Active NPI
Annastatia Shannon Wheeler, LCSW
- Social Worker
- Missoula, MT
National Provider Identifier
1700284668
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 9755
- Practice address
- 725 W Central Ave Ste 109
Missoula, MT 59801-6867 - Phone
- (406) 207-3913
- NPI assigned
- Dec 9, 2014
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 9755 | MT | Primary |
Addresses
Primary practice location
725 W Central Ave Ste 109
Missoula, MT 59801-6867
Mailing address
PO Box 361
Clinton, MT 59825-0361
Phone (406) 207-3913
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 7171710 | Medicaid | MT |
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: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20170530002649 | MT | Practitioner - Clinical Social Worker | 1658648316 | Practice locations: Missoula, MT |
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Social Worker
- Education
- Other, 2010
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
Practice addresses (Care Compare)
2801 S Russell St
Suite 49
Missoula, MT 59801-7914
Phone (406) 207-3913
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 9755 | MT | MD | Orthopaedic Foot and Ankle Surgery Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1418083200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1521072000000",
"number": "1700284668",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 361",
"city": "CLINTON",
"state": "MT",
"postal_code": "598250361",
"telephone_number": "406-207-3913"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "725 W CENTRAL AVE STE 109",
"city": "MISSOULA",
"state": "MT",
"postal_code": "598016867",
"telephone_number": "406-207-3913"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WHEELER",
"first_name": "ANNASTATIA",
"middle_name": "SHANNON",
"name_prefix": "Mrs.",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-12-09",
"last_updated": "2018-03-15",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "MT",
"license": "9755",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "7171710",
"state": "MT"
}
],
"endpoints": [],
"other_names": []
}Other providers in Missoula, MT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- 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.