NPIMap

Organization Active NPI

Partnership Health Center Inc

  • Federally Qualified Health Center (FQHC)
  • Missoula, MT
National Provider Identifier
1629800313
Registry record updated Apr 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
PARTNERSHIP HEALTH CENTER INC
Practice address
3216 S Russell St
Missoula, MT 59801-8537
Phone
(406) 258-4496
Fax
(406) 258-4732
NPI assigned
Aug 20, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 16, 2025

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

Authorized official

Name
Lara Salazar
Title
Billing Manager
Phone
(406) 258-3360

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X Primary
Adolescent and Children Mental Health Clinic/Center 261QM0855X

Addresses

Primary practice location

3216 S Russell St
Missoula, MT 59801-8537

Mailing address

401 Railroad St W
Missoula, MT 59802-4178
Phone (406) 258-4496

Other names 1

  • PHC Russell Elementary Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240830002183 MT Part A Provider - Federally Qualified Health Center (FQHC) 6103843479 Practice locations: Missoula, MT

Federally qualified health center certification: CCN 271017

Legal name
PARTNERSHIP HEALTH CENTER INC
Doing business as
PHC RUSSELL ELEMENTARY
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Aug 21, 2024
Last certification
Aug 21, 2024
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Jun 5, 1992 in MT
Enrollment address
3216 S Russell St
Missoula, MT 59801-8537

Other NPIs with the same Medicare PAC ID 14

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

View all 14

National Provider Directory

National Provider Directory
Tax ID family
Partnership Health Ctr Inc18 organizations share this tax ID, including this one

Other organizations with this tax ID 17

Organizations that report the same tax identification number in the National Provider Directory.

View all 17

Ownership & related parties

All disclosed owners & managing parties 16

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Kathleen Walters Individual Corporate DirectorBoard Member Jul 1, 2013
Jay Raines Individual Corporate DirectorBoard Member Jan 1, 2024
Bryan William Chalmers Individual Corporate OfficerCfo Dec 16, 2019
Mark Thane Individual Corporate DirectorBoard Member Oct 1, 2019
Patricia Kero Individual Corporate DirectorBoard Member Nov 1, 2021
Jeffrey Weist Individual Corporate DirectorBoard Member Mar 1, 2020
Lara Salazar Individual Corporate OfficerCeo Oct 3, 2022
Suzette Baker Individual Corporate DirectorBoard Member Apr 24, 2024
Kristin Petersen Individual Corporate DirectorBoard Member Aug 20, 2024
Andrea Green Individual Corporate DirectorBoard Member Mar 1, 2021
Natalie Wolfram Individual Corporate DirectorBoard Member Oct 1, 2018
Holly Blaylock Individual W-2 Managing EmployeeRevenue Cycle Administrator Jul 6, 2015
Dawn Briggs Individual W-2 Managing EmployeeBilling Manager Apr 14, 2003
David Strohmaier Individual Corporate DirectorBoard Member Jul 1, 2019
John Crawford Individual Corporate DirectorBoard Member Oct 3, 2022
Jilayne Dunn Individual Corporate DirectorBoard Member Dec 1, 2013

NPI Registry JSON

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

{
    "created_epoch": "1724112000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1744761600000",
    "number": "1629800313",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 RAILROAD ST W",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598024178",
            "telephone_number": "406-258-4496",
            "fax_number": "406-258-4578"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3216 S RUSSELL ST",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598018537",
            "telephone_number": "406-258-4496",
            "fax_number": "406-258-4732"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PARTNERSHIP HEALTH CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-08-20",
        "last_updated": "2025-04-16",
        "certification_date": "2025-04-16",
        "status": "A",
        "authorized_official_last_name": "SALAZAR",
        "authorized_official_first_name": "LARA",
        "authorized_official_title_or_position": "BILLING MANAGER",
        "authorized_official_telephone_number": "406-258-3360"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PHC Russell Elementary",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "PHC Russell Elementary",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Missoula, MT

Sources for this page

Verify at the official NPI Registry.