Partnership Health Center Inc
Organization Active NPI Federally Qualified Health Center (FQHC) · Missoula, MT
NPI 1437196243 · NPPES record last updated Feb 21, 2025
Key facts
- NPI
- 1437196243
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Federally Qualified Health Center (FQHC) 261QF0400X
- Legal business name
- PARTNERSHIP HEALTH CENTER INC
- Practice address
- 323 W Alder St
Missoula, MT 59802-4123 - Phone
- (406) 258-4191
- Fax
- (406) 258-4180
- NPI assigned
- Jun 1, 2006
- Organization subpart
- No
Authorized official
- Name
- Lara Salazar
- Title
- Chief Executive Officer
- Phone
- (406) 258-3360
Other NPIs on the same Medicare enrollment 6
Other NPIs with the same Medicare PAC ID 14
Practitioners 102
-
Noor Alain Bass, DO
-
Brett Marie Bell, M.D., M.P.H.
-
Darin M Bell, M.D.
-
Ellen Jean Bluett, PHD
-
Benjamin Joshua Bryden, M.D.
-
Ingrid Marie Calle, D.O.
-
Nathaniel Brent Chapman, LCSW
-
Robert W Cruikshank, M.D.
-
Johanna Dreiling, M.D.
-
Julie A Eggleton, MD
-
Leah Macke Gordon, M.D.
-
Jason Hall, APRN
-
Shanna L. Harris Romero, LCSW
-
Emily E. Heid, M.D.
-
Tara Ivanovitch, LCSW, LAC
-
Jordan Jeffrey Jolly, LCPC
-
Nerissa Koehn, MD
-
Jenna Marceau, MSW
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in MT
Federally qualified health center certification: CCN 271803
- Legal name
- PARTNERSHIP HEALTH CENTER INC
- Certification status
- Active
- Provider type (POS)
- Federally qualified health center
- Participating since
- Oct 1, 1992
- Last certification
- Oct 1, 1992
- Ownership / control type
- Non-profit – corporation
- Organization structure
- Corporation · Non-profit
- Incorporated
- Nov 1, 1992 in MT
- Enrollment address
- 323 W Alder St
Missoula, MT 59802-4123
All disclosed owners & managing parties 16
| Name | Role | Since | Share |
|---|---|---|---|
| Kathleen Walters |
Corporate Director |
Jul 1, 2013 | |
| Bryan William Chalmers |
Corporate Officer |
Dec 16, 2019 | 1% |
| Mark Thane |
Corporate Director |
Oct 1, 2019 | |
| Patricia Kero |
Corporate Director |
Nov 1, 2021 | |
| Jeffrey Weist |
Corporate Director |
Oct 1, 2006 | |
| Lara Salazar |
5% Or Greater Direct Ownership Interest |
Oct 3, 2022 | 1% |
| Corporate Officer |
Oct 1, 2022 | 5% | |
| Talbert Demeester |
Corporate Director |
Oct 1, 2018 | |
| Joseph Melvin |
Corporate Director |
Jan 1, 2019 | |
| Andrea Green |
Corporate Director |
Mar 1, 2021 | |
| Natalie Wolfram |
Corporate Director |
Oct 1, 2018 | |
| Holly Blaylock |
W-2 Managing Employee |
Jul 6, 2015 | |
| Karen Myers |
Corporate Director |
Sep 1, 2019 | |
| David Strohmaier |
Corporate Director |
Jul 1, 2019 | |
| John Crawford |
Corporate Director |
Feb 1, 2016 | |
| Bruce W Richardson |
Corporate Director |
Oct 1, 2020 | |
| Jilayne Dunn |
Corporate Director |
Dec 1, 2013 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20051026000379 | MT | Part B Supplier - Clinic/Group Practice | 6103843479 |
Receives reassigned benefits from 98 practitioners 6 other NPIs on this enrollment Practice locations: Missoula, MT; Seeley Lake, MT; Superior, MT |
| O20100728001283 | MT | Part a Provider - Federally Qualified Health Center (FQHC) | 6103843479 | Practice locations: Missoula, MT |
National Provider Directory
Locations
323 W Alder St
Missoula, MT 59802
Phone (406) 258-4195
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist |
122300000X | |||
| Registered Nurse |
163W00000X | |||
| Pharmacist |
183500000X | |||
| Family Medicine Physician |
207Q00000X | |||
| Federally Qualified Health Center (FQHC) | 261QF0400X | Yes | ||
| Pharmacy | 333600000X | |||
| Clinic Pharmacy | 3336C0002X | |||
| Physician Assistant |
363A00000X | |||
| Nurse Practitioner |
363L00000X |
Addresses
Primary practice location
323 W Alder St
Missoula, MT 59802-4123
Mailing address
323 W Alder St
Missoula, MT 59802-4123
Phone (406) 258-4496
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1437196243 | Medicaid | MT |
Other providers in Missoula, MT
- Partnership Health Center Inc
- Partnership Health Center Inc
- Partnership Health Center Inc
- Partnership Health Center Inc
- Partnership Health Center Inc
- Partnership Health Center Inc
- Partnership Health Center Inc
- Partnership Health Center Inc
- Partnership Health Center Inc
- Partnership Health Center Inc
All providers in Missoula, MT · Federally Qualified Health Center (FQHC) in Montana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 21, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.