Individual provider Active NPI

Jordan Guffin, M.D.

  • Emergency Medicine Physician
  • Missoula, MT
National Provider Identifier
1689985376
Registry record updated Jun 18, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
MT196931 Issued in PA
Practice address
500 W Broadway St
Missoula, MT 59802-4008
Phone
(406) 327-1918
NPI assigned
Jun 28, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X MT196931 PA Primary

Addresses

Primary practice location

500 W Broadway St
Missoula, MT 59802-4008

Mailing address

500 W Broadway St
Missoula, MT 59802-4008
Phone (406) 327-1918

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
I20130702000861 MT Practitioner - Emergency Medicine 1759530983 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
University of Washington School of Medicine, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Providence Health and Services MtGroup PAC ID 6608786306, 358 clinicians

Practice addresses (Care Compare)

500 W Broadway St
Missoula, MT 59802-4008
Phone (406) 329-5635

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MT196931PAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Health & Services Mt Current Accepting new patients
Providence Health & Services Mt CurrentSince Jul 1, 2013 Accepting new patients
Providence Health & Services Mt CurrentSince Jul 1, 2013 Accepting new patients
Credena Health LLC CurrentSince Dec 1, 2024 Accepting new patients
Providence St Joseph Medical Center CurrentSince Dec 1, 2024 Accepting new patients

Locations

401 W Pennsylvania Ave
Anaconda, MT 59711
Phone (406) 563-5261

500 W Broadway St
Missoula, MT 59802
Phone (406) 327-1918

500 W Broadway St
Ste 320
Missoula, MT 59802

6 13th Ave E
Polson, MT 59860
Phone (406) 883-5377

Organizations & group practices 5

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.

Hospital & facility affiliations 4

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": "1277683200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1371513600000",
    "number": "1689985376",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 W BROADWAY ST",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598024008",
            "telephone_number": "406-327-1918"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 W BROADWAY ST",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598024008",
            "telephone_number": "406-327-1918"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUFFIN",
        "first_name": "JORDAN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-06-28",
        "last_updated": "2013-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "PA",
            "license": "MT196931",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Missoula, MT

Sources for this page

Verify at the official NPI Registry.