NPIMap

Organization Active NPI

Bozeman Health Deaconess Hospital

  • Family Medicine Physician
  • Bozeman, MT
National Provider Identifier
1427612845
Registry record updated Nov 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
BOZEMAN HEALTH DEACONESS HOSPITAL
Practice address
935 Highland Blvd Ste 2200
Bozeman, MT 59715-6915
Phone
(406) 414-5700
NPI assigned
May 1, 2019
Last updated
Nov 19, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 19, 2024

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

Authorized official

Name
Brad K Ludford
Title
Cfo
Phone
(406) 414-1036

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X Primary
Physician Assistant 363A00000X
Nurse Practitioner 363L00000X

Addresses

Primary practice location

935 Highland Blvd Ste 2200
Bozeman, MT 59715-6915

Mailing address

915 Highland Blvd Ste 2170
Bozeman, MT 59715-6902
Phone (406) 414-5552

Other names 1

  • Bozeman Health Family Medicine Clinic Medicaid Passport NPI Other name

National Provider Directory

National Provider Directory
Tax ID family
Bozeman Health Deaconess Hospital9 organizations share this tax ID, including this one

Other organizations with this tax ID 8

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1556668800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1731974400000",
    "number": "1427612845",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "915 HIGHLAND BLVD STE 2170",
            "city": "BOZEMAN",
            "state": "MT",
            "postal_code": "597156902",
            "telephone_number": "406-414-5552"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "935 HIGHLAND BLVD STE 2200",
            "city": "BOZEMAN",
            "state": "MT",
            "postal_code": "597156915",
            "telephone_number": "406-414-5700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOZEMAN HEALTH DEACONESS HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-05-01",
        "last_updated": "2024-11-19",
        "certification_date": "2024-11-19",
        "status": "A",
        "authorized_official_last_name": "LUDFORD",
        "authorized_official_first_name": "BRAD",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "406-414-1036"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bozeman Health Family Medicine Clinic Medicaid Passport NPI",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Bozeman, MT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2024; 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.