Kimberly Blakeslee, D.O.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

9618 Issued in MT

Practice address

2230 N Reserve St
Suite 402
Missoula, MT 59808-1321

Phone

(406) 721-0533

Fax

(406) 728-4463

NPI assigned

May 25, 2006

Last updated

Oct 2, 2007By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Mrs. Kimberly Ravitz Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

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.

• Community Medical Center Inc

  dba Physician Billing Services

  • Specialist
  • Missoula, MT
  • NPI 1548353519
  NPD (past)

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

{
    "created_epoch": "1148515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1191283200000",
    "number": "1659327609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2827 FORT MISSOULA RD",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598047408",
            "telephone_number": "406-728-4100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2230 N RESERVE ST",
            "address_2": "SUITE 402",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598081321",
            "telephone_number": "406-721-0533",
            "fax_number": "406-728-4463"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLAKESLEE",
        "first_name": "KIMBERLY",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-25",
        "last_updated": "2007-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MT",
            "license": "9618",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIMBERLY",
            "last_name": "RAVITZ",
            "prefix": "MRS.",
            "credential": "D.O.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Kaylee Virginia Blackwell, LAC
• Katherine Blaedow
• Donald Robert Blair, DC
• Jolynn Marie Blakeley, BCBA, LBA
• Benjamin Blakely, PT, DPT
• Tonya Blaney, BCBA
• Brandon Blank, DC
• Natalie Blauer, DPT
• Blair Bliss
• Jeanne Kathryn Bloom, FNP-BC

• Family Medicine Physician in Missoula, MT
• Providers in Missoula, MT by specialty
• Family Medicine Physician in Montana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2007; 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.