Active NPI
Natasha Haines, NP
- Nurse Practitioner
- Libby, MT
National Provider Identifier
1336457571
On this page
OIG exclusion record
The HHS Office of Inspector General’s List of Excluded Individuals/Entities (LEIE) contains a record with this NPI:
- Section 1128b(4) exclusion effective Dec 20, 2018.
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 31522
- Practice address
- 116 E Balsam St
Libby, MT 59923-2402 - Phone
- (406) 334-4550
- NPI assigned
- Sep 22, 2010
- Last updated
- Sep 20, 2016
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 31522 | MT | Primary |
Addresses
Primary practice location
116 E Balsam St
Libby, MT 59923-2402
Mailing address
116 E Balsam St
Libby, MT 59923-2402
Phone (406) 334-4550
Other names 1
- Mrs. Natasha Pennock
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 31522 | MT | MD | Assisted Living Facility |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1285113600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1474329600000",
"number": "1336457571",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "116 E BALSAM ST",
"city": "LIBBY",
"state": "MT",
"postal_code": "599232402",
"telephone_number": "406-334-4550"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "116 E BALSAM ST",
"city": "LIBBY",
"state": "MT",
"postal_code": "599232402",
"telephone_number": "406-334-4550"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HAINES",
"first_name": "NATASHA",
"credential": "NP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-09-22",
"last_updated": "2016-09-20",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "MT",
"license": "31522",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "NATASHA",
"last_name": "PENNOCK",
"prefix": "MRS.",
"credential": "NP",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Libby, MT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.