Individual provider Active NPI

Annalise Emma Mann, DO

  • Family Medicine Physician
  • Missoula, MT
National Provider Identifier
1710672902
Registry record updated Feb 18, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
166773 Issued in MT
Practice address
401 Railroad St W
Missoula, MT 59802-4178
Phone
(406) 258-4789
Fax
(406) 258-4732
NPI assigned
Apr 5, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 18, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 166773 MT Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

401 Railroad St W
Missoula, MT 59802-4178

Mailing address

401 Railroad St W
Missoula, MT 59802-4178
Phone (406) 258-4789

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
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
I20260615001280 CO Practitioner - Family Practice 4587104245

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
At Still Un of HLTH Sciences, Col of Osteo Med, Mesa, 2023
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

401 Railroad St W
Missoula, MT 59802-4178

715 Horizon Dr
Grand Junction, CO 81506-8759

PO Box
Salida, CO 81201

PO Box
Grand Junction, CO 81502

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
166773MTMDFamily Medicine Physician

Hospital & facility affiliations 5

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": "1680652800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1771372800000",
    "number": "1710672902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 RAILROAD ST W",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598024178",
            "telephone_number": "406-258-4789",
            "fax_number": "406-258-4732"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 RAILROAD ST W",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598024178",
            "telephone_number": "406-258-4789",
            "fax_number": "406-258-4732"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANN",
        "first_name": "ANNALISE",
        "middle_name": "EMMA",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-04-05",
        "last_updated": "2026-02-18",
        "certification_date": "2026-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MT",
            "license": "166773",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Missoula, MT

Sources for this page

Verify at the official NPI Registry.