Individual provider Active NPI

Gareth Loosle, OTR/L

  • Occupational Therapist
  • Kalispell, MT
National Provider Identifier
1508252800
Registry record updated Nov 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OTP-OT-LIC-6547 Issued in MT
Practice address
205 Sunnyview LN
Kalispell, MT 59901-3120
Phone
(406) 751-4100
NPI assigned
Apr 13, 2015
Last updated
Nov 27, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X OTP-OT-LIC-6547 MT Primary

Addresses

Primary practice location

205 Sunnyview LN
Kalispell, MT 59901-3120

Mailing address

11 Mill Ave
Whitefish, MT 59937-2524
Phone (801) 750-9387

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address krmcmedicalrecords@krhdirect.org Northwest Orthopedics and Sports Medicine LLC

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190821002543 MT Practitioner - Occupational Therapist in Private Practice 5092043554 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

435 S Crystal St
Suite 400
Butte, MT 59701-1506
Phone (406) 496-3470

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
SCL Health Medical Group-Butte LLC CurrentSince May 1, 2023 Accepting new patients
SCL Health Medical Group-Butte LLC CurrentSince May 1, 2023 Accepting new patients

Locations

400 S Clark St
Butte, MT 59701
Phone (406) 495-7260

435 S Crystal St
Ste 400
Butte, MT 59701
Phone (406) 496-3456

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1428883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701043200000",
    "number": "1508252800",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 MILL AVE",
            "city": "WHITEFISH",
            "state": "MT",
            "postal_code": "599372524",
            "telephone_number": "801-750-9387"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 SUNNYVIEW LN",
            "city": "KALISPELL",
            "state": "MT",
            "postal_code": "599013120",
            "telephone_number": "406-751-4100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOOSLE",
        "first_name": "GARETH",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-04-13",
        "last_updated": "2023-11-27",
        "certification_date": "2020-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MT",
            "license": "OTP-OT-LIC-6547",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "krmcmedicalrecords@krhdirect.org",
            "affiliation": "Y",
            "affiliationName": "Northwest Orthopedics and Sports Medicine LLC",
            "address_1": "350 Heritage Way Ste 1200",
            "city": "Kalispell",
            "state": "MT",
            "country_code": "US",
            "postal_code": "599013160",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Kalispell, MT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2023; 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.