Individual provider Active NPI

Brittany Mae Mitchell Eppard, NP

  • Nurse Practitioner
  • Kalispell, MT
National Provider Identifier
1649627936
Registry record updated Aug 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
128154 Issued in MT
Practice address
118 Main St
Kalispell, MT 59901-4452
Phone
(406) 219-1104
NPI assigned
May 17, 2016
Last updated
Aug 9, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 9, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X CNP4567 MN
Nurse Practitioner 363L00000X 128154 MT Primary

Addresses

Primary practice location

118 Main St
Kalispell, MT 59901-4452

Mailing address

61 Bearpaw Loop
Bigfork, MT 59911-3597
Phone (651) 315-5684

Other practice location 1

106 Ridgewater Dr Ste A
Polson, MT 59860
Phone (406) 883-3200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MT
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171211002446 MT Practitioner - Nurse Practitioner 5597057752 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
CNP4567MNMDNurse Practitioner
128154MTMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Headwaters Wellness PLLC CurrentSince Jan 2, 2022 Accepting new patients
Western Montana Mental Health Center CurrentSince Dec 18, 2018 Accepting new patients
Sara Boilen Psy D PLLC PastSince Nov 1, 2020 Accepting new patients

Locations

118 Main St
Kalispell, MT 59901
Phone (406) 219-1104

410 Windward Way
Kalispell, MT 59901
Phone (406) 257-1336

1315 Wyoming St
Missoula, MT 59801
Phone (406) 532-9700

1321 Wyoming St
Missoula, MT 59801
Phone (406) 532-9770

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1463443200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628467200000",
    "number": "1649627936",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "61 BEARPAW LOOP",
            "city": "BIGFORK",
            "state": "MT",
            "postal_code": "599113597",
            "telephone_number": "651-315-5684",
            "fax_number": "406-730-5027"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "118 MAIN ST",
            "city": "KALISPELL",
            "state": "MT",
            "postal_code": "599014452",
            "telephone_number": "406-219-1104"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "106 Ridgewater Dr Ste A",
            "address_purpose": "LOCATION",
            "city": "Polson",
            "state": "MT",
            "postal_code": "59860",
            "country_code": "US",
            "telephone_number": "406-883-3200",
            "fax_number": "406-883-9483",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EPPARD",
        "first_name": "BRITTANY",
        "middle_name": "MAE MITCHELL",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-05-17",
        "last_updated": "2021-08-09",
        "certification_date": "2021-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MN",
            "license": "CNP4567",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MT",
            "license": "128154",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kalispell, MT

Sources for this page

Verify at the official NPI Registry.