Organization Active NPI

Tim Cordial PT PC

Doing business as Cordial Physical Therapy

  • Physical Therapy Clinic/Center
  • Missoula, MT
National Provider Identifier
1437331063
Registry record updated Jun 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
License
257 Issued in MT
Legal business name
TIM CORDIAL PT PC
Doing business as
Cordial Physical Therapy
Practice address
701 W Spruce St
Missoula, MT 59802-3904
Phone
(406) 721-8858
Fax
(406) 542-0960
NPI assigned
Dec 5, 2007
Last updated
Jun 13, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2024

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

Authorized official

Name
Mr. Timothy J Cordial, PT
Title
Owner/Physical Therapist
Phone
(406) 721-8858

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X
Physical Therapy Clinic/Center 261QP2000X 257 MT Primary

Addresses

Primary practice location

701 W Spruce St
Missoula, MT 59802-3904

Mailing address

701 W Spruce St
Missoula, MT 59802-3904
Phone (406) 721-8858

Other identifiers 3

IdentifierTypeStateIssuer
000061750OtherMTBLUE CROSS BLUE SHIELD
000060776OtherMTBLUE CROSS
0000344097MedicaidMT

Other names 1

  • Cordial Physical Therapy Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080115000774 MT Part B Supplier - Clinic/Group Practice 5496836447 Receives reassigned benefits from 1 practitioner
Practice locations: Missoula, MT

National Provider Directory

National Provider Directory

Locations

701 W Spruce St
Missoula, MT 59802
Phone (406) 721-8858

Practitioners & affiliated clinicians

Practitioners 8

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": "1196812800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1718236800000",
    "number": "1437331063",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701 W SPRUCE ST",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598023904",
            "telephone_number": "406-721-8858",
            "fax_number": "406-542-0960"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 W SPRUCE ST",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598023904",
            "telephone_number": "406-721-8858",
            "fax_number": "406-542-0960"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TIM CORDIAL PT PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-05",
        "last_updated": "2024-06-13",
        "certification_date": "2024-06-13",
        "status": "A",
        "authorized_official_last_name": "CORDIAL",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER/PHYSICAL THERAPIST",
        "authorized_official_telephone_number": "406-721-8858",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "MT",
            "license": "257",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "000061750",
            "state": "MT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "000060776",
            "state": "MT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0000344097",
            "state": "MT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Cordial Physical Therapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Jun 13, 2024; 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.