Active NPI
Jesse T Parks, RPH
- Pharmacist
- Conrad, MT
National Provider Identifier
1609956200
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 476
- Practice address
- 600 South Main
Ste 2
Conrad, MT 59425 - Phone
- (406) 278-3267
- Fax
- (406) 278-3851
- NPI assigned
- Oct 17, 2006
- Last updated
- Jul 8, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 476 | MT | Primary |
Addresses
Primary practice location
600 South Main
Ste 2
Conrad, MT 59425
Mailing address
600 South Main
Ste 2
Conrad, MT 59425
Phone (406) 278-3267
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2704535 | Medicaid | MT |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 476 | MT | MD | Addiction (Substance Use Disorder) Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Utterback RX Inc | Past | Accepting new patients |
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, 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": "1161043200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1609956200",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "600 SOUTH MAIN",
"address_2": "STE 2",
"city": "CONRAD",
"state": "MT",
"postal_code": "59425",
"telephone_number": "406-278-3267",
"fax_number": "406-278-3851"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "600 SOUTH MAIN",
"address_2": "STE 2",
"city": "CONRAD",
"state": "MT",
"postal_code": "59425",
"telephone_number": "406-278-3267",
"fax_number": "406-278-3851"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PARKS",
"first_name": "JESSE",
"middle_name": "T",
"name_prefix": "Mr.",
"credential": "RPH",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-17",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MT",
"license": "476",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2704535",
"state": "MT"
}
],
"endpoints": [],
"other_names": []
}Other providers in Conrad, MT
- Richard Joseph Murack, DC
- My Hearing Centers, LLC
- Shawn Thomas Nesbo, MD
- North Central Area Agency on Aging
- Onyx Counseling & Consultation
- Pondera County (Pondera County Health Dept.)
- Pondera Medical Center
- Pondera Medical Center
- Pondera Medical Center (Pondera Medical Center Referral Clinic)
- Pondera Medical Center Eye Clinic PLLC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.