NPIMap

Organization Active NPI

Shannon Setzer M.D., P.C.

  • Dermatology Physician
  • Bozeman, MT
National Provider Identifier
1316188337
Registry record updated Feb 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
Legal business name
SHANNON SETZER M.D., P.C.
Practice address
4515 Valley Commons Dr Ste 202
Bozeman, MT 59718-4532
Phone
(406) 587-7546
Fax
(406) 585-5672
NPI assigned
Mar 20, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2025

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

Authorized official

Name
Shannon Voirin Setzer, M.D.NPI 1639355928
Title
President
Phone
(406) 587-7546

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
Dermatology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207N00000X Primary
Clinic/Center 261Q00000X 11661 MT

Addresses

Primary practice location

4515 Valley Commons Dr Ste 202
Bozeman, MT 59718-4532

Mailing address

4515 Valley Commons Dr Ste 202
Bozeman, MT 59718-4532
Phone (406) 587-7546

Other names 1

  • Big Sky Dermatology Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090401000475 MT Part B Supplier - Clinic/Group Practice 5698822989 Receives reassigned benefits from 5 practitioners
Practice locations: Bozeman, MT

National Provider Directory

National Provider Directory

Locations

1600 Ellis St
Ste 3B
Bozeman, MT 59715
Phone (406) 587-7546

Practitioners & affiliated clinicians

Practitioners 5

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": "1237507200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1740009600000",
    "number": "1316188337",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4515 VALLEY COMMONS DR STE 202",
            "city": "BOZEMAN",
            "state": "MT",
            "postal_code": "597184532",
            "telephone_number": "406-587-7546",
            "fax_number": "406-585-5672"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4515 VALLEY COMMONS DR STE 202",
            "city": "BOZEMAN",
            "state": "MT",
            "postal_code": "597184532",
            "telephone_number": "406-587-7546",
            "fax_number": "406-585-5672"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHANNON SETZER M.D., P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-03-20",
        "last_updated": "2025-02-20",
        "certification_date": "2025-02-20",
        "status": "A",
        "authorized_official_last_name": "SETZER",
        "authorized_official_first_name": "SHANNON",
        "authorized_official_middle_name": "VOIRIN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "406-587-7546",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "MT",
            "license": "11661",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Big Sky Dermatology",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Big Sky Dermatology",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Feb 20, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.