NPIMap

Organization Active NPI

Sidney Health Center

  • Emergency Care Clinic/Center
  • Sidney, MT
National Provider Identifier
1568532802
Registry record updated Dec 8, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Care Clinic/CenterTaxonomy code 261QE0002X
License
10905 Issued in MT
Legal business name
SIDNEY HEALTH CENTER
Practice address
216 14TH Ave SW
Sidney, MT 59270-3519
Phone
(406) 488-2100
Fax
(406) 488-2125
NPI assigned
Nov 8, 2006
Last updated
Dec 8, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2020

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

Authorized official

Name
Tina Montgomery
Title
Senior Executive, Finance/Cfo
Phone
(406) 488-2117

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Care Clinic/Center 261QE0002X 10905 MT Primary

Addresses

Primary practice location

216 14TH Ave SW
Sidney, MT 59270-3519

Mailing address

216 14TH Ave SW
Sidney, MT 59270-3519
Phone (406) 488-2100

Other identifiers 2

IdentifierTypeStateIssuer
0355290MedicaidMT
0000016330OtherMTBC/BS

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address sanford_toc1008865@direct.sanfordhealth.org Direct

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040115000513 MT Part B Supplier - Clinic/Group Practice 0749181535 Receives reassigned benefits from 149 practitioners
2 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Sidney, MT

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Community Meml HSP ER S9 organizations share this tax ID, including this one

Other organizations with this tax ID 8

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 53

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.

View all 53

NPI Registry JSON

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

{
    "created_epoch": "1162944000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1607385600000",
    "number": "1568532802",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "216 14TH AVE SW",
            "city": "SIDNEY",
            "state": "MT",
            "postal_code": "592703519",
            "telephone_number": "406-488-2100",
            "fax_number": "406-488-2125"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "216 14TH AVE SW",
            "city": "SIDNEY",
            "state": "MT",
            "postal_code": "592703519",
            "telephone_number": "406-488-2100",
            "fax_number": "406-488-2125"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SIDNEY HEALTH CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-08",
        "last_updated": "2020-12-08",
        "certification_date": "2020-12-08",
        "status": "A",
        "authorized_official_last_name": "MONTGOMERY",
        "authorized_official_first_name": "TINA",
        "authorized_official_title_or_position": "SENIOR EXECUTIVE, FINANCE/CFO",
        "authorized_official_telephone_number": "406-488-2117"
    },
    "taxonomies": [
        {
            "code": "261QE0002X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Emergency Care",
            "state": "MT",
            "license": "10905",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0355290",
            "state": "MT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS",
            "identifier": "0000016330",
            "state": "MT"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sanford_toc1008865@direct.sanfordhealth.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCDA",
            "address_1": "216 14th Ave SW",
            "city": "Sidney",
            "state": "MT",
            "country_code": "US",
            "postal_code": "592703519",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Sidney, MT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2020; 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.