NPIMap

Organization Active NPI

Rehab Department

  • Physical Therapist
  • Anaconda, MT
National Provider Identifier
1417408394
Registry record updated Oct 17, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
REHAB DEPARTMENT
Practice address
401 W Pennsylvania Ave
Anaconda, MT 59711-1931
Phone
(406) 563-8500
Fax
(406) 563-8694
NPI assigned
Oct 17, 2016
Last updated
Oct 17, 2016By the provider in NPPES
Organization subpart
Yes
Parent organization
COMMUNITY HOSPITAL OF ANACONDAAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 17, 2016

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

Authorized official

Name
Alice R Cortright
Title
Dept Dir
Phone
(406) 563-8528

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X Primary
Occupational Therapist 225X00000X
Speech-Language Pathologist 235Z00000X

Addresses

Primary practice location

401 W Pennsylvania Ave
Anaconda, MT 59711-1931

Mailing address

401 W Pennsylvania Ave
Anaconda, MT 59711-1931
Phone (406) 563-8500

Other identifiers 1

IdentifierTypeStateIssuer
12768OtherMTSTATE LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MT

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031119000745 MT Part B Supplier - Clinic/Group Practice 8123938974 Receives reassigned benefits from 85 practitioners
10 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Anaconda, MT; Philipsburg, MT; Butte, MT

Other NPIs on the same Medicare enrollment 10

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Part of
Eugeneie T Haight MD

NPI Registry JSON

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

{
    "created_epoch": "1476662400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1476662400000",
    "number": "1417408394",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 W PENNSYLVANIA AVE",
            "city": "ANACONDA",
            "state": "MT",
            "postal_code": "597111931",
            "telephone_number": "406-563-8500",
            "fax_number": "406-563-8694"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 W PENNSYLVANIA AVE",
            "city": "ANACONDA",
            "state": "MT",
            "postal_code": "597111931",
            "telephone_number": "406-563-8500",
            "fax_number": "406-563-8694"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REHAB DEPARTMENT",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "COMMUNITY HOSPITAL OF ANACONDA",
        "enumeration_date": "2016-10-17",
        "last_updated": "2016-10-17",
        "status": "A",
        "authorized_official_last_name": "CORTRIGHT",
        "authorized_official_first_name": "ALICE",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "DEPT DIR",
        "authorized_official_telephone_number": "406-563-8528"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "12768",
            "state": "MT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Anaconda, MT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.