Blue Mountain Clinic, Inc.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

9607 Issued in MT

Legal business name

BLUE MOUNTAIN CLINIC, INC.

Practice address

610 N California St
Missoula, MT 59802-3950

Phone

(406) 721-1946

Fax

(406) 543-9890

NPI assigned

Mar 8, 2007

Last updated

May 24, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ms. Annie Hansen

Title

Executive Director

Phone

(406) 721-1646

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MT

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/15229/brand/1/csg/1/fhir/r4

Practitioners 11

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Claire A Frost, M.D.

  • Family Medicine Physician
  • Missoula, MT
  • NPI 1235571993
  Medicare reassignment Care Compare group NPD
• Eric A. Ravitz, D.O.

  • Family Medicine Physician
  • Missoula, MT
  • NPI 1215034681
  Medicare reassignment Care Compare group NPD
• Katrin Johanna Kahl, PA-C

  • Physician Assistant
  • Missoula, MT
  • NPI 1730664723
  Medicare reassignment Care Compare group
• Kelly Polus, PAC

  • Physician Assistant
  • Missoula, MT
  • NPI 1689770919
  Medicare reassignment Care Compare group
• Alison B Charman, NP

  • Adult Health Nurse Practitioner
  • Missoula, MT
  • NPI 1669543039

  Family Medicine

  Medicare reassignment NPD
• Vasa Esther Parsons, LCSW

  • Clinical Social Worker
  • Missoula, MT
  • NPI 1174056170
  Medicare reassignment NPD
• Deanna Phinney, MD

  • Family Medicine Physician
  • Missoula, MT
  • NPI 1780714071
  Medicare reassignment NPD
• Adriana Raquel Ramos, LCSW

  • Clinical Social Worker
  • Missoula, MT
  • NPI 1568103364
  Medicare reassignment NPD
• Caitlin Savannah Hepburn, MPH

  • Health Educator
  • Missoula, MT
  • NPI 1316787971
  NPD
• Lois Doubleday, MA, LPC

  • Professional Counselor
  • Missoula, MT
  • NPI 1831295047
  NPD (past)
• Jean Paul Gourguechon

  • Acupuncturist
  • Missoula, MT
  • NPI 1801931977
  NPD (past)

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

{
    "created_epoch": "1173312000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1464048000000",
    "number": "1407987548",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "610 N CALIFORNIA ST",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598023950",
            "telephone_number": "406-721-1946",
            "fax_number": "406-543-9890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "610 N CALIFORNIA ST",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598023950",
            "telephone_number": "406-721-1946",
            "fax_number": "406-543-9890"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLUE MOUNTAIN CLINIC, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-08",
        "last_updated": "2016-05-24",
        "status": "A",
        "authorized_official_last_name": "HANSEN",
        "authorized_official_first_name": "ANNIE",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "406-721-1646",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MT",
            "license": "9607",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0218478",
            "state": "MT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Natalie Blauer, DPT
• Blair Bliss
• Jeanne Kathryn Bloom, FNP-BC
• Nicole M Blubaugh, ATC, LAT
• Blue Cedar Counseling LLC
• Bluebird Medical, LLC
• Bluebird Psychotherapy, PLLC
• Ellen Jean Bluett, PHD
• Nathan Dale Blumenbach
• Glenn Blumenson, LCSW

• Family Medicine Physician in Missoula, MT
• Providers in Missoula, MT by specialty
• Family Medicine Physician in Montana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.

Verify at the official NPI Registry.