Indian Health Service

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

License

DH00006133 Issued in WA

Legal business name

INDIAN HEALTH SERVICE

Practice address

107 H Street E
Poplar, MT 59255

Phone

(406) 768-2101

NPI assigned

Dec 22, 2015

Organization subpart

Yes

Parent organization

DEPT. OF HEALTH & HUMAN SERVICESAs reported in NPPES

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

Authorized official

Name

Julie Bemer

Title

Service Unit Director/Ceo

Phone

(406) 768-2101

Specialties & licenses 1

Addresses

Other names 1

• Verne E. Gibbs Health Center Other name

Part of

Heart Butte Health Station Pharmacy

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

{
    "created_epoch": "1450742400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1450742400000",
    "number": "1457716227",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 67",
            "city": "POPLAR",
            "state": "MT",
            "postal_code": "592550067",
            "telephone_number": "406-768-2101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 H STREET E",
            "city": "POPLAR",
            "state": "MT",
            "postal_code": "59255",
            "telephone_number": "406-768-2101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INDIAN HEALTH SERVICE",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "DEPT. OF HEALTH & HUMAN SERVICES",
        "enumeration_date": "2015-12-22",
        "last_updated": "2015-12-22",
        "status": "A",
        "authorized_official_last_name": "BEMER",
        "authorized_official_first_name": "JULIE",
        "authorized_official_title_or_position": "SERVICE UNIT DIRECTOR/CEO",
        "authorized_official_telephone_number": "406-768-2101"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "WA",
            "license": "DH00006133",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Verne E. Gibbs Health Center",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Christopher Headdress
• Larry Heater, D.D.S.
• Brenda Lee Henry, R.T (R)
• Abigaile Julio Higgins, FNP-C
• Janell R Hopkins, LAC
• Wally Jean, MD
• Karen Emi Kajiwara-Nelson, M.S.
• Scott D Kinzie, RN
• David Michael Korkowski, MLT (ASCP)
• Mark Wray Korman

• All providers in Poplar, MT
• Dental Clinic/Center in Montana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.