NPIMap

Organization Active NPI

Clearwater Therapeutics LLC

  • Orthopedic Physical Therapist
  • Bozeman, MT
National Provider Identifier
1659600203
Registry record updated Oct 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic Physical TherapistTaxonomy code 2251X0800X
License
MT1861 Issued in MT
Legal business name
CLEARWATER THERAPEUTICS LLC
Practice address
117 E Oak St Ste 1a
Bozeman, MT 59715-2977
Phone
(406) 585-3701
Fax
(406) 586-9708
NPI assigned
Dec 10, 2009
Last updated
Oct 13, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 13, 2023

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

Authorized official

Name
Jorden Border
Title
Office Admin
Phone
(406) 585-3701

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopedic Physical TherapistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 2251X0800X MT1861 MT Primary
Orthopedic Physical TherapistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 2251X0800X MT2360 MT
Orthopedic Physical TherapistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 2251X0800X MT2289 MT
Physical Therapy Clinic/Center 261QP2000X 1861 MT

Addresses

Primary practice location

117 E Oak St Ste 1a
Bozeman, MT 59715-2977

Mailing address

117 E Oak St Ste 1a
Bozeman, MT 59715-2977
Phone (406) 585-3701

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100319000430 MT Part B Supplier - Clinic/Group Practice 3476688151 Receives reassigned benefits from 7 practitioners
Practice locations: Bozeman, MT

National Provider Directory

National Provider Directory

Locations

1648 Ellis St
Ste 201
Bozeman, MT 59715
Phone (406) 556-4649

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1260403200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1697155200000",
    "number": "1659600203",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "117 E OAK ST STE 1A",
            "city": "BOZEMAN",
            "state": "MT",
            "postal_code": "597152977",
            "telephone_number": "406-585-3701",
            "fax_number": "406-586-9708"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "117 E OAK ST STE 1A",
            "city": "BOZEMAN",
            "state": "MT",
            "postal_code": "597152977",
            "telephone_number": "406-585-3701",
            "fax_number": "406-586-9708"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLEARWATER THERAPEUTICS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-12-10",
        "last_updated": "2023-10-13",
        "certification_date": "2023-10-13",
        "status": "A",
        "authorized_official_last_name": "BORDER",
        "authorized_official_first_name": "JORDEN",
        "authorized_official_title_or_position": "OFFICE ADMIN",
        "authorized_official_telephone_number": "406-585-3701"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Physical Therapist, Orthopedic",
            "state": "MT",
            "license": "MT1861",
            "primary": true
        },
        {
            "code": "2251X0800X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Physical Therapist, Orthopedic",
            "state": "MT",
            "license": "MT2360",
            "primary": false
        },
        {
            "code": "2251X0800X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Physical Therapist, Orthopedic",
            "state": "MT",
            "license": "MT2289",
            "primary": false
        },
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "MT",
            "license": "1861",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bozeman, MT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.