NPIMap

Individual provider Active NPI

Kevin Oberholser, PA-C

  • Medical Physician Assistant
  • Kalispell, MT
National Provider Identifier
1386046316
Registry record updated Nov 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
35029 Issued in MT
Practice address
1287 Burns Way
Kalispell, MT 59901-3109
Phone
(406) 752-8120
NPI assigned
Sep 22, 2014
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 27, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X
Medical Physician Assistant 363AM0700X 35029 MT Primary

Addresses

Primary practice location

1287 Burns Way
Kalispell, MT 59901-3109

Mailing address

1287 Burns Way
Kalispell, MT 59901-3109
Phone (406) 752-8120

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address krmcmedicalrecords@krhdirect.org Kalispell Regional Medical Center 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
I20141118001633 MT Practitioner - Physician Assistant 0840412334 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kalispell Regional Medical Center IncGroup PAC ID 5294644381, 422 clinicians

Practice addresses (Care Compare)

1273 Burns Way
Kalispell, MT 59901-3109
Phone (406) 752-8300

160 Heritage Way
Kalispell, MT 59901-3127

350 Heritage Way
Kalispell, MT 59901-3167

Hospital & facility affiliations

  • Logan Health Medical Center Hospital, Kalispell, MT, CCN 270051
  • Logan Health - Whitefish Hospital, Whitefish, MT, CCN 271336

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
35029MTMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Kalispell Regional Medical Center, Inc CurrentSince Oct 13, 2014 Accepting new patients
Kalispell Regional Medical Center Inc Current Accepting new patients
Kalispell Regional Medical Center Inc CurrentSince Oct 13, 2014 Accepting new patients
Kalispell Regional Medical Center, Inc Past Accepting new patients

Locations

1280 Burns Way
Kalispell, MT 59901
Phone (406) 752-2010

1287 Burns Way
Kalispell, MT 59901
Phone (406) 752-8120

350 Heritage Way
Ste 2100
Kalispell, MT 59901
Phone (406) 257-8992

310 Sunnyview Ln
Kalispell, MT 59901
Phone (406) 751-5310

Interoperability endpoints

  • Direct secure messaging: krmcmedicalrecords@krhdirect.org

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 8

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": "1411344000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701043200000",
    "number": "1386046316",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1287 BURNS WAY",
            "city": "KALISPELL",
            "state": "MT",
            "postal_code": "599013109",
            "telephone_number": "406-752-8120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1287 BURNS WAY",
            "city": "KALISPELL",
            "state": "MT",
            "postal_code": "599013109",
            "telephone_number": "406-752-8120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OBERHOLSER",
        "first_name": "KEVIN",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-09-22",
        "last_updated": "2023-11-27",
        "certification_date": "2020-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MT",
            "license": "35029",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "krmcmedicalrecords@krhdirect.org",
            "affiliation": "Y",
            "affiliationName": "Kalispell Regional Medical Center Inc",
            "address_1": "1287 Burns Way",
            "city": "Kalispell",
            "state": "MT",
            "country_code": "US",
            "postal_code": "599013109",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Kalispell, MT

Sources for this page

Verify at the official NPI Registry.