Cailyn Gillis, RD, LN

Individual provider Active NPI Registered Dietitian · Glen, MT

NPI 1609401496 · NPPES record last updated Mar 18, 2024

Key facts

NPI
1609401496
Entity type
Individual (NPI type 1)
Primary specialty
Registered Dietitian 133V00000X
License
MED-NUTR-LIC-79498 (MT)
Practice address
19750 Mt Highway 91 N
Glen, MT 59732-8507
Phone
(406) 868-8915
NPI assigned
Mar 11, 2020
Sex
Female
Sole proprietor
No

Organizations & group practices 1

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

State licenses

LicenseStateTypeSpecialty
MED-NUTR-LIC-79498MTMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Pursuit Dietetics, PLLC Dietitian, Registered Current
since Mar 24, 2024
Accepting new patients

Locations

609 Pronghorn Trl
#C
Bozeman, MT 59718
Phone (406) 201-9020

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X MED-NUTR-LIC-79498 MT Yes

Addresses

Primary practice location

19750 Mt Highway 91 N
Glen, MT 59732-8507

Mailing address

PO Box 922
Bozeman, MT 59771-0922

Other practice location 1

609 Pronghorn Trl # C
Bozeman, MT 59718-7090
Phone (406) 868-8915

Other identifiers

IdentifierTypeStateIssuer
86130394OtherCOMMISSION ON DIETETIC REGISTRATION
MED-NUTR-LIC-79498OtherMTSTATE OF MONTANA BOARD OF MEDICAL EXAMINERS
336OtherWYSTATE OF WYOMING DIETETICS LICENSING BOARD

Other names

  • Cailyn Schroeder Former name

Other providers in Glen, MT

All providers in Glen, MT · Registered Dietitian in Montana

Sources for this page

Verify at the official NPI Registry.