Individual provider Active NPI

Betty J Nelson, CRNA

  • Certified Registered Nurse Anesthetist
  • Anaconda, MT
National Provider Identifier
1467555847
Registry record updated Feb 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
101768 Issued in MT
Practice address
401 W Pennsylvania Ave
Anaconda, MT 59711-1999
Phone
(406) 563-8500
Fax
(406) 563-8694
NPI assigned
Sep 7, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 17, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X AP30001970 WA
Certified Registered Nurse Anesthetist 367500000X 101768 MT Primary

Addresses

Primary practice location

401 W Pennsylvania Ave
Anaconda, MT 59711-1999

Mailing address

401 W Pennsylvania Ave
Anaconda, MT 59711-1999
Phone (406) 563-8500

Other practice location 1

835 SE Bishop Blvd
Pullman, WA 99163-5512
Phone (509) 332-2541

Other identifiers 1

IdentifierTypeStateIssuer
1275515660OtherMTNPI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MT, AK2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20160204001361 MT Practitioner - Certified Registered Nurse Anesthetist (Crna) 6406743954 Reassigns benefits to 5 organizations
I20250505000948 AK Practitioner - Certified Registered Nurse Anesthetist (Crna) 6406743954 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
101768MTMDCertified Registered Nurse Anesthetist
AP30001970WAMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Community Hospital of Anaconda Current Accepting new patients
Community Hospital of Anaconda Current Accepting new patients
Community Hospital of Anaconda CurrentSince Jan 18, 2016 Accepting new patients
Providence Health & Services Washington CurrentSince Mar 1, 2025 Accepting new patients
Missoula Community Health Services, Inc CurrentSince Oct 25, 2024 Accepting new patients
Providence Health & Services - Washington CurrentSince Mar 1, 2025 Accepting new patients
Missoula Community Health Services, Inc Current Accepting new patients
Missoula Community Health Services, Inc. CurrentSince Oct 13, 2024 Accepting new patients
Missoula Community Health Services, Inc. CurrentSince Oct 13, 2024 Accepting new patients
Community Hospital of Anaconda CurrentSince Jan 18, 2016 Accepting new patients

Locations

1915 E Rezanof Dr
Kodiak, AK 99615
Phone (907) 486-3281

401 W Pennsylvania Ave
Anaconda, MT 59711
Phone (406) 563-5261

305 W Pennsylvania Ave
Anaconda, MT 59711
Phone (406) 563-8571

1208 6th Ave
Superior, MT 59872
Phone (406) 683-3401

Organizations & group practices 11

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

NPI Registry JSON

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

{
    "created_epoch": "1157587200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613520000000",
    "number": "1467555847",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 W PENNSYLVANIA AVE",
            "city": "ANACONDA",
            "state": "MT",
            "postal_code": "597111999",
            "telephone_number": "406-563-8500",
            "fax_number": "406-563-8694"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 W PENNSYLVANIA AVE",
            "city": "ANACONDA",
            "state": "MT",
            "postal_code": "597111999",
            "telephone_number": "406-563-8500",
            "fax_number": "406-563-8694"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "835 SE Bishop Blvd",
            "address_purpose": "LOCATION",
            "city": "Pullman",
            "state": "WA",
            "postal_code": "991635512",
            "country_code": "US",
            "telephone_number": "509-332-2541",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NELSON",
        "first_name": "BETTY",
        "middle_name": "J",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-07",
        "last_updated": "2021-02-17",
        "certification_date": "2021-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "WA",
            "license": "AP30001970",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MT",
            "license": "101768",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1275515660",
            "state": "MT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Anaconda, MT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 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.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.