Bozeman Primary Care PLLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

BOZEMAN PRIMARY CARE PLLC

Doing business as

Bozeman Primary Care

Practice address

4535 Valley Commons Dr Ste 104
Bozeman, MT 59718-4160

Phone

(406) 404-1525

NPI assigned

Oct 24, 2018

Organization subpart

No

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

Authorized official

Name

Dr. Terry Scott Edwards, MDNPI 1811912991

Title

Owner

Phone

(406) 404-1525

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Bozeman Primary Care Doing business as

Medicare fee-for-service enrollment

Enrolled in MT

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Terry Scott Edwards, MD

  • Family Medicine Physician
  • Bozeman, MT
  • NPI 1811912991
  Medicare reassignment Care Compare group NPD Authorized official
• Melissa N Blixt, DNP, APRN, FNP-BC

  • Family Nurse Practitioner
  • Bozeman, MT
  • NPI 1588179873
  Medicare reassignment Care Compare group NPD
• Jennifer Lee Cain, CRNP

  • Family Nurse Practitioner
  • Clarion, PA
  • NPI 1528571965

  MT

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1540339200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1560729600000",
    "number": "1477020824",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4535 VALLEY COMMONS DR STE 104",
            "city": "BOZEMAN",
            "state": "MT",
            "postal_code": "597184160",
            "telephone_number": "406-404-1525",
            "fax_number": "406-548-9777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4535 VALLEY COMMONS DR STE 104",
            "city": "BOZEMAN",
            "state": "MT",
            "postal_code": "597184160",
            "telephone_number": "406-404-1525"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOZEMAN PRIMARY CARE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-10-24",
        "last_updated": "2019-06-17",
        "status": "A",
        "authorized_official_last_name": "EDWARDS",
        "authorized_official_first_name": "TERRY",
        "authorized_official_middle_name": "SCOTT",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "406-404-1525",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8210759",
            "state": "MT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bozeman Primary Care",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Bozeman Primary Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Bozeman School District #7 (School District Related Services - Bozeman)
• Bozeman School District #7

• Family Medicine Physician in Bozeman, MT
• Providers in Bozeman, MT by specialty
• Family Medicine Physician in Montana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2019; 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.