West Yellowstone Back & Neck Clinic

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

License

940 Issued in MT

Legal business name

WEST YELLOWSTONE BACK & NECK CLINIC

Practice address

425 Yellowstone Ave.
West Yellowstone, MT 59758

Phone

(406) 646-4444

NPI assigned

Mar 7, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Kyle Goltz, D.C.NPI 1417049891

Title

Owner

Phone

(406) 646-4444

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MT

Enrollment records 1

Practitioners 1

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.

• Kyle Goltz, D.C.

  • Chiropractor
  • West Yellowstone, MT
  • NPI 1417049891
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1173225600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1247788800000",
    "number": "1699806471",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1167",
            "city": "WEST YELLOWSTONE",
            "state": "MT",
            "postal_code": "597581167",
            "telephone_number": "406-646-4444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "425 YELLOWSTONE AVE.",
            "city": "WEST YELLOWSTONE",
            "state": "MT",
            "postal_code": "59758",
            "telephone_number": "406-646-4444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WEST YELLOWSTONE BACK & NECK CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-07",
        "last_updated": "2009-07-17",
        "status": "A",
        "authorized_official_last_name": "GOLTZ",
        "authorized_official_first_name": "KYLE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "406-646-4444",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "MT",
            "license": "940",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Parkside Physical Therapy, LLC
• Rocky Mountain Holdings, LLC (Air Idaho Rescue)
• Silvertip Pharmacy Inc (Silvertip Pharmacy)
• Emma Jane Sparboe, DNP, FNP
• Town of West Yellowstone EMS
• West Yellowstone Dental
• Yellowstone Family Medical Center Inc

• Clinic/Center in West Yellowstone, MT
• Providers in West Yellowstone, MT by specialty
• Clinic/Center in Montana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2009; 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.