Libby A Costello Gard, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

NUR-APRN-LIC-126782 Issued in MT

Practice address

1211 S Reserve St Ste 101
Missoula, MT 59801-3103

Phone

(406) 327-3057

Fax

(406) 327-3231

NPI assigned

Aug 7, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in MT

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Sapphire Community Health IncGroup PAC ID 8123153244, 38 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• St. Patrick Hospital Hospital, Missoula, MT, CCN 270014
• Bitterroot Health - Daly Hospital Hospital, Hamilton, MT, CCN 271340
• Community Medical Center Hospital, Missoula, MT, CCN 270023

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir-myrecord.cerner.com/r4/b2651172-99ed-43dd-9814-59d9dbd8df43/
• Direct secure messaging: lcostellogard107901@wm.providencedirect.org

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Sapphire Community Health Inc

  • Federally Qualified Health Center (FQHC)
  • Hamilton, MT
  • NPI 1003146812
  Medicare reassignment Care Compare group NPD
• Providence Health & Services Mt

  • Rehabilitation Hospital Unit
  • Missoula, MT
  • NPI 1144319138
  Medicare reassignment NPD
• Providence Health & Services Mt

  • Family Medicine Physician
  • Missoula, MT
  • NPI 1215222617
  NPD
• Providence Health & Services Mt

  • Psychiatric/Mental Health Nurse Practitioner
  • Missoula, MT
  • NPI 1558530683
  NPD
• Providence Health & Services Mt

  • Pulmonary Disease Physician
  • Missoula, MT
  • NPI 1427096585
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Marcus Daly Memorial Hospital Corporation

  • Critical Access Hospital
  • Hamilton, MT
  • NPI 1659475846
  Care Compare affiliation
• Providence Health & Services Mt

  • General Acute Care Hospital
  • Missoula, MT
  • NPI 1023032588
  Care Compare affiliation
• Providence Health & Services Mt

  • Medical Oncology Physician
  • Missoula, MT
  • NPI 1326483587

  Hospital

  Care Compare affiliation
• Providence Health & Services Mt

  • Anatomic Pathology & Clinical Pathology Physician
  • Missoula, MT
  • NPI 1366185928

  Hospital

  Care Compare affiliation
• Providence Health & Services Mt

  • Psychiatric Hospital Unit
  • Missoula, MT
  • NPI 1619058302
  Care Compare affiliation
• RCHP Billings - Missoula LLC

  • General Acute Care Hospital
  • Missoula, MT
  • NPI 1346642899
  Care Compare affiliation

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

{
    "created_epoch": "1186444800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620604800000",
    "number": "1326239195",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 W BROADWAY ST",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598024008",
            "telephone_number": "406-327-1918",
            "fax_number": "406-549-2246"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1211 S RESERVE ST STE 101",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598013103",
            "telephone_number": "406-327-3057",
            "fax_number": "406-327-3231"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COSTELLO GARD",
        "first_name": "LIBBY",
        "middle_name": "A",
        "name_prefix": "Mrs.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-07",
        "last_updated": "2021-05-10",
        "certification_date": "2021-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP2201X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Ambulatory Care",
            "state": "OR",
            "license": "099007632RN",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OR",
            "license": "200850014NP",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MT",
            "license": "NUR-APRN-LIC-126782",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500616442",
            "state": "OR"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lcostellogard107901@wm.providencedirect.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1211 S Reserve St Ste 101",
            "city": "Missoula",
            "state": "MT",
            "country_code": "US",
            "postal_code": "598013103",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Keegan Shea Cossio, LAT, ATC
• Costcare, PLLC
• Costco Wholesale Corporation
• Costco Wholesale Corporation
• Costco Wholesale Corporation
• Haley Marie Cote, PHARMD
• Joan Cottrell, LMT
• Valerie Coulter, LCSW
• Country Home Estate, Inc
• County of Missoula

• Family Nurse Practitioner in Missoula, MT
• Providers in Missoula, MT by specialty
• Family Nurse Practitioner in Montana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.