Organization Active NPI

Fetal Diagnostic Center PC

  • Maternal & Fetal Medicine Physician
  • Billings, MT
National Provider Identifier
1306055645
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Maternal & Fetal Medicine PhysicianTaxonomy code 207VM0101X
License
8687 Issued in MT
Legal business name
FETAL DIAGNOSTIC CENTER PC
Practice address
2900 12TH Ave N Ste 130W
Billings, MT 59101-7595
Phone
(406) 237-5888
Fax
(406) 237-5899
NPI assigned
May 22, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. David Neal Jackson, M.D.
Title
Owner
Phone
(406) 238-5888

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Maternal & Fetal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207VM0101X 8687 MT Primary

Addresses

Primary practice location

2900 12TH Ave N Ste 130W
Billings, MT 59101-7595

Mailing address

2900 12TH Ave N Ste 130W
Billings, MT 59101-7595
Phone (406) 237-5888

Other identifiers 1

IdentifierTypeStateIssuer
0000017663MedicaidMT

National Provider Directory

National Provider Directory

Locations

44215 15th St W
Ste 112
Lancaster, CA 93534

50 Alessandro Pl
Ste 330
Pasadena, CA 91105
Phone (626) 583-8911

2900 12th Ave N
Ste 130W
Billings, MT 59101
Phone (406) 237-5888

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1179792000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1306055645",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2900 12TH AVE N STE 130W",
            "city": "BILLINGS",
            "state": "MT",
            "postal_code": "591017595",
            "telephone_number": "406-237-5888",
            "fax_number": "406-237-5899"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2900 12TH AVE N STE 130W",
            "city": "BILLINGS",
            "state": "MT",
            "postal_code": "591017595",
            "telephone_number": "406-237-5888",
            "fax_number": "406-237-5899"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FETAL DIAGNOSTIC CENTER PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-22",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "NEAL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "406-238-5888",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207VM0101X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology, Maternal & Fetal Medicine",
            "state": "MT",
            "license": "8687",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0000017663",
            "state": "MT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Billings, MT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.