Organization Active NPI

Cottonwood Clinic, LLC

  • Clinic/Center
  • Deer Lodge, MT
National Provider Identifier
1306262803
Registry record updated Mar 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
COTTONWOOD CLINIC, LLC
Practice address
310 Main St
Deer Lodge, MT 59722-1000
Phone
(406) 846-4275
Fax
(406) 846-7278
NPI assigned
Mar 10, 2014
Last updated
Mar 12, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 12, 2024

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

Authorized official

Name
Heide Lynn Applegate, FNP-CNPI 1043337140
Title
Owner, NP
Phone
(406) 846-4275

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X NU Primary
Family Nurse Practitioner 363LF0000X 25000 MT

Addresses

Primary practice location

310 Main St
Deer Lodge, MT 59722-1000

Mailing address

310 Main St
Deer Lodge, MT 59722-1000
Phone (406) 846-4275

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MT

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140527000755 MT Part B Supplier - Clinic/Group Practice 0648493387 Receives reassigned benefits from 2 practitioners
Practice locations: Deer Lodge, MT

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
27D2076119Cottonwood Clinic, LLC310 Main St, Deer Lodge, MT 59722Certificate of waiverApr 10, 2028

National Provider Directory

National Provider Directory

Locations

310 Main St
Deer Lodge, MT 59722
Phone (406) 846-3448

Practitioners & affiliated clinicians

Practitioners 2

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": "1394409600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1710201600000",
    "number": "1306262803",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "310 MAIN ST",
            "city": "DEER LODGE",
            "state": "MT",
            "postal_code": "597221000",
            "telephone_number": "406-846-4275",
            "fax_number": "406-846-7278"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "310 MAIN ST",
            "city": "DEER LODGE",
            "state": "MT",
            "postal_code": "597221000",
            "telephone_number": "406-846-4275",
            "fax_number": "406-846-7278"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COTTONWOOD CLINIC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-03-10",
        "last_updated": "2024-03-12",
        "certification_date": "2024-03-12",
        "status": "A",
        "authorized_official_last_name": "APPLEGATE",
        "authorized_official_first_name": "HEIDE",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "OWNER, NP",
        "authorized_official_telephone_number": "406-846-4275",
        "authorized_official_credential": "FNP-C"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MT",
            "license": "25000",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Deer Lodge, MT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.