Nicholas Charles Anthony
Individual provider Active NPI Clinical Psychologist · Bozeman, MT
NPI 1629137880 · NPPES record last updated Dec 8, 2015
Key facts
- NPI
- 1629137880
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Psychologist 103TC0700X
- License
- PSY-PSY-LIC 1484 (MT)
- Practice address
- 905 Highland Blvd
Ste. 4500
Bozeman, MT 59715-6901 - Phone
- (406) 551-0533
- NPI assigned
- Dec 6, 2006
- Sex
- Male
- Sole proprietor
- Yes
Medicare Care Compare profile
- Specialty
- Clinical Psychologist
- Education
- Other, 1973
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
118 Slough Creek Dr
Bozeman, MT 59718-2064
Phone (406) 551-0533
1200 S Reserve St H
Missoula, MT 59801-3107
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MT
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160302002320 | MT | Practitioner - Clinical Psychologist | 1658400106 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PY 3960 | FL | MD | Clinical Psychologist |
| PSY-PSY-LIC 1484 | MT | MD | Clinical Psychologist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | PY 3960 | FL | |
| Clinical Psychologist | 103TC0700X | PSY-PSY-LIC 1484 | MT | Yes |
Addresses
Primary practice location
905 Highland Blvd
Ste. 4500
Bozeman, MT 59715-6901
Mailing address
905 Highland Blvd
Ste. 4500
Bozeman, MT 59715-6901
Phone (406) 551-0533
Other providers in Bozeman, MT
- Iris Ankrom-Crittenden
- Annemarie Dubois, LCSW, L.L.C
- Elizabeth A Ansley
- Answers Health Care Inc
- Haili Anthony
- Amy M Appel
- Christian E Appel
- Sandy Appleby
- Apr Medical LLC
- Apricity Medical PLLC
All providers in Bozeman, MT · Clinical Psychologist in Montana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 8, 2015. 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.
- Order and Referring (CMS).
- 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.