NPIMap

Organization Active NPI

Sidney Health Center

Doing business as Sidney Health Center Clinic

  • Clinic/Center
  • Sidney, MT
National Provider Identifier
1376617191
Registry record updated Dec 8, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
SIDNEY HEALTH CENTER
Doing business as
Sidney Health Center Clinic
Practice address
214 14TH Ave SW
Ste 107
Sidney, MT 59270-3521
Phone
(406) 488-2169
Fax
(406) 488-2149
NPI assigned
Nov 20, 2006
Last updated
Dec 8, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2020

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

Authorized official

Name
Tina Montgomery
Title
Senior Executive, Finance/Cfo
Phone
(406) 488-2117

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X NU Primary

Addresses

Primary practice location

214 14TH Ave SW
Ste 107
Sidney, MT 59270-3521

Mailing address

214 14TH Ave SW
Ste 107
Sidney, MT 59270-3521
Phone (406) 488-2169

Other identifiers 2

IdentifierTypeStateIssuer
000082342OtherMTBLUE CROSS OF MT
15860MedicaidND

Other names 1

  • Sidney Health Center Clinic Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address sanford_toc1008865@direct.sanfordhealth.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MT2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040115000513 MT Part B Supplier - Clinic/Group Practice 0749181535 Receives reassigned benefits from 149 practitioners
2 other NPIs on this enrollment
Practice locations: Sidney, MT
O20180622001288 MT DME Supplier - Physician - Podiatry 0749181535 Practice locations: Sidney, MT

Other NPIs with the same Medicare PAC ID 5

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Ownership & related parties

All facility ownership & control disclosures 3

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Sidney Health CenterSidney, MT, CCN 271344 Hospital 5% Or Greater Direct Ownership Interest (100%) Jan 1, 1966
Sidney Health CenterSidney, MT, CCN 27Z344 Hospital 5% Or Greater Direct Ownership Interest (100%) Oct 1, 2007
Sidney Health Center Extended CareSidney, MT, CCN 275121 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control
Direct Ownership Interest (100%)		 Jun 28, 1996
Feb 6, 1988
Jun 28, 1996

Owned or controlled facilities with NPI records 3

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Practitioners & affiliated clinicians

Practitioners 164

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 164

NPI Registry JSON

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

{
    "created_epoch": "1163980800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1607385600000",
    "number": "1376617191",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "214 14TH AVE SW",
            "address_2": "STE 107",
            "city": "SIDNEY",
            "state": "MT",
            "postal_code": "592703521",
            "telephone_number": "406-488-2169",
            "fax_number": "406-488-2149"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "214 14TH AVE SW",
            "address_2": "STE 107",
            "city": "SIDNEY",
            "state": "MT",
            "postal_code": "592703521",
            "telephone_number": "406-488-2169",
            "fax_number": "406-488-2149"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SIDNEY HEALTH CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-20",
        "last_updated": "2020-12-08",
        "certification_date": "2020-12-08",
        "status": "A",
        "authorized_official_last_name": "MONTGOMERY",
        "authorized_official_first_name": "TINA",
        "authorized_official_title_or_position": "SENIOR EXECUTIVE, FINANCE/CFO",
        "authorized_official_telephone_number": "406-488-2117"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS OF MT",
            "identifier": "000082342",
            "state": "MT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "15860",
            "state": "ND"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sanford_toc1008865@direct.sanfordhealth.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCDA",
            "address_1": "214 14th Ave SW",
            "address_2": "Ste 107",
            "city": "Sidney",
            "state": "MT",
            "country_code": "US",
            "postal_code": "592703521",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Sidney Health Center Clinic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Sidney Health Center Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Sidney, MT

Sources for this page

Verify at the official NPI Registry.