Mountain States Precision Healthcare PLLC

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

Legal business name

MOUNTAIN STATES PRECISION HEALTHCARE PLLC

Practice address

2825 Stockyard Rd Ste A18
Missoula, MT 59808-1545

Phone

(406) 219-1233

Fax

(219) 244-6019

NPI assigned

Jan 28, 2021

Organization subpart

No

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

Authorized official

Name

Hayley Ann Miller, MDNPI 1366672578

Title

Owner, Director

Phone

(206) 459-0334

Specialties & licenses 1

Addresses

Other names 1

• Mountain States Precision Healthcare Doing business as

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in MT

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Hayley Ann Miller, MD

  • Internal Medicine Physician
  • Missoula, MT
  • NPI 1366672578
  Medicare reassignment NPD Authorized official
• Carla Gibson, APRN

  • Family Nurse Practitioner
  • Missoula, MT
  • NPI 1245310135
  NPD (past)

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

{
    "created_epoch": "1611792000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1621296000000",
    "number": "1679164149",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2004 SILVER TIPS DR",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598088602",
            "telephone_number": "206-459-0334",
            "fax_number": "219-244-6019"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2825 STOCKYARD RD STE A18",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598081545",
            "telephone_number": "406-219-1233",
            "fax_number": "219-244-6019"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOUNTAIN STATES PRECISION HEALTHCARE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-01-28",
        "last_updated": "2021-05-18",
        "certification_date": "2021-05-18",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "HAYLEY",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "OWNER, DIRECTOR",
        "authorized_official_telephone_number": "206-459-0334",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://montanadiabetes.com",
            "affiliation": "N",
            "endpointDescription": "website",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "2004 Silver Tips Dr",
            "city": "Missoula",
            "state": "MT",
            "country_code": "US",
            "postal_code": "598088602",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Mountain States Precision Healthcare",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Primary Care Clinic/Center in Missoula, MT
• Providers in Missoula, MT by specialty
• Primary Care Clinic/Center in Montana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2021; 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.