NPIMap

Individual provider Active NPI

Kathleen S Blair, DO

  • Internal Medicine Physician
  • Great Falls, MT
National Provider Identifier
1346335189
Registry record updated Apr 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
11368 Issued in MT
Practice address
1401 25TH St S
Great Falls, MT 59405-5183
Phone
(406) 731-8888
Fax
(406) 731-8876
NPI assigned
Oct 4, 2006
Last updated
Apr 5, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 5, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 4193 AZ
Internal Medicine Physician 207R00000X 11368 MT Primary

Addresses

Primary practice location

1401 25TH St S
Great Falls, MT 59405-5183

Mailing address

1401 25TH St S
Great Falls, MT 59405-5183
Phone (406) 731-8888

Other identifiers 1

IdentifierTypeStateIssuer
945363MedicaidAZ

Other names 1

  • Kathleen Suzanne Suckow Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kblair19129@benefishs.direct-ci.com Benefis Hospitals Inc

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
I20070525000220 MT Practitioner - Internal Medicine 8729016936 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Benefis Hospitals IncGroup PAC ID 1153235296, 390 clinicians

Practice addresses (Care Compare)

1401 25TH St S
Great Falls, MT 59405-5183
Phone (406) 455-5000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
82.99 of 100Reported as group
Quality
62.64
Promoting interoperability
100
Improvement activities
40
Cost
80.67

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11368MTMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Benefis Hospitals Inc CurrentSince Jan 1, 2012 Accepting new patients
Benefis Hospitals, Inc. CurrentSince Jan 1, 2012 Accepting new patients
Glendale Urgent Care LLC Past Accepting new patients
Cogent Healthcare of Montana P C Internal Medicine Past Accepting new patients
Shea Urgent Care LLC Past Accepting new patients
Avondale Urgent Care LLC Past Accepting new patients
Pinnacle Medicine Inc. Past Accepting new patients
Greenway Urgent Care LLC Past Accepting new patients
Frances Mahon Deaconess Hospital Past Accepting new patients
Benefis Hospitals, Inc. Past Accepting new patients
Dana Landing Urgent Care LLC Past Accepting new patients
Desert Ridge Urgent Care LLC Past Accepting new patients
Chandler Urgent Care LLC Past Accepting new patients
Sun City Urgent Care LLC Past Accepting new patients

Locations

1101 26th St S
Great Falls, MT 59405
Phone (406) 455-4690

1101 26th St S
Fl 5
Great Falls, MT 59405
Phone (406) 455-2132

1401 25th St S
Great Falls, MT 59405
Phone (406) 455-3650

400 13th Ave S
Ste 101
Great Falls, MT 59405
Phone (406) 455-2821

500 15th Ave S
Great Falls, MT 59405
Phone (406) 455-2021

Organizations & group practices 14

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.

View all 14

Hospital & facility affiliations 10

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": "1159920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712275200000",
    "number": "1346335189",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1401 25TH ST S",
            "city": "GREAT FALLS",
            "state": "MT",
            "postal_code": "594055183",
            "telephone_number": "406-731-8888",
            "fax_number": "406-731-8876"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 25TH ST S",
            "city": "GREAT FALLS",
            "state": "MT",
            "postal_code": "594055183",
            "telephone_number": "406-731-8888",
            "fax_number": "406-731-8876"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLAIR",
        "first_name": "KATHLEEN",
        "middle_name": "S",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-04",
        "last_updated": "2024-04-05",
        "certification_date": "2024-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AZ",
            "license": "4193",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MT",
            "license": "11368",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "945363",
            "state": "AZ"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kblair19129@benefishs.direct-ci.com",
            "affiliation": "Y",
            "affiliationName": "Benefis Hospitals Inc",
            "address_1": "1401 25th St S",
            "city": "Great Falls",
            "state": "MT",
            "country_code": "US",
            "postal_code": "594055183",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "KATHLEEN",
            "last_name": "SUCKOW",
            "middle_name": "SUZANNE",
            "credential": "DO",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Great Falls, MT

Sources for this page

Verify at the official NPI Registry.