Individual provider Active NPI

Kristin C Spoon, MD

  • Sleep Medicine (Psychiatry & Neurology) Physician
  • Missoula, MT
National Provider Identifier
1275633174
Registry record updated Apr 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sleep Medicine (Psychiatry & Neurology) PhysicianTaxonomy code 2084S0012X
License
49276 Issued in MT
Practice address
2829 Great Northern Loop Ste 300
Missoula, MT 59808-1752
Phone
(406) 541-7000
NPI assigned
Sep 22, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 2, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sleep Medicine (Psychiatry & Neurology) Physician 2084S0012X 49276 MT Primary

Addresses

Primary practice location

2829 Great Northern Loop Ste 300
Missoula, MT 59808-1752

Mailing address

PO Box 12
Liberty Lake, WA 99019-0012
Phone (507) 529-6616

Other practice location 1

900 N Orange St Ste 106
Missoula, MT 59802-2951
Phone (406) 327-3100

Other identifiers 2

IdentifierTypeStateIssuer
352638000MedicaidMN
P00918779OtherMNRAILROAD MEDICARE

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address kspoon623307@wm.providencedirect.org
Direct Messaging Address kspoon623307@wm.providencedirect.org

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160629001618 MT Practitioner - Sleep Medicine 1759389216 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Sleep Medicine
Education
Creighton University School of Medicine, 2005
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)

500 W Broadway St
Suite 310
Missoula, MT 59802-4003
Phone (406) 728-6520

Hospital & facility affiliations

  • St. Patrick Hospital Hospital, Missoula, MT, CCN 270014

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
49276MTMDSleep Medicine (Psychiatry & Neurology) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Health & Services Mt Current Accepting new patients
Providence Health & Services Mt CurrentSince Aug 1, 2016 Accepting new patients

Locations

900 N Orange St
Ste 106
Missoula, MT 59802
Phone (406) 327-3100

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

500 W Broadway St
Missoula, MT 59802
Phone (406) 327-1918

500 W Broadway St
Ste 310
Missoula, MT 59802
Phone (406) 728-6520

2829 Great Northern Loop
Ste 300
Missoula, MT 59808
Phone (406) 541-7000

Interoperability endpoints

  • Direct secure messaging: kspoon623307@wm.providencedirect.org

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 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": "1158883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617321600000",
    "number": "1275633174",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 12",
            "city": "LIBERTY LAKE",
            "state": "WA",
            "postal_code": "990190012",
            "telephone_number": "507-529-6616"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2829 GREAT NORTHERN LOOP STE 300",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598081752",
            "telephone_number": "406-541-7000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "900 N Orange St Ste 106",
            "address_purpose": "LOCATION",
            "city": "Missoula",
            "state": "MT",
            "postal_code": "598022951",
            "country_code": "US",
            "telephone_number": "406-327-3100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SPOON",
        "first_name": "KRISTIN",
        "middle_name": "C",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-22",
        "last_updated": "2021-04-02",
        "certification_date": "2021-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084S0012X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Sleep Medicine",
            "state": "MT",
            "license": "49276",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "352638000",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00918779",
            "state": "MN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kspoon623307@wm.providencedirect.org",
            "affiliation": "N",
            "address_1": "2829 Great Northern Loop Ste 300",
            "city": "Missoula",
            "state": "MT",
            "country_code": "US",
            "postal_code": "598081752",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kspoon623307@wm.providencedirect.org",
            "affiliation": "N",
            "address_1": "900 N Orange St Ste 106",
            "city": "Missoula",
            "state": "MT",
            "country_code": "US",
            "postal_code": "598022951",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Missoula, MT

Sources for this page

Verify at the official NPI Registry.