NPIMap

Individual provider Active NPI

Devin Michael Mock, NP

  • Nurse Practitioner
  • Bozeman, MT
National Provider Identifier
1447825534
Registry record updated Sep 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
NUR-APRN-LIC-240601 Issued in MT
Practice address
1819 S 22ND Ave Ste 100
Bozeman, MT 59718-7070
Phone
(406) 426-3200
NPI assigned
May 21, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 26, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Neuromusculoskeletal Medicine) Physician 204C00000X NUR-APRN-LIC-240601 MT
Nurse Practitioner 363L00000X NUR-APRN-LIC-240601 MT Primary

Addresses

Primary practice location

1819 S 22ND Ave Ste 100
Bozeman, MT 59718-7070

Mailing address

51 E Julie CT
Bozeman, MT 59718-7693
Phone (208) 589-1524

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MT
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240816002768 MT Practitioner - Nurse Practitioner 7911445242 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Three Rivers Clinic, LLCGroup PAC ID 5698848869, 6 clinicians
Bates Family Diversified LLCGroup PAC ID 6406288547, 6 clinicians
Montana Advanced Pain and Spine PLLCGroup PAC ID 1850745621, 4 clinicians

Practice addresses (Care Compare)

16 Railway Ave
Three Forks, MT 59752-9080

1819 S 22ND Ave
Suite 100
Bozeman, MT 59718-7070
Phone (406) 426-3200

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
NUR-APRN-LIC-240601MTMDSports Medicine (Neuromusculoskeletal Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Montana Advanced Pain and Spine PLLC CurrentSince Jul 22, 2024 Accepting new patients

Locations

1819 S 22nd Ave
Ste 100
Bozeman, MT 59718
Phone (406) 426-3200

3745 Harrison Ave
Ste G
Butte, MT 59701
Phone (406) 426-3200

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 13

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1621555200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727308800000",
    "number": "1447825534",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "51 E JULIE CT",
            "city": "BOZEMAN",
            "state": "MT",
            "postal_code": "597187693",
            "telephone_number": "208-589-1524"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1819 S 22ND AVE STE 100",
            "city": "BOZEMAN",
            "state": "MT",
            "postal_code": "597187070",
            "telephone_number": "406-426-3200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOCK",
        "first_name": "DEVIN",
        "middle_name": "MICHAEL",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-05-21",
        "last_updated": "2024-09-26",
        "certification_date": "2024-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "204C00000X",
            "taxonomy_group": "",
            "desc": "Neuromusculoskeletal Medicine, Sports Medicine",
            "state": "MT",
            "license": "NUR-APRN-LIC-240601",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MT",
            "license": "NUR-APRN-LIC-240601",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bozeman, MT

Sources for this page

Verify at the official NPI Registry.