Active NPI
Alicia Gootkin
- Pharmacist
- Bozeman, MT
National Provider Identifier
1487373783
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PHA-PHA-LIC-88775
- Practice address
- 200 S 23Rd Ave
Bozeman, MT 59718-3965 - Phone
- (406) 539-0648
- NPI assigned
- Aug 22, 2022
- Last updated
- Aug 22, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | PHA-PHA-LIC-88775 | MT | Primary |
Addresses
Primary practice location
200 S 23Rd Ave
Bozeman, MT 59718-3965
Mailing address
659 Westgate Ave Apt a
Bozeman, MT 59718-6588
Phone (406) 539-0648
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PHA-PHA-LIC-88775 | MT | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1661126400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1661126400000",
"number": "1487373783",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "659 WESTGATE AVE APT A",
"city": "BOZEMAN",
"state": "MT",
"postal_code": "597186588",
"telephone_number": "406-539-0648"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "200 S 23RD AVE",
"city": "BOZEMAN",
"state": "MT",
"postal_code": "597183965",
"telephone_number": "406-539-0648"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOOTKIN",
"first_name": "ALICIA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-08-22",
"last_updated": "2022-08-22",
"certification_date": "2022-08-22",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MT",
"license": "PHA-PHA-LIC-88775",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bozeman, MT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.