Penny Palm Bucher, AGNP-AC
Individual provider Active NPI Gerontology Nurse Practitioner · Missoula, MT
NPI 1407519366 · NPPES record last updated Oct 18, 2021
Key facts
- NPI
- 1407519366
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Gerontology Nurse Practitioner 363LG0600X
- License
- NUR-APRN-APP-178863 (MT)
- Practice address
- 700 SW Higgins Ave Ste 102
Missoula, MT 59803-1489 - Phone
- (406) 540-4302
- Fax
- (406) 540-4306
- NPI assigned
- Oct 18, 2021
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Hospital & facility affiliations 8
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2021
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Sentinel Healthcare LLC
Practice addresses (Care Compare)
3760 Mullan Rd
Unit a
Missoula, MT 59808-5123
Phone (406) 543-4408
Hospital & facility affiliations
- Big Sky Home Health
- Big Sky Home Health
- Community Medical Center
- St. Patrick Hospital
- Village Health & Rehabilitation
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MT
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20220114002128 | MT | Practitioner - Nurse Practitioner | 2365834777 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| NUR-APRN-APP-178863 | MT | MD | Gerontology Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sentinel Healthcare LLC | Current |
Accepting new patients | |
| Hestia in-Home Support LLC | Current |
Accepting new patients |
Locations
700 SW Higgins Ave
Ste 102
Missoula, MT 59803
Phone (406) 540-3402
3760 Mullan Rd
Unit A
Missoula, MT 59808
Phone (406) 543-4408
1900 S Reserve St
Missoula, MT 59801
Phone (406) 543-4408
1916 N 700 W
Ste 110
Layton, UT 84041
Phone (801) 444-0221
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Gerontology Nurse Practitioner | 363LG0600X | NUR-APRN-APP-178863 | MT | Yes |
Addresses
Primary practice location
700 SW Higgins Ave Ste 102
Missoula, MT 59803-1489
Mailing address
3820 Snowdrift LN
Missoula, MT 59808-5902
Phone (406) 529-4922
Other providers in Missoula, MT
- Mariel Kareen Bryden
- Chloe Bryson
- Cindy R Bryson
- Daniel Brzozowski
- Cameron Lynn Bucheit
- Frances Marks Buck
- Mallory J Buck
- Christopher Paul Buckles
- Taylor Buckley
- Mendy Bucy
All providers in Missoula, MT · Gerontology Nurse Practitioner in Montana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 18, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.