Michael Vannatta, D.P.T.

Key facts

NPI

1497982797

Entity type

Individual (NPI type 1)

Primary specialty

Physical Therapist 225100000X

License

PT-2524 (ID)

Practice address

135 Prospect Loop
Bozeman, MT 59718-5985

Phone

(406) 585-9044

Fax

(406) 585-9220

NPI assigned

Jun 15, 2009

Sex

Male

Sole proprietor

No

Organizations & group practices 6

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.

• Lone Peak Physical Therapy Inc. Physical Therapist · Big Sky, MT · NPI 1477678969
  Medicare reassignment Care Compare group NPD MT · PHYSICAL THERAPIST
• Lone Peak Physical Therapy Inc Durable Medical Equipment & Medical Supplies · Bozeman, MT · NPI 1740070564
  Care Compare group NPD PHYSICAL THERAPIST
• Lone Peak Physical Therapy Inc Durable Medical Equipment & Medical Supplies · Billings, MT · NPI 1811700305
  Care Compare group
• Lone Peak Physical Therapy Inc Physical Therapist · Big Sky, MT · NPI 1891849022
  NPD (past) PHYSICAL THERAPIST
• Therapeutic Associates Inc Physical Therapist · Portland, OR · NPI 1144042649
  NPD (past) PHYSICAL THERAPIST
• Therapeutic Associates Inc Physical Therapist · Boise, ID · NPI 1326024472
  NPD (past) PHYSICAL THERAPIST

Medicare Care Compare profile

Specialty

Physical Therapist in Private Practice

Education

Other, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Lone Peak Physical Therapy Inc (42 clinicians)

Practice addresses (Care Compare)

Medicare participation

Medicare fee-for-service enrollment

Enrolled in MT

Medicare enrollment records

National Provider Directory

Medicare enrollment (NPD)

Yes

State licenses

Practice roles

Locations

Specialties & licenses

Addresses

Other identifiers

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jan 27, 2012.

{
    "created_epoch": "1245024000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1327622400000",
    "number": "1497982797",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 160010",
            "city": "BIG SKY",
            "state": "MT",
            "postal_code": "597160010",
            "telephone_number": "406-522-7488",
            "fax_number": "406-522-7487"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "135 PROSPECT LOOP",
            "city": "BOZEMAN",
            "state": "MT",
            "postal_code": "597185985",
            "telephone_number": "406-585-9044",
            "fax_number": "406-585-9220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANNATTA",
        "first_name": "MICHAEL",
        "credential": "D.P.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-06-15",
        "last_updated": "2012-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "ID",
            "license": "PT-2524",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1497982797",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P0080244",
            "state": "ID"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1497982797-001",
            "state": "ID"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1497982797-002",
            "state": "ID"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1497982797-000",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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All providers in Bozeman, MT · Physical Therapist in Montana