Individual provider Active NPI

Mary Pannill Stuart McIntyre, FNP-BC

  • Primary Care Nurse Practitioner
  • Missoula, MT
National Provider Identifier
1578246161
Registry record updated Aug 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
NUR-APRN-LIC-217792 Issued in MT
Practice address
2230 N Reserve St Ste 402
Missoula, MT 59808-1364
Phone
(406) 721-0533
NPI assigned
Aug 9, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 9, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner 363LP2300X NUR-APRN-LIC-217792 MT Primary

Addresses

Primary practice location

2230 N Reserve St Ste 402
Missoula, MT 59808-1364

Mailing address

2827 Fort Missoula Rd
Missoula, MT 59804-7408

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MT
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231026000914 MT Practitioner - Nurse Practitioner 2062868185 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of Virginia School of Medicine, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
RCHP Billings - Missoula LLCGroup PAC ID 8426370842, 69 clinicians

Practice addresses (Care Compare)

2230 N Reserve St
Suite 402
Missoula, MT 59808-1364
Phone (406) 721-0533

Hospital & facility affiliations

  • Community Medical Center Hospital, Missoula, MT, CCN 270023

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
NUR-APRN-LIC-217792MTMDPrimary Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
RCHP Billings - Missoula LLC CurrentSince Sep 4, 2023 Accepting new patients
RCHP Billings - Missoula LLC CurrentSince Sep 4, 2023 Accepting new patients

Locations

2230 N Reserve St
Ste 402
Missoula, MT 59808
Phone (406) 327-3850

2307 Brooks St
Missoula, MT 59801
Phone (406) 493-3110

2827 Fort Missoula Rd
Missoula, MT 59804
Phone (406) 327-4202

2230 N Reserve St
Missoula, MT 59808
Phone (406) 721-0533

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1691539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691539200000",
    "number": "1578246161",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2827 FORT MISSOULA RD",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598047408"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2230 N RESERVE ST STE 402",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598081364",
            "telephone_number": "406-721-0533"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCINTYRE",
        "first_name": "MARY",
        "middle_name": "PANNILL STUART",
        "credential": "FNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-08-09",
        "last_updated": "2023-08-09",
        "certification_date": "2023-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "MT",
            "license": "NUR-APRN-LIC-217792",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Missoula, MT

Sources for this page

Verify at the official NPI Registry.