Active NPI
Carley Hennessy
- Surgical Physician Assistant
- Williston, ND
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgical Physician Assistant
- License
- MED-PAC-LIC-76234
- Practice address
- 1700 11TH St W
Williston, ND 58801-4500 - Phone
- (701) 774-7687
- NPI assigned
- Oct 7, 2015
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PAC0617 | ND | |
| Surgical Physician Assistant | 363AS0400X | MED-PAC-LIC-76234 | MT | Primary |
Addresses
Primary practice location
1700 11TH St W
Williston, ND 58801-4500
Mailing address
1700 11TH St W
Williston, ND 58801-4500
Phone (701) 774-7687
Other names 1
- Carley Buttelman
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MT
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2015
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
110 N Oak St
Townsend, MT 59644-2306
Phone (406) 238-2500
2800 10TH Ave N
Billings, MT 59101-0703
Phone (406) 657-4000
320 Alpenglow LN
Livingston, MT 59047-8506
Phone (406) 222-3541
3901 Wellness Way
Bozeman, MT 59718-2402
Phone (406) 898-1200
3905 Wellness Way
Bozeman, MT 59718-2402
Phone (406) 898-1200
Hospital & facility affiliations
- Billings Clinic Hospital
- Bozeman Health Deaconess Hospital
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PAC0617 | ND | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Billings Clinic | Current | Accepting new patients | |
| Billings Clinic | Current | Accepting new patients | |
| Frances Mahon Deaconess Hospital | Past | Accepting new patients |
Locations
2800 10th Ave N
Billings, MT 59101
Phone (406) 248-3290
3905 Wellness Way
Bozeman, MT 59718
Phone (406) 587-9202
3905 Wellness Way
Ste 2A
Bozeman, MT 59718
110 N Oak St
Townsend, MT 59644
Phone (406) 266-3186
Interoperability endpoints
- chennessy1@billingsclinic.cernerdirect.com
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.
-
- Emergency Care Clinic/Center
- Billings, MT
- NPI 1326104845
-
- Endocrinology, Diabetes & Metabolism Physician
- Billings, MT
- NPI 1124310537
-
- General Practice Physician
- Billings, MT
- NPI 1376598714
-
- Critical Access Hospital
- Glasgow, MT
- NPI 1689685323
Hospital & facility affiliations 9
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Bozeman, MT
- NPI 1215660840
-
- General Acute Care Hospital
- Billings, MT
- NPI 1265478291
-
- General Acute Care Hospital
- Bozeman, MT
- NPI 1104295864
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1444176000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1639440000000",
"number": "1407227101",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1700 11TH ST W",
"city": "WILLISTON",
"state": "ND",
"postal_code": "588014500",
"telephone_number": "701-774-7687"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1700 11TH ST W",
"city": "WILLISTON",
"state": "ND",
"postal_code": "588014500",
"telephone_number": "701-774-7687"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HENNESSY",
"first_name": "CARLEY",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-10-07",
"last_updated": "2021-12-14",
"certification_date": "2021-12-14",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "ND",
"license": "PAC0617",
"primary": false
},
{
"code": "363AS0400X",
"taxonomy_group": "",
"desc": "Physician Assistant, Surgical",
"state": "MT",
"license": "MED-PAC-LIC-76234",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "CARLEY",
"last_name": "BUTTELMAN",
"credential": "PA-C",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Williston, ND
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.