Three Rivers Eye Care Center, PC

Primary specialty

Exclusive Provider OrganizationTaxonomy code 302F00000X

License

8180 Issued in MT

Legal business name

THREE RIVERS EYE CARE CENTER, PC

Practice address

1200 South Reserve Street
Suite H
Missoula, MT 59801-3701

Phone

(406) 543-9200

Fax

(406) 543-9222

NPI assigned

Aug 3, 2006

Organization subpart

No

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

Authorized official

Name

Dr. George A Stern, M.D.

Title

President

Phone

(406) 543-9200

Specialties & licenses 1

Addresses

Other identifiers 4

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

{
    "created_epoch": "1154563200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1255478400000",
    "number": "1316955909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 SOUTH RESERVE STREET",
            "address_2": "SUITE H",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598013701",
            "telephone_number": "406-543-9200",
            "fax_number": "406-543-9222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 SOUTH RESERVE STREET",
            "address_2": "SUITE H",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598013701",
            "telephone_number": "406-543-9200",
            "fax_number": "406-543-9222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THREE RIVERS EYE CARE CENTER, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-03",
        "last_updated": "2009-10-14",
        "status": "A",
        "authorized_official_last_name": "STERN",
        "authorized_official_first_name": "GEORGE",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "406-543-9200",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "302F00000X",
            "taxonomy_group": "",
            "desc": "Exclusive Provider Organization",
            "state": "MT",
            "license": "8180",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "95001",
            "state": "MT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0169507",
            "state": "MT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0035581",
            "state": "MT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "0005120600",
            "state": "MT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Carolyn Louise Thornton, R.N.
• Naomi S Thornton, L.C.S.W.
• Christi L Thorsell
• Darci Thorsrud, CNP
• Michael Thrall, CRT
• Three Rivers Oncology
• Thrive Therapy, LLC
• Derek Lee Thrush, ACLC
• THS, Inc (Advantage Therapy)
• Lorraine Thunstrom, M.S., SLP-CF

• Exclusive Provider Organization in Missoula, MT
• Providers in Missoula, MT by specialty
• Exclusive Provider Organization in Montana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2009; 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.