NPIMap

Individual provider Active NPI

Penny Palm Bucher, AGNP-AC

  • Gerontology Nurse Practitioner
  • Missoula, MT
National Provider Identifier
1407519366
Registry record updated Oct 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
NUR-APRN-APP-178863 Issued in 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
Last updated
Oct 18, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X NUR-APRN-APP-178863 MT Primary

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

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
I20220114002128 MT Practitioner - Nurse Practitioner 2365834777 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sentinel Healthcare LLCGroup PAC ID 0244654135, 5 clinicians

Practice addresses (Care Compare)

3760 Mullan Rd
Unit a
Missoula, MT 59808-5123
Phone (406) 543-4408

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
NUR-APRN-APP-178863MTMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Hestia in-Home Support LLC CurrentSince Dec 1, 2021 Accepting new patients
Sentinel Healthcare LLC CurrentSince Jun 20, 2022 Accepting new patients

Locations

1900 S Reserve St
Missoula, MT 59801
Phone (406) 543-4408

3760 Mullan Rd
Unit A
Missoula, MT 59808
Phone (406) 543-4408

700 SW Higgins Ave
Ste 102
Missoula, MT 59803
Phone (406) 540-3402

1916 N 700 W
Ste 110
Layton, UT 84041
Phone (801) 444-0221

Organizations & group practices 2

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

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": "1634515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634515200000",
    "number": "1407519366",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3820 SNOWDRIFT LN",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598085902",
            "telephone_number": "406-529-4922"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 SW HIGGINS AVE STE 102",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598031489",
            "telephone_number": "406-540-4302",
            "fax_number": "406-540-4306"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUCHER",
        "first_name": "PENNY",
        "middle_name": "PALM",
        "credential": "AGNP-AC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-10-18",
        "last_updated": "2021-10-18",
        "certification_date": "2021-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "MT",
            "license": "NUR-APRN-APP-178863",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Missoula, MT

Sources for this page

Verify at the official NPI Registry.