NPIMap

Organization Active NPI

Glacier Oncology, PLLC

  • Oncology Clinic/Center
  • Kalispell, MT
National Provider Identifier
1275789901
Registry record updated Aug 13, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oncology Clinic/CenterTaxonomy code 261QX0200X
License
8025 Issued in MT
Legal business name
GLACIER ONCOLOGY, PLLC
Practice address
75 Claremont St
Suite E
Kalispell, MT 59901-3585
Phone
(406) 752-7600
Fax
(406) 752-7614
NPI assigned
Aug 13, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2008

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

Authorized official

Name
Dr. Michael G Goodman, M.D.
Title
Sole Proprietor
Phone
(406) 752-7600

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oncology Clinic/Center 261QX0200X 8025 MT Primary

Addresses

Primary practice location

75 Claremont St
Suite E
Kalispell, MT 59901-3585

Mailing address

75 Claremont St
Suite E
Kalispell, MT 59901-3585
Phone (406) 752-7600

Other identifiers 3

IdentifierTypeStateIssuer
830004450OtherMTRAILROAD MEDICARE
011071OtherMTBLUE CROSS BLUE SHIELD
0105825MedicaidMT

Other names 1

  • Michael G Goodman, M.D. Other name

National Provider Directory

National Provider Directory

Locations

75 Claremont St
Ste E
Kalispell, MT 59901
Phone (406) 752-7600

NPI Registry JSON

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

{
    "created_epoch": "1218585600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1218585600000",
    "number": "1275789901",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "75 CLAREMONT ST",
            "address_2": "SUITE E",
            "city": "KALISPELL",
            "state": "MT",
            "postal_code": "599013585",
            "telephone_number": "406-752-7600",
            "fax_number": "406-752-7614"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75 CLAREMONT ST",
            "address_2": "SUITE E",
            "city": "KALISPELL",
            "state": "MT",
            "postal_code": "599013585",
            "telephone_number": "406-752-7600",
            "fax_number": "406-752-7614"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GLACIER ONCOLOGY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-08-13",
        "last_updated": "2008-08-13",
        "status": "A",
        "authorized_official_last_name": "GOODMAN",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "SOLE PROPRIETOR",
        "authorized_official_telephone_number": "406-752-7600",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QX0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Oncology",
            "state": "MT",
            "license": "8025",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "830004450",
            "state": "MT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "011071",
            "state": "MT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0105825",
            "state": "MT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Michael G Goodman, M.D.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Kalispell, MT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.