Michael Jon Close, RPT
Individual provider Active NPI Physical Therapist · Bigfork, MT
NPI 1609932037 · NPPES record last updated Oct 30, 2007
Key facts
- NPI
- 1609932037
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- 1350PT (MT)
- Practice address
- 850 Holt Drive
Bigfork, MT 59911 - Phone
- (406) 837-6892
- Fax
- (406) 837-6435
- NPI assigned
- Dec 29, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 1996
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
6400 Mt Hwy 35
Bigfork, MT 59911-6078
Phone (406) 837-6892
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MT
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20040318000051 | MT | Practitioner - Physical Therapist in Private Practice | 3375433824 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1350PT | MT | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Bigfork Physical Therapy & Sports Rehabilitation Inc | Current |
Accepting new patients |
Locations
6400 MT Highway 35
Bigfork, MT 59911
Phone (406) 837-6892
850 Holt Dr
Bigfork, MT 59911
Phone (406) 837-3255
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 1350PT | MT | Yes |
Addresses
Primary practice location
850 Holt Drive
Bigfork, MT 59911
Mailing address
PO Box 1527
Bigfork, MT 59911-1527
Phone (406) 837-6892
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 61996 | Other | MT | BCBS OF MONTANA PROVIDER |
| 0000345185 | Medicaid | MT |
Other providers in Bigfork, MT
- Clay I. Campbell
- Delaney J Carlson
- Jourdan Carlson
- Dora Downer Carroll
- Larry Clayton
- Lauren Coley
- Elizabeth Connor
- Matthew Cronk
- Lianna Mary Danielson
- Anna M Danz
All providers in Bigfork, MT · Physical Therapist in Montana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 30, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.