Janice Lea Nystrom, RN, MSN, FNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

40604803 Issued in MT

Practice address

6850 Upper Box Elder Rd
Box Elder, MT 59521-0000

Phone

(406) 395-4486

Fax

(406) 395-4138

NPI assigned

Apr 10, 2007

Last updated

Jan 30, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MT

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science - Nursing, Nurse Practitioner, Registered Nurse

State licenses

Practice roles

Locations

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.

• Rocky Boy Health Center

  • Federally Qualified Health Center (FQHC)
  • Box Elder, MT
  • NPI 1598802332
  Medicare reassignment NPD

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

{
    "created_epoch": "1176163200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580342400000",
    "number": "1619190519",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6850 UPPER BOX ELDER RD",
            "city": "BOX ELDER",
            "state": "MT",
            "postal_code": "595210000",
            "telephone_number": "406-395-4486",
            "fax_number": "406-395-4138"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6850 UPPER BOX ELDER RD",
            "city": "BOX ELDER",
            "state": "MT",
            "postal_code": "595210000",
            "telephone_number": "406-395-4486",
            "fax_number": "406-395-4138"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NYSTROM",
        "first_name": "JANICE",
        "middle_name": "LEA",
        "credential": "RN, MSN, FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-10",
        "last_updated": "2020-01-30",
        "certification_date": "2020-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MT",
            "license": "RN23489",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MT",
            "license": "40604803",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lenore Myers, LCPC, LAC
• Nat's Medical Supply
• Darel Arvin Nelson, DDS
• Victor NG
• Janet Nordrum
• Jamie Marie Oats-Swan, RN
• Crissa Oliva, EMT-B
• Amber Marie Ophus, MT (ASCP)
• Carol Jean Ortman, LCSW
• Gary Palladino, PHARMD

• Nurse Practitioner in Box Elder, MT
• Providers in Box Elder, MT by specialty
• Nurse Practitioner in Montana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2020; 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.