Active NPI
Ryan Timothy Davis
- Pharmacist
- Bozeman, MT
National Provider Identifier
1265872675
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 6267
- Practice address
- 115 N 19TH Ave
Bozeman, MT 59718-4072 - Phone
- (406) 587-9252
- NPI assigned
- Jun 29, 2013
- Last updated
- Jun 29, 2013
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 6267 | MT | Primary |
Addresses
Primary practice location
115 N 19TH Ave
Bozeman, MT 59718-4072
Mailing address
339 Christopher Way
Bozeman, MT 59718-6298
Phone (406) 239-3379
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6267 | MT | MD | Anesthesiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Montana CVS Pharmacy LLC | Past | Accepting new patients | |
| Montana CVS Pharmacy LLC | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1372464000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1372464000000",
"number": "1265872675",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "339 CHRISTOPHER WAY",
"city": "BOZEMAN",
"state": "MT",
"postal_code": "597186298",
"telephone_number": "406-239-3379"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "115 N 19TH AVE",
"city": "BOZEMAN",
"state": "MT",
"postal_code": "597184072",
"telephone_number": "406-587-9252"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVIS",
"first_name": "RYAN",
"middle_name": "TIMOTHY",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2013-06-29",
"last_updated": "2013-06-29",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MT",
"license": "6267",
"primary": true
}
],
"identifiers": [],
"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 Jun 29, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.