NPIMap

Organization Active NPI

Ideal Telemedicine Services, LLC

  • Clinic/Center
  • Great Falls, MT
National Provider Identifier
1649031824
Registry record updated Jan 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
IDEAL TELEMEDICINE SERVICES, LLC
Practice address
617 10TH Ave S
Great Falls, MT 59405-4048
Phone
(877) 522-1275
Fax
(833) 888-7145
NPI assigned
Jan 16, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2024

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

Authorized official

Name
Shannon Marie Bowden
Title
Credentialing Manager
Phone
(509) 570-9302

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X Primary

Addresses

Primary practice location

617 10TH Ave S
Great Falls, MT 59405-4048

Mailing address

5615 Dunbarton Ave
Pasco, WA 99301-8216
Phone (877) 522-1275

National Provider Directory

National Provider Directory
Tax ID family
Ideal Telemedicine Serv LLC36 organizations share this tax ID, including this one

Other organizations with this tax ID 35

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

View all 35

NPI Registry JSON

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

{
    "created_epoch": "1705363200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1705363200000",
    "number": "1649031824",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5615 DUNBARTON AVE",
            "city": "PASCO",
            "state": "WA",
            "postal_code": "993018216",
            "telephone_number": "877-522-1275",
            "fax_number": "833-888-7145"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "617 10TH AVE S",
            "city": "GREAT FALLS",
            "state": "MT",
            "postal_code": "594054048",
            "telephone_number": "877-522-1275",
            "fax_number": "833-888-7145"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IDEAL TELEMEDICINE SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-01-16",
        "last_updated": "2024-01-16",
        "certification_date": "2024-01-16",
        "status": "A",
        "authorized_official_last_name": "BOWDEN",
        "authorized_official_first_name": "SHANNON",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "CREDENTIALING MANAGER",
        "authorized_official_telephone_number": "509-570-9302"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Great Falls, MT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.