providers in Bozeman, MT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.