Organization Active NPI

Benton Physical Therapy

  • Physical Therapist
  • Fort Benton, MT
National Provider Identifier
1477676492
Registry record updated Aug 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
1597PT Issued in MT
Legal business name
BENTON PHYSICAL THERAPY
Practice address
1510 Saint Charles St.
Fort Benton, MT 59442
Phone
(406) 622-3684
Fax
(406) 622-5047
NPI assigned
Apr 6, 2007
Last updated
Aug 1, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 1, 2023

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

Authorized official

Name
Miss Dawn M Nelson, P.T.NPI 1174623979
Title
President
Phone
(406) 622-3684

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 1597PT MT Primary

Addresses

Primary practice location

1510 Saint Charles St.
Fort Benton, MT 59442

Mailing address

PO Box 3
Fort Benton, MT 59442-0003
Phone (406) 622-3684

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120314000753 MT Part B Supplier - Clinic/Group Practice 6103085907 Receives reassigned benefits from 1 practitioner
Practice locations: Fort Benton, MT

National Provider Directory

National Provider Directory

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": "1175817600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1690848000000",
    "number": "1477676492",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3",
            "city": "FORT BENTON",
            "state": "MT",
            "postal_code": "594420003",
            "telephone_number": "406-622-3684",
            "fax_number": "406-622-5047"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1510 SAINT CHARLES ST.",
            "city": "FORT BENTON",
            "state": "MT",
            "postal_code": "59442",
            "telephone_number": "406-622-3684",
            "fax_number": "406-622-5047"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BENTON PHYSICAL THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-06",
        "last_updated": "2023-08-01",
        "certification_date": "2023-08-01",
        "status": "A",
        "authorized_official_last_name": "NELSON",
        "authorized_official_first_name": "DAWN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "406-622-3684",
        "authorized_official_name_prefix": "Miss",
        "authorized_official_credential": "P.T."
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MT",
            "license": "1597PT",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Benton, MT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2023; 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.