Randy J Lovell DO PC

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

439 Issued in MT

Legal business name

RANDY J LOVELL DO PC

Practice address

907 Main Street
Thompson Falls, MT 59873-0969

Phone

(406) 827-4307

NPI assigned

Dec 20, 2006

Last updated

Sep 11, 2025By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Wanda K Larsen

Title

Office Manager

Phone

(406) 827-4307

Specialties & licenses 2

Addresses

Other names 1

• MAIN STREET MEDICAL Other name

Medicare fee-for-service enrollment

Enrolled in MT2 enrollments

Enrollment records 2

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1447314174. Details of each certification follow.

• CCN 273828 Rural health clinic · Active · Details

Rural health clinic certification: CCN 273828

Legal name

RANDY J LOVELL DO PC

Doing business as

MAIN STREET MEDICAL

Certification status

Active

Provider type (POS)

Rural health clinic

Participating since

Apr 29, 2008

Last certification

Jul 9, 2025

Ownership / control type

1B

Organization structure

CorporationProprietary

Incorporated

Sep 4, 2002 in MT

Enrollment address

907 Main Street
Thompson Falls, MT 59873-0969

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

• Randy J. Lovell, DO, PC

  dba Main Street Medical

  • Rural Health Clinic/Center
  • Thompson Falls, MT
  • NPI 1013172675

  2769479823

  Same PAC ID

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Randy J. Lovell, DO, PC

  dba Main Street Medical

  • Rural Health Clinic/Center
  • Thompson Falls, MT
  • NPI 1013172675

  O20080117000042

  Same enrollment

All disclosed owners & managing parties 2

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

• Randy J Lovell, DO

  • Family Medicine Physician
  • Thompson Falls, MT
  • NPI 1003836313

  5% Or Greater Direct Ownership Interest, Corporate Director, W-2 Managing Employee

  CMS ownership

Practitioners 2

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.

• Randy J Lovell, DO

  • Family Medicine Physician
  • Thompson Falls, MT
  • NPI 1003836313
  Medicare reassignment Care Compare group NPD
• Jane E Taylor, PAC

  • Medical Physician Assistant
  • Thompson Falls, MT
  • NPI 1558383323
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1166572800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757548800000",
    "number": "1447314174",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 969",
            "city": "THOMPSON FALLS",
            "state": "MT",
            "postal_code": "598730969",
            "telephone_number": "406-827-4307",
            "fax_number": "406-827-9514"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "907 MAIN STREET",
            "city": "THOMPSON FALLS",
            "state": "MT",
            "postal_code": "598730969",
            "telephone_number": "406-827-4307"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RANDY J LOVELL DO PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-20",
        "last_updated": "2025-09-11",
        "status": "A",
        "authorized_official_last_name": "LARSEN",
        "authorized_official_first_name": "WANDA",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "406-827-4307"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MT",
            "license": "439",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MT",
            "license": "6022",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MAIN STREET MEDICAL",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Providence Health & Services Mt (PMG MT IHI Thompson Falls)
• Randy J. Lovell, DO, PC (Main Street Medical)
• Reflections Academy, Inc.
• Peter Reinschmidt, LAC
• Raoul Anthony Ribeiro, LCSW
• Haiden Bree Richmond, PHARMD

• Nurse Practitioner in Thompson Falls, MT
• Providers in Thompson Falls, MT by specialty
• Nurse Practitioner in Montana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.