NPIMap

Individual provider Active NPI

Scott Richard Jahnke, DO

  • Interventional Pain Medicine Physician
  • Kalispell, MT
National Provider Identifier
1336250208
Registry record updated Mar 26, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X
License
10947 Issued in MT
Practice address
3 Meridian CT Ste 2
Kalispell, MT 59901-4240
Phone
(406) 755-4488
NPI assigned
Aug 31, 2006
Last updated
Mar 26, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 26, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine (Physical Medicine & Rehabilitation) Physician 2081P2900X 10947 MT
Interventional Pain Medicine Physician 208VP0014X 10947 MT Primary

Addresses

Primary practice location

3 Meridian CT Ste 2
Kalispell, MT 59901-4240

Mailing address

3 Meridian CT Ste 2
Kalispell, MT 59901-4240
Phone (406) 755-4488

Other identifiers 2

IdentifierTypeStateIssuer
554111654OtherMIBLUE CROSS BLUE SHIELD
4976249-11MedicaidMI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MT
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051130000620 MT Practitioner - Interventional Pain ManagementPractitioner - Family PracticePractitioner - Physical Medicine and Rehabilitation 9133149537 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Interventional Pain ManagementAlso: Physical Medicine and Rehabilitation
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3 Meridian CT
Suite 2
Kalispell, MT 59901-4240
Phone (406) 755-4488

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
10947MTMDPain Medicine (Physical Medicine & Rehabilitation) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kansas Orthopaedic Center, P.a. Past Accepting new patients
Michigan Pain Consultants PC Past Accepting new patients
Frances Mahon Deaconess Hospital Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/EJDADD

Organizations & group practices 4

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

Hospital & facility affiliations 8

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

NPI Registry JSON

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1585180800000",
    "number": "1336250208",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 MERIDIAN CT STE 2",
            "city": "KALISPELL",
            "state": "MT",
            "postal_code": "599014240",
            "telephone_number": "406-755-4488"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 MERIDIAN CT STE 2",
            "city": "KALISPELL",
            "state": "MT",
            "postal_code": "599014240",
            "telephone_number": "406-755-4488"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAHNKE",
        "first_name": "SCOTT",
        "middle_name": "RICHARD",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-31",
        "last_updated": "2020-03-26",
        "certification_date": "2020-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2081P2900X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": "MT",
            "license": "10947",
            "primary": false
        },
        {
            "code": "208VP0014X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "MT",
            "license": "10947",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "554111654",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4976249-11",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kalispell, MT

Sources for this page

Verify at the official NPI Registry.