Individual provider Active NPI

Danielle Marie Bertram, APRN

  • Psychiatric/Mental Health Nurse Practitioner
  • Butte, MT
National Provider Identifier
1457699498
Registry record updated Dec 5, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
0991635 Issued in CO
Practice address
305 W Mercury St Ste 403
Butte, MT 59701-1659
Phone
(406) 491-6343
Fax
(406) 723-5345
NPI assigned
Jan 25, 2013
Last updated
Dec 5, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 5, 2017

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 0991635 CO Primary
Child & Family Psychiatric/Mental Health Clinical Nurse Specialist 364SP0810X NUR-RN-LIC-67646 MT
Registered Nurse 163W00000X 1631449 CO

Addresses

Primary practice location

305 W Mercury St Ste 403
Butte, MT 59701-1659

Mailing address

98 Burning Tree LN
Butte, MT 59701-3904
Phone (406) 491-6343

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MT
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171201002584 MT Practitioner - Nurse Practitioner 2466758305 Practice locations: Butte, MT

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1631449COMDRegistered Nurse
0991635COMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Psychiatric Consultants of Montana, PLLC Psychiatric/Mental Health Current Accepting new patients

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": "1359072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1512432000000",
    "number": "1457699498",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "98 BURNING TREE LN",
            "city": "BUTTE",
            "state": "MT",
            "postal_code": "597013904",
            "telephone_number": "406-491-6343"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "305 W MERCURY ST STE 403",
            "city": "BUTTE",
            "state": "MT",
            "postal_code": "597011659",
            "telephone_number": "406-491-6343",
            "fax_number": "406-723-5345"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERTRAM",
        "first_name": "DANIELLE",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-01-25",
        "last_updated": "2017-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CO",
            "license": "0991635",
            "primary": true
        },
        {
            "code": "364SP0810X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Psychiatric/Mental Health, Child & Family",
            "state": "MT",
            "license": "NUR-RN-LIC-67646",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CO",
            "license": "1631449",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Butte, MT

Sources for this page

Verify at the official NPI Registry.