NPIMap

Individual provider Active NPI

Staci Noel Allen, D.O.

  • Anesthesiology Physician
  • Whitefish, MT
National Provider Identifier
1639517519
Registry record updated Oct 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
E-11407 Issued in AR
Practice address
147 Hawthorne CT Unit B
Whitefish, MT 59937-7975
Phone
(405) 831-2195
NPI assigned
Jun 12, 2013
Last updated
Oct 6, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 6, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X E-11407 AR Primary
Pediatric Anesthesiology Physician 207LP3000X MED-PHYS-LIC-128975 MT
Pediatric Anesthesiology Physician 207LP3000X E11407 AR

Addresses

Primary practice location

147 Hawthorne CT Unit B
Whitefish, MT 59937-7975

Mailing address

147 Hawthorne CT Unit B
Whitefish, MT 59937-7975
Phone (405) 831-2195

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR, MT2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20180725000249 AR Practitioner - Anesthesiology 5193091106 Reassigns benefits to 3 organizations
I20231019001819 MT Practitioner - Anesthesiology 5193091106 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northern Rockies Anesthesia Consultants PLLCGroup PAC ID 8022900208, 33 clinicians

Practice addresses (Care Compare)

310 Sunnyview LN
Kalispell, MT 59901-3129
Phone (406) 752-5111

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
E-11407ARMDAnesthesiology Physician
E11407ARMDPediatric Anesthesiology Physician
MED-PHYS-LIC-128975MTMDPediatric Anesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Arkansas for Medical Sciences CurrentSince Aug 27, 2018 Accepting new patients
University of Arkansas for Medical Sciences CurrentSince Aug 27, 2018 Accepting new patients
University of Arkansas for Medical Sciences CurrentSince Aug 27, 2018 Accepting new patients
University of Arkansas for Medical Sciences Anesthesiology Current Accepting new patients
Arkansas Children's Hospital CurrentSince Aug 27, 2018 Accepting new patients
University of Arkansas for Medical Sciences Anesthesiology Current Accepting new patients
Arkansas Childrens Hospital CurrentSince Aug 27, 2018 Accepting new patients
Northern Rockies Anesthesia Consultants PLLC Anesthesiology CurrentSince Nov 1, 2023 Accepting new patients

Locations

1 Childrens Way
Little Rock, AR 72202
Phone (501) 364-1874

1 Childrens Way
#203
Little Rock, AR 72202
Phone (501) 364-2180

1 Childrens Way
#653
Little Rock, AR 72202
Phone (501) 614-2006

4301 W Markham St
Little Rock, AR 72205
Phone (501) 603-1278

310 Sunnyview Ln
Kalispell, MT 59901
Phone (406) 751-5310

Organizations & group practices 8

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.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1370995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696550400000",
    "number": "1639517519",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "147 HAWTHORNE CT UNIT B",
            "city": "WHITEFISH",
            "state": "MT",
            "postal_code": "599377975",
            "telephone_number": "405-831-2195"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "147 HAWTHORNE CT UNIT B",
            "city": "WHITEFISH",
            "state": "MT",
            "postal_code": "599377975",
            "telephone_number": "405-831-2195"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALLEN",
        "first_name": "STACI",
        "middle_name": "NOEL",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-06-12",
        "last_updated": "2023-10-06",
        "certification_date": "2023-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "AR",
            "license": "E-11407",
            "primary": true
        },
        {
            "code": "207LP3000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pediatric Anesthesiology",
            "state": "MT",
            "license": "MED-PHYS-LIC-128975",
            "primary": false
        },
        {
            "code": "207LP3000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pediatric Anesthesiology",
            "state": "AR",
            "license": "E11407",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Whitefish, MT

Sources for this page

Verify at the official NPI Registry.