NPIMap

Organization Active NPI

Rocky Mountain Neuropsychology PLLC

  • Clinical Neuropsychologist
  • Bozeman, MT
National Provider Identifier
1316089451
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical NeuropsychologistTaxonomy code 103G00000X
License
368 Issued in MT
Legal business name
ROCKY MOUNTAIN NEUROPSYCHOLOGY PLLC
Practice address
1648 Ellis St
#302
Bozeman, MT 59715-8810
Phone
(406) 582-4466
Fax
(406) 587-1513
NPI assigned
Feb 13, 2007
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. Jeffrey Michael Cory, PH.D.NPI 1427110600
Title
Owner Member
Phone
(406) 582-4466

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical NeuropsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103G00000X 368 MT Primary

Addresses

Primary practice location

1648 Ellis St
#302
Bozeman, MT 59715-8810

Mailing address

1648 Ellis St
#302
Bozeman, MT 59715-8810
Phone (406) 582-4466

Other identifiers 2

IdentifierTypeStateIssuer
0493221MedicaidMT
52571OtherMTBCBS MT

National Provider Directory

National Provider Directory

Locations

115 W Kagy Blvd
Ste O
Bozeman, MT 59715
Phone (406) 414-6774

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1171324800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1316089451",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1648 ELLIS ST",
            "address_2": "#302",
            "city": "BOZEMAN",
            "state": "MT",
            "postal_code": "597158810",
            "telephone_number": "406-582-4466",
            "fax_number": "406-587-1513"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1648 ELLIS ST",
            "address_2": "#302",
            "city": "BOZEMAN",
            "state": "MT",
            "postal_code": "597158810",
            "telephone_number": "406-582-4466",
            "fax_number": "406-587-1513"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROCKY MOUNTAIN NEUROPSYCHOLOGY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-13",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "CORY",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "MICHAEL",
        "authorized_official_title_or_position": "OWNER MEMBER",
        "authorized_official_telephone_number": "406-582-4466",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Clinical Neuropsychologist",
            "state": "MT",
            "license": "368",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0493221",
            "state": "MT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS MT",
            "identifier": "52571",
            "state": "MT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bozeman, 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.