NPIMap

Organization Active NPI

Western Montana Foot and Ankle PLLC

  • Foot & Ankle Surgery Podiatrist
  • Missoula, MT
National Provider Identifier
1417461732
Registry record updated Nov 28, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
174 Issued in MT
Legal business name
WESTERN MONTANA FOOT AND ANKLE PLLC
Practice address
2825 Stockyard Rd Ste J1
Missoula, MT 59808-1548
Phone
(406) 543-5333
Fax
(406) 543-5621
NPI assigned
Nov 22, 2017
Last updated
Nov 28, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 28, 2018

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

Authorized official

Name
Dr. Karl J Mangold, DPMNPI 1659528263
Title
Owner/Manager
Phone
(406) 543-5333

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X
Foot & Ankle Surgery Podiatrist 213ES0103X 174 MT Primary

Addresses

Primary practice location

2825 Stockyard Rd Ste J1
Missoula, MT 59808-1548

Mailing address

2825 Stockyard Rd Ste J1
Missoula, MT 59808-1548
Phone (406) 543-5333

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MT2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20180206001502 MT Part B Supplier - Clinic/Group Practice 6002176302 Receives reassigned benefits from 3 practitioners
Practice locations: Missoula, MT
O20180504000238 MT DME Supplier - Physician - Podiatry 6002176302 Practice locations: Missoula, MT

National Provider Directory

National Provider Directory

Locations

1220 Westwood Dr
Hamilton, MT 59840
Phone (406) 543-5333

2825 Stockyard Rd
Ste J1
Missoula, MT 59808
Phone (406) 543-5333

2831 Fort Missoula Rd
Ste 302
Missoula, MT 59804
Phone (406) 493-1600

Practitioners & affiliated clinicians

Practitioners 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1511308800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1543363200000",
    "number": "1417461732",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2825 STOCKYARD RD STE J1",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598081548",
            "telephone_number": "406-543-5333",
            "fax_number": "406-543-5621"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2825 STOCKYARD RD STE J1",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598081548",
            "telephone_number": "406-543-5333",
            "fax_number": "406-543-5621"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WESTERN MONTANA FOOT AND ANKLE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-11-22",
        "last_updated": "2018-11-28",
        "status": "A",
        "authorized_official_last_name": "MANGOLD",
        "authorized_official_first_name": "KARL",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER/MANAGER",
        "authorized_official_telephone_number": "406-543-5333",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "MT",
            "license": "174",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Missoula, MT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2018; 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.