Individual provider Active NPI

Sandra Slay Poyner

  • Clinical Laboratory Director (Non-physician)
  • Poplar, MT
National Provider Identifier
1336587740
Registry record updated Jun 7, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Laboratory Director (Non-physician)Taxonomy code 247ZC0005X
License
80859 Issued in LA
Practice address
107 H Street East
Box 67
Poplar, MT 59255-0067
Phone
(406) 653-1656
NPI assigned
Jun 7, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 7, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Laboratory Director (Non-physician) 247ZC0005X 80859 LA Primary

Addresses

Primary practice location

107 H Street East
Box 67
Poplar, MT 59255-0067

Mailing address

PO Box 67
107 H Street East
Poplar, MT 59255-0067
Phone (406) 653-1656

Other identifiers 1

IdentifierTypeStateIssuer
9990118MedicaidMT

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

State licenses

LicenseStateTypeSpecialty
80859LAMDClinical Laboratory Director (Non-physician)

NPI Registry JSON

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

{
    "created_epoch": "1370563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1370563200000",
    "number": "1336587740",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 67",
            "address_2": "107 H STREET EAST",
            "city": "POPLAR",
            "state": "MT",
            "postal_code": "592550067",
            "telephone_number": "406-653-1656"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 H STREET EAST",
            "address_2": "BOX 67",
            "city": "POPLAR",
            "state": "MT",
            "postal_code": "592550067",
            "telephone_number": "406-653-1656"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POYNER",
        "first_name": "SANDRA",
        "middle_name": "SLAY",
        "name_prefix": "Miss",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-06-07",
        "last_updated": "2013-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "247ZC0005X",
            "taxonomy_group": "",
            "desc": "Technician, Pathology, Clinical Laboratory Director, Non-physician",
            "state": "LA",
            "license": "80859",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9990118",
            "state": "MT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Poplar, MT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 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.