NPIMap

Organization Active NPI

Missoula Community Health Services, Inc

Doing business as Tamarack Medical Clinic

  • General Practice Physician
  • Superior, MT
National Provider Identifier
1710165105
Registry record updated Apr 5, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
Legal business name
MISSOULA COMMUNITY HEALTH SERVICES, INC
Doing business as
Tamarack Medical Clinic
Practice address
1208 6TH Ave
Superior, MT 59872-9618
Phone
(406) 822-4278
Fax
(406) 822-4912
NPI assigned
Feb 7, 2008
Last updated
Apr 5, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 5, 2019

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

Authorized official

Name
Mr. John S McNeece
Title
Ceo
Phone
(406) 822-4841

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X NU Primary

Addresses

Primary practice location

1208 6TH Ave
Superior, MT 59872-9618

Mailing address

PO Box 66
Superior, MT 59872-0066
Phone (406) 822-4278

Other names 1

  • Tamarack Medical Clinic Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MT

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031114000597 MT Part B Supplier - Clinic/Group Practice 6709790603 Receives reassigned benefits from 20 practitioners
2 other NPIs on this enrollment
Practice locations: Superior, MT

Other NPIs with the same Medicare PAC ID 3

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 20

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.

View all 20

NPI Registry JSON

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

{
    "created_epoch": "1202342400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1554422400000",
    "number": "1710165105",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 66",
            "city": "SUPERIOR",
            "state": "MT",
            "postal_code": "598720066",
            "telephone_number": "406-822-4278",
            "fax_number": "406-822-4912"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1208 6TH AVE",
            "city": "SUPERIOR",
            "state": "MT",
            "postal_code": "598729618",
            "telephone_number": "406-822-4278",
            "fax_number": "406-822-4912"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MISSOULA COMMUNITY HEALTH SERVICES, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-07",
        "last_updated": "2019-04-05",
        "status": "A",
        "authorized_official_last_name": "MCNEECE",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "406-822-4841",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Tamarack Medical Clinic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Tamarack Medical Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Superior, MT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2019; 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.