Individual provider Active NPI

Lynn Ann Dykstra, M.D.

  • Pediatrics Physician
  • Kalispell, MT
National Provider Identifier
1285654020
Registry record updated Nov 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
10389 Issued in MT
Practice address
1273 Burns Way
Kalispell, MT 59901-3109
Phone
(406) 752-8300
Fax
(406) 752-3542
NPI assigned
Jul 21, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 10389 MT Primary

Addresses

Primary practice location

1273 Burns Way
Kalispell, MT 59901-3109

Mailing address

1273 Burns Way
Kalispell, MT 59901-3109
Phone (406) 752-8300

Other identifiers 2

IdentifierTypeStateIssuer
0066495MedicaidMT
95755OtherMTBLUE CROSS

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address krmcmedicalrecords@krhdirect.org Kalispell Regional Medical Center Inc

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
I20210621000973 MT Practitioner - Pediatric Medicine 1658771175 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
10389MTMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kalispell Regional Medical Center Inc Current Accepting new patients
Kalispell Regional Medical Center, Inc CurrentSince Apr 1, 2021 Accepting new patients
Kalispell Regional Medical Center Inc CurrentSince Apr 1, 2021 Accepting new patients
Kalispell Regional Medical Center, Inc Past Accepting new patients

Locations

350 Heritage Way
Ste 2100
Kalispell, MT 59901
Phone (406) 257-8992

1273 Burns Way
Kalispell, MT 59901
Phone (406) 752-5000

310 Sunnyview Ln
Kalispell, MT 59901
Phone (406) 751-5310

Interoperability endpoints

  • Direct secure messaging: krmcmedicalrecords@krhdirect.org

Organizations & group practices 5

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": "1153440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701043200000",
    "number": "1285654020",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1273 BURNS WAY",
            "city": "KALISPELL",
            "state": "MT",
            "postal_code": "599013109",
            "telephone_number": "406-752-8300",
            "fax_number": "406-752-3542"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1273 BURNS WAY",
            "city": "KALISPELL",
            "state": "MT",
            "postal_code": "599013109",
            "telephone_number": "406-752-8300",
            "fax_number": "406-752-3542"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DYKSTRA",
        "first_name": "LYNN",
        "middle_name": "ANN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-21",
        "last_updated": "2023-11-27",
        "certification_date": "2020-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MT",
            "license": "10389",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0066495",
            "state": "MT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "95755",
            "state": "MT"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "krmcmedicalrecords@krhdirect.org",
            "affiliation": "Y",
            "affiliationName": "Kalispell Regional Medical Center Inc",
            "address_1": "1273 Burns Way",
            "city": "Kalispell",
            "state": "MT",
            "country_code": "US",
            "postal_code": "599013109",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Kalispell, MT

Sources for this page

Verify at the official NPI Registry.