NPIMap

Organization Active NPI

Missoula Community Health Services, Inc.

Doing business as Tamarack Medical Clinic

  • Rural Health Clinic/Center
  • Superior, MT
National Provider Identifier
1376637470
Registry record updated Apr 5, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
MISSOULA COMMUNITY HEALTH SERVICES, INC.
Doing business as
Tamarack Medical Clinic
Practice address
1208 6TH Ave E
Superior, MT 59872
Phone
(406) 822-4841
Fax
(406) 822-4963
NPI assigned
Oct 3, 2006
Organization subpart
Yes
Parent organization
MISSOULA COMMUNITY HEALTH SERVICES, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 5, 2019

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

Authorized official

Name
Mr. John S McNeece
Title
Ceo
Phone
(406) 822-4841

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207Q00000X
Family Medicine PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207Q00000X MT
Rural Health Clinic/Center 261QR1300X 11203 MT
Rural Health Clinic/Center 261QR1300X MT Primary

Addresses

Primary practice location

1208 6TH Ave E
Superior, MT 59872

Mailing address

PO Box 66
Superior, MT 59872
Phone (406) 822-4841

Other identifiers 3

IdentifierTypeStateIssuer
9989941OtherMTPASSPORT PROVIDER NUMBER
720460MedicaidMT
0000066882OtherMTBLUE CROSS BLUE SHEILD

Other names 1

  • Tamarack Medical Clinic Doing business as

National Provider Directory

National Provider Directory
Part of
MCHS Inc

NPI Registry JSON

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1554422400000",
    "number": "1376637470",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 66",
            "city": "SUPERIOR",
            "state": "MT",
            "postal_code": "59872",
            "telephone_number": "406-822-4841",
            "fax_number": "406-822-4963"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1208 6TH AVE E",
            "city": "SUPERIOR",
            "state": "MT",
            "postal_code": "59872",
            "telephone_number": "406-822-4841",
            "fax_number": "406-822-4963"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MISSOULA COMMUNITY HEALTH SERVICES, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MISSOULA COMMUNITY HEALTH SERVICES, INC.",
        "enumeration_date": "2006-10-03",
        "last_updated": "2019-04-05",
        "status": "A",
        "authorized_official_last_name": "MCNEECE",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "406-822-4841",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "MT",
            "license": null,
            "primary": false
        },
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "MT",
            "license": "11203",
            "primary": false
        },
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "MT",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PASSPORT PROVIDER NUMBER",
            "identifier": "9989941",
            "state": "MT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "720460",
            "state": "MT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHEILD",
            "identifier": "0000066882",
            "state": "MT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Tamarack Medical Clinic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Tamarack Medical Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Superior, MT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2019; 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.