Individual provider Active NPI

Jeannette Marielle McIntyre, M.D.

  • Family Medicine Physician
  • Miles City, MT
National Provider Identifier
1679916340
Registry record updated Nov 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MED-PHYS-LIC-99122 Issued in MT
Practice address
2600 Wilson St
Miles City, MT 59301-5094
Phone
(406) 233-2500
Fax
(406) 233-2553
NPI assigned
Apr 12, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 19, 2021

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 29005 NE
Student in an Organized Health Care Education/Training Program 390200000X
Student in an Organized Health Care Education/Training Program 390200000X 390200000 FL
Family Medicine Physician 207Q00000X MED-PHYS-LIC-99122 MT Primary

Addresses

Primary practice location

2600 Wilson St
Miles City, MT 59301-5094

Mailing address

2600 Wilson St
Miles City, MT 59301-5094
Phone (406) 233-2500

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210609002303 MT Practitioner - Family Practice 4486934593 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Indiana University School of Medicine, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Holy Rosary HealthcareGroup PAC ID 8921045667, 49 clinicians

Practice addresses (Care Compare)

2600 Wilson St
Miles City, MT 59301-5094
Phone (406) 233-2600

Hospital & facility affiliations

  • Holy Rosary Hospital Hospital, Miles City, MT, CCN 271347

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MED-PHYS-LIC-99122MTMDFamily Medicine Physician
390200000FLMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Holy Rosary Healthcare Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1365724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637280000000",
    "number": "1679916340",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2600 WILSON ST",
            "city": "MILES CITY",
            "state": "MT",
            "postal_code": "593015094",
            "telephone_number": "406-233-2500",
            "fax_number": "406-233-2553"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2600 WILSON ST",
            "city": "MILES CITY",
            "state": "MT",
            "postal_code": "593015094",
            "telephone_number": "406-233-2500",
            "fax_number": "406-233-2553"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCINTYRE",
        "first_name": "JEANNETTE",
        "middle_name": "MARIELLE",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-04-12",
        "last_updated": "2021-11-19",
        "certification_date": "2021-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NE",
            "license": "29005",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "FL",
            "license": "390200000",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MT",
            "license": "MED-PHYS-LIC-99122",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miles City, MT

Sources for this page

Verify at the official NPI Registry.