Bill J Tacke, MD

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

License

4564 Issued in MT

Practice address

500 15TH Ave S
Suite One
Great Falls, MT 59405-4304

Phone

(406) 455-2149

Fax

(406) 455-2141

NPI assigned

Dec 14, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Montana Plains Rehabilitation PC

  • Physical Medicine & Rehabilitation Physician
  • Great Falls, MT
  • NPI 1679550107
  NPD (past) Authorized official
• Frances Mahon Deaconess Hospital

  • Critical Access Hospital
  • Glasgow, MT
  • NPI 1689685323
  NPD (past)

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

{
    "created_epoch": "1134518400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1379289600000",
    "number": "1336124288",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 15TH AVE S",
            "address_2": "SUITE ONE",
            "city": "GREAT FALLS",
            "state": "MT",
            "postal_code": "594054304",
            "telephone_number": "406-455-2140",
            "fax_number": "406-455-2141"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 15TH AVE S",
            "address_2": "SUITE ONE",
            "city": "GREAT FALLS",
            "state": "MT",
            "postal_code": "594054304",
            "telephone_number": "406-455-2149",
            "fax_number": "406-455-2141"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TACKE",
        "first_name": "BILL",
        "middle_name": "J",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-14",
        "last_updated": "2013-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "MT",
            "license": "4564",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "250002667",
            "state": "MT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0013286",
            "state": "MT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jeff Alan Swift, PT
• Carly H Swingley, LCPC
• Tiffany Denise Sykes
• Charity Marie Symonds, BCBA
• Synergy Medical Care
• Belinda Tadej
• Andrew Steven Taecker, DO
• Matthew Clayton Taecker
• Amanda Taggart, PHARMD
• Patrick Tang, MD

• Physical Medicine & Rehabilitation Physician in Great Falls, MT
• Providers in Great Falls, MT by specialty
• Physical Medicine & Rehabilitation Physician in Montana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2013; 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.