Jacquelyn Kaye Free, FNP
Individual provider Active NPI Family Nurse Practitioner · Fairview, MT
NPI 1336302736 · NPPES record last updated Dec 10, 2020
Key facts
- NPI
- 1336302736
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 37798 (MT)
- Practice address
- 304 S Ellery Ave
Fairview, MT 59221-7210 - Phone
- (406) 742-5261
- NPI assigned
- Jul 7, 2008
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 5
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MT
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20100106000161 | MT | Practitioner - Nurse Practitioner | 7719052067 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 37798 | MT | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sidney Health Center | Current |
Accepting new patients | |
| Sidney Health Center | Current | Accepting new patients | |
| Sidney Health Center | Current |
Accepting new patients | |
| Frances Mahon Deaconess Hospital | Past | Accepting new patients |
Locations
214 14th Ave SW
Sidney, MT 59270
Phone (406) 488-2100
216 14th Ave SW
Sidney, MT 59270
Phone (406) 488-2100
214 14th Ave SW
Ste 110
Sidney, MT 59270
Phone (406) 488-2100
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | R29434 | ND | |
| Family Nurse Practitioner | 363LF0000X | 37798 | MT | Yes |
Addresses
Primary practice location
304 S Ellery Ave
Fairview, MT 59221-7210
Mailing address
304 S Ellery Ave
Fairview, MT 59221-7210
Phone (406) 742-5261
Other names
- Jacquelyn Kaye Cayko
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | jfree4984733@direct.sanfordhealth.org | Direct |
Other providers in Fairview, MT
- Gabriel Anthony Bernacchi Jr.
- Barbara Diane Danielson
- Lori Dore
- Dee Laura Hamburg
- Montana Migrant and Seasonal Farmworkers Council Inc
- Cammi Seader
- Sidney Health Center
- Sidney Health Center
All providers in Fairview, MT · Family Nurse Practitioner in Montana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 10, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.