Mountain Internal Medicine, PLLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

MOUNTAIN INTERNAL MEDICINE, PLLC

Practice address

323 E Front St
Missoula, MT 59802-4715

Phone

(406) 317-4800

NPI assigned

May 23, 2022

Organization subpart

No

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

Authorized official

Name

Sarah Faaborg, MDNPI 1386809101

Title

Partner

Phone

(406) 579-3160

Specialties & licenses 1

Addresses

Other names 1

• Mountain Internal Medicine Other name

Medicare fee-for-service enrollment

Enrolled in MT

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 2

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

• Sarah Lynn Faaborg, MD

  • Internal Medicine Physician
  • Missoula, MT
  • NPI 1386809101

  Internal Medicine, MT

  Medicare reassignment Care Compare group NPD Authorized official
• Marnie Jean Dichiaro, APRN

  • Gerontology Nurse Practitioner
  • Missoula, MT
  • NPI 1811497076

  MT

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1653264000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1674604800000",
    "number": "1689312449",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "323 E FRONT ST",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598024715",
            "telephone_number": "406-317-4800",
            "fax_number": "406-416-4800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "323 E FRONT ST",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598024715",
            "telephone_number": "406-317-4800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOUNTAIN INTERNAL MEDICINE, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-05-23",
        "last_updated": "2023-01-25",
        "certification_date": "2022-12-06",
        "status": "A",
        "authorized_official_last_name": "FAABORG",
        "authorized_official_first_name": "SARAH",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "406-579-3160",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mountain Internal Medicine",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Motion Medical Solutions, Inc
• Moua Ko Moua, LAC, SWLC
• Mountain Compounding
• Mountain Home Montana Inc
• Mountain Horizon Counseling
• Mountain Kids Pediatrics
• Mountain Mobile Wound Care
• Mountain Sage Acupuncture PLLC
• Mountain States Precision Healthcare PLLC
• Mountain Top Psychotherapy, PLLC

• All providers in Missoula, MT
• Internal Medicine Physician in Montana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.