Kevin Russell Hayworth, EMT

Individual provider Active NPI Basic Emergency Medical Technician · Libby, MT

NPI 1497555759 · NPPES record last updated Mar 17, 2025

Key facts

NPI
1497555759
Entity type
Individual (NPI type 1)
Primary specialty
Basic Emergency Medical Technician 146N00000X
License
88015 (MT)
Practice address
307 Montana Ave
Libby, MT 59923-2037
Phone
(406) 293-5582
NPI assigned
Mar 17, 2025
Sex
Male
Sole proprietor
Yes

Organizations & group practices 2

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.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Emergency Medical Technician

State licenses

LicenseStateTypeSpecialty
88015MTMDBasic Emergency Medical Technician

Practice roles

OrganizationSpecialtyStatusNew patients
Family Health & Wellness, Inc. Current
since Mar 24, 2025
Accepting new patients
Libby Volunteer Ambulance Service Inc Past
since Mar 24, 2025
Accepting new patients

Locations

108 E 9th St
Ste 1
Libby, MT 59923
Phone (406) 293-3113

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Basic Emergency Medical Technician 146N00000X 88015 MT Yes

Addresses

Primary practice location

307 Montana Ave
Libby, MT 59923-2037

Mailing address

108 E 9TH St Ste 1
Libby, MT 59923-2019
Phone (406) 293-3113

Other providers in Libby, MT

All providers in Libby, MT · Basic Emergency Medical Technician in Montana

Sources for this page

Verify at the official NPI Registry.