NPIMap

Organization Active NPI

State of Montana

  • Oral and Maxillofacial Surgery Clinic/Center
  • Helena, MT
National Provider Identifier
1366748147
Registry record updated Jan 27, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery Clinic/CenterTaxonomy code 261QS0112X
Legal business name
STATE OF MONTANA
Practice address
1400 Broadway RM A116
Helena, MT 59620
Phone
(406) 444-3529
Fax
(406) 444-2750
NPI assigned
Jan 27, 2011
Organization subpart
Yes
Parent organization
STATE OF MONTANAAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 27, 2011

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

Authorized official

Name
Michele S O'Donnell
Title
Billing Agent
Phone
(406) 444-3529

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery Clinic/Center 261QS0112X Primary

Addresses

Primary practice location

1400 Broadway RM A116
Helena, MT 59620

Mailing address

PO Box 202951
Helena, MT 59620-2951
Phone (406) 444-3529

Other identifiers 4

IdentifierTypeStateIssuer
99248OtherMTBLUE CROSS BLUE SHIELD OF MONTANA
0260000MedicaidMT
92046OtherMTBLUE CROSS BLUE SHIELD OF MONTANA
92056OtherMTBLUE CROSS BLUE SHIELD OF MONTANA

Other names 1

  • Children's Special Health Services Other name

National Provider Directory

National Provider Directory
Tax ID family
John D Moore MD12 organizations share this tax ID, including this one
Part of
John D Moore MD

Other organizations with this tax ID 11

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1400 E Broadway St
Rm A116
Helena, MT 59601
Phone (406) 444-3529

NPI Registry JSON

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

{
    "created_epoch": "1296086400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1296086400000",
    "number": "1366748147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 202951",
            "city": "HELENA",
            "state": "MT",
            "postal_code": "596202951",
            "telephone_number": "406-444-3529",
            "fax_number": "406-444-2750"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 BROADWAY RM A116",
            "city": "HELENA",
            "state": "MT",
            "postal_code": "59620",
            "telephone_number": "406-444-3529",
            "fax_number": "406-444-2750"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STATE OF MONTANA",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "STATE OF MONTANA",
        "enumeration_date": "2011-01-27",
        "last_updated": "2011-01-27",
        "status": "A",
        "authorized_official_last_name": "O'DONNELL",
        "authorized_official_first_name": "MICHELE",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "BILLING AGENT",
        "authorized_official_telephone_number": "406-444-3529"
    },
    "taxonomies": [
        {
            "code": "261QS0112X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Oral and Maxillofacial Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD OF MONTANA",
            "identifier": "99248",
            "state": "MT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0260000",
            "state": "MT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD OF MONTANA",
            "identifier": "92046",
            "state": "MT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD OF MONTANA",
            "identifier": "92056",
            "state": "MT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Children's Special Health Services",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Helena, MT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2011; 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.