NPIMap

Organization Active NPI

Kalispell Regional Medical Center Inc

Doing business as Glacier Neuroscience and Spine Center

  • Neurology Physician
  • Kalispell, MT
National Provider Identifier
1457647877
Registry record updated Jun 29, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
Legal business name
KALISPELL REGIONAL MEDICAL CENTER INC
Doing business as
Glacier Neuroscience and Spine Center
Practice address
200 Commons Way
Kalispell, MT 59901-1914
Phone
(406) 752-5095
Fax
(406) 752-5058
NPI assigned
Jun 23, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2011

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

Authorized official

Name
Velinda J Stevens
Title
Ceo/President
Phone
(406) 752-1724

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084N0400X Primary

Addresses

Primary practice location

200 Commons Way
Kalispell, MT 59901-1914

Mailing address

200 Commons Way
Kalispell, MT 59901-1914
Phone (406) 752-5095

Other names 1

  • Glacier Neuroscience and Spine Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031122000142 MT Part B Supplier - Clinic/Group Practice 5294644381 Receives reassigned benefits from 555 practitioners
This NPI is an additional NPI on the enrollment
Practice locations: Kalispell, MT; Lakeside, MT; Libby, MT; Missoula, MT; Polson, MT; Whitefish, MT; Bigfork, MT; Bozeman, MT…

National Provider Directory

National Provider Directory

Locations

200 Commons Way
Kalispell, MT 59901
Phone (406) 752-5095

Practitioners & affiliated clinicians

Practitioners 1

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": "1308787200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1309305600000",
    "number": "1457647877",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 COMMONS WAY",
            "city": "KALISPELL",
            "state": "MT",
            "postal_code": "599011914",
            "telephone_number": "406-752-5095",
            "fax_number": "406-752-5058"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 COMMONS WAY",
            "city": "KALISPELL",
            "state": "MT",
            "postal_code": "599011914",
            "telephone_number": "406-752-5095",
            "fax_number": "406-752-5058"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KALISPELL REGIONAL MEDICAL CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-06-23",
        "last_updated": "2011-06-29",
        "status": "A",
        "authorized_official_last_name": "STEVENS",
        "authorized_official_first_name": "VELINDA",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "CEO/PRESIDENT",
        "authorized_official_telephone_number": "406-752-1724"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Glacier Neuroscience and Spine Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Kalispell, MT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2011; 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.