Individual provider Active NPI

Kelly Ann Klauber, PA-C

  • Medical Physician Assistant
  • Missoula, MT
National Provider Identifier
1245537760
Registry record updated Jan 26, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
MED-PAC-LIC-78377 Issued in MT
Practice address
3017 Paxson St
Missoula, MT 59801-8325
Phone
(406) 325-0123
Fax
(406) 203-5085
NPI assigned
Feb 18, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 26, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 4800 AZ
Medical Physician Assistant 363AM0700X MED-PAC-LIC-78377 MT Primary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X 4977 CO

Addresses

Primary practice location

3017 Paxson St
Missoula, MT 59801-8325

Mailing address

PO Box 31001
4114
Pasadena, CA 91110-4114
Phone (406) 325-0123

Other practice location 1

3075 N Reserve St Ste Q
Missoula, MT 59808-1390
Phone (406) 327-1850

Other practice location 2

3075 N Reserve St Ste Q
Missoula, MT 59808-1390
Phone (406) 327-1750

Other identifiers 1

IdentifierTypeStateIssuer
856096MedicaidAZ

Other names 1

  • N/a N/a Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MT
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251224002311 MT Practitioner - Physician Assistant 5890966659 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Providence Health and Services MtGroup PAC ID 6608786306, 358 clinicians

Practice addresses (Care Compare)

3075 N Reserve St
Suite Q
Missoula, MT 59808-1390
Phone (406) 327-1850

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
4800AZMDGeneral Practice Dentistry
4977COMDFamily Medicine Physician
MED-PAC-LIC-78377MTMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Health & Services Mt Single Specialty CurrentSince Jan 12, 2026 Accepting new patients
Providence Health & Services Mt CurrentSince Jan 12, 2026 Accepting new patients

Locations

3017 Paxson St
Missoula, MT 59801
Phone (406) 325-0123

500 W Broadway St
Ste 320
Missoula, MT 59802
Phone (406) 329-2945

3075 N Reserve St
Ste Q
Missoula, MT 59808
Phone (406) 327-1750

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1297987200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1769385600000",
    "number": "1245537760",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 31001",
            "address_2": "4114",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911104114",
            "telephone_number": "406-325-0123",
            "fax_number": "406-203-5085"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3017 PAXSON ST",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598018325",
            "telephone_number": "406-325-0123",
            "fax_number": "406-203-5085"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3075 N Reserve St Ste Q",
            "address_purpose": "LOCATION",
            "city": "Missoula",
            "state": "MT",
            "postal_code": "598081390",
            "country_code": "US",
            "telephone_number": "406-327-1850",
            "fax_number": "406-327-1875",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3075 N Reserve St Ste Q",
            "address_purpose": "LOCATION",
            "city": "Missoula",
            "state": "MT",
            "postal_code": "598081390",
            "country_code": "US",
            "telephone_number": "406-327-1750",
            "fax_number": "406-327-1960",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KLAUBER",
        "first_name": "KELLY",
        "middle_name": "ANN",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-02-18",
        "last_updated": "2026-01-26",
        "certification_date": "2026-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "AZ",
            "license": "4800",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MT",
            "license": "MED-PAC-LIC-78377",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "CO",
            "license": "4977",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "856096",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "N/A",
            "last_name": "N/A",
            "credential": "PA-C",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Missoula, MT

Sources for this page

Verify at the official NPI Registry.