Main Street Clinic – Primary Care Clinic/Center

Key facts

NPI: 1427294792
Entity type: Organization (NPI type 2)
Primary specialty: Primary Care Clinic/Center 261QP2300X
License: 10584 (MT)
Legal business name: MAIN STREET CLINIC
Practice address: 11 W Main St
Suite 225
Belgrade, MT 59714-3700
Phone: (406) 388-6151
NPI assigned: Dec 16, 2008
Organization subpart: No

Authorized official

Name: Dr. Marc Charles Mentel, D.O.
Title: Physician/Owner
Phone: (406) 570-1639

National Provider Directory

Locations

11 W Main St
Ste 225
Belgrade, MT 59714
Phone (406) 388-6151

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Primary Care Clinic/Center	261QP2300X	10584	MT	Yes

Addresses

Primary practice location

11 W Main St
Suite 225
Belgrade, MT 59714-3700

Mailing address

11 W Main St
Suite 225
Belgrade, MT 59714-3700
Phone (406) 388-6151

Other identifiers

Identifier	Type	State	Issuer
0079186	Medicaid	MT

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Dec 16, 2008.

{
    "created_epoch": "1229385600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1229385600000",
    "number": "1427294792",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 W MAIN ST",
            "address_2": "SUITE 225",
            "city": "BELGRADE",
            "state": "MT",
            "postal_code": "597143700",
            "telephone_number": "406-388-6151"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 W MAIN ST",
            "address_2": "SUITE 225",
            "city": "BELGRADE",
            "state": "MT",
            "postal_code": "597143700",
            "telephone_number": "406-388-6151"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAIN STREET CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-12-16",
        "last_updated": "2008-12-16",
        "status": "A",
        "authorized_official_last_name": "MENTEL",
        "authorized_official_first_name": "MARC",
        "authorized_official_middle_name": "CHARLES",
        "authorized_official_title_or_position": "PHYSICIAN/OWNER",
        "authorized_official_telephone_number": "406-570-1639",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "MT",
            "license": "10584",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0079186",
            "state": "MT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Belgrade, MT

All providers in Belgrade, MT · Primary Care Clinic/Center in Montana

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 16, 2008. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.