Individual provider Active NPI

Samuel Norden

  • Occupational Therapist
  • Bozeman, MT
National Provider Identifier
1447832647
Registry record updated Sep 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OTP-OT-LIC-7849 Issued in MT
Practice address
777 E Main St Ste 108
Bozeman, MT 59715-3809
Phone
(406) 589-6083
Fax
(406) 219-0403
NPI assigned
Apr 27, 2021
Last updated
Sep 17, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X OTP-OT-LIC-7849 MT Primary

Addresses

Primary practice location

777 E Main St Ste 108
Bozeman, MT 59715-3809

Mailing address

7 Mineral Ave
Bozeman, MT 59718-6249
Phone (414) 350-1876

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210927000803 MT Practitioner - Occupational Therapist in Private Practice 9739586215 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Gabel PT Plus Wellness LLCGroup PAC ID 5597161349, 7 clinicians

Practice addresses (Care Compare)

777 E Main St
Suite 108
Bozeman, MT 59715-3809
Phone (406) 589-6083

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Gabel PT Plus Wellness LLC CurrentSince Jun 19, 2021 Accepting new patients

Locations

777 E Main St
Ste 108
Bozeman, MT 59715
Phone (406) 589-6083

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1619481600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631836800000",
    "number": "1447832647",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7 MINERAL AVE",
            "city": "BOZEMAN",
            "state": "MT",
            "postal_code": "597186249",
            "telephone_number": "414-350-1876"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "777 E MAIN ST STE 108",
            "city": "BOZEMAN",
            "state": "MT",
            "postal_code": "597153809",
            "telephone_number": "406-589-6083",
            "fax_number": "406-219-0403"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NORDEN",
        "first_name": "SAMUEL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-04-27",
        "last_updated": "2021-09-17",
        "certification_date": "2021-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MT",
            "license": "OTP-OT-LIC-7849",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Sep 17, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.