NPIMap

Organization Active NPI

Glacier Regional Pathology, LTD.

  • Anatomic Pathology Physician
  • Kalispell, MT
National Provider Identifier
1619081767
Registry record updated Oct 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology PhysicianTaxonomy code 207ZP0101X
Legal business name
GLACIER REGIONAL PATHOLOGY, LTD.
Practice address
310 Sunnyview Lane
Pathology Department
Kalispell, MT 59901-3129
Phone
(406) 752-1789
Fax
(406) 751-5776
NPI assigned
Aug 18, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2024

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

Authorized official

Name
Pete Anthony Fisher, M.D.
Title
President
Phone
(406) 752-1789

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207ZP0101X Primary

Addresses

Primary practice location

310 Sunnyview Lane
Pathology Department
Kalispell, MT 59901-3129

Mailing address

PO Box 10760
Kalispell, MT 59904-3760
Phone (406) 752-1789

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040126000679 MT Part B Supplier - Clinic/Group Practice 5395647648 Receives reassigned benefits from 4 practitioners
Practice locations: Kalispell, MT

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 317

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 317

NPI Registry JSON

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

{
    "created_epoch": "1155859200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1730073600000",
    "number": "1619081767",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 10760",
            "city": "KALISPELL",
            "state": "MT",
            "postal_code": "599043760",
            "telephone_number": "406-752-1789",
            "fax_number": "406-751-5776"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "310 SUNNYVIEW LANE",
            "address_2": "PATHOLOGY DEPARTMENT",
            "city": "KALISPELL",
            "state": "MT",
            "postal_code": "599013129",
            "telephone_number": "406-752-1789",
            "fax_number": "406-751-5776"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GLACIER REGIONAL PATHOLOGY, LTD.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-18",
        "last_updated": "2024-10-28",
        "certification_date": "2024-10-09",
        "status": "A",
        "authorized_official_last_name": "FISHER",
        "authorized_official_first_name": "PETE",
        "authorized_official_middle_name": "ANTHONY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "406-752-1789",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207ZP0101X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pathology, Anatomic Pathology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kalispell, MT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2024; 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.