Individual provider Active NPI

Beau Lufborough

  • Home Modifications Contractor
  • Miles City, MT
National Provider Identifier
1417356007
Registry record updated Aug 19, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Modifications ContractorTaxonomy code 171WH0202X
License
161378 Issued in MT
Practice address
605 Knight St
Miles City, MT 59301-2524
Phone
(406) 439-8619
NPI assigned
Aug 19, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Modifications Contractor 171WH0202X 161378 MT Primary

Addresses

Primary practice location

605 Knight St
Miles City, MT 59301-2524

Mailing address

605 Knigh St
Miles City, MT 59301-2425
Phone (406) 439-8619

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
161378MTMDHome Modifications Contractor

NPI Registry JSON

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

{
    "created_epoch": "1408406400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1408406400000",
    "number": "1417356007",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "605 KNIGH ST",
            "city": "MILES CITY",
            "state": "MT",
            "postal_code": "593012425",
            "telephone_number": "406-439-8619"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "605 KNIGHT ST",
            "city": "MILES CITY",
            "state": "MT",
            "postal_code": "593012524",
            "telephone_number": "406-439-8619"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUFBOROUGH",
        "first_name": "BEAU",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-08-19",
        "last_updated": "2014-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171WH0202X",
            "taxonomy_group": "",
            "desc": "Contractor, Home Modifications",
            "state": "MT",
            "license": "161378",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miles City, MT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.