Active NPI
Five Valleys Urology
- Urology Physician
- Missoula, MT
National Provider Identifier
1720067705
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Urology Physician
- Legal business name
- FIVE VALLEYS UROLOGY
- Practice address
- 2875 Tina
Suite 101
Missoula, MT 59808-1308 - Phone
- (406) 728-3366
- Fax
- (406) 329-2896
- NPI assigned
- Jan 10, 2006
- Last updated
- Apr 21, 2011
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. John Terry O'Connor
- Title
- Practice Administrator
- Phone
- (406) 728-3366
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Urology Physician | 208800000X | Primary |
Addresses
Primary practice location
2875 Tina
Suite 101
Missoula, MT 59808-1308
Mailing address
2875 Tina Ave
Suite 101
Missoula, MT 59808
Phone (406) 728-3366
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MT
Enrollment records 2
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 27D0707089 | Five Valleys Urology | Compliance | Sep 13, 2027 |
National Provider Directory
National Provider DirectoryLocations
601 W Spruce St
Ste G
Missoula, MT 59802
Phone (406) 728-3366
Practitioners & affiliated clinicians
Practitioners 13
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.
-
- Family Nurse Practitioner
- Missoula, MT
- NPI 1346984408
-
- Urology Physician
- Missoula, MT
- NPI 1033615406
-
- Urology Physician
- Missoula, MT
- NPI 1174502173
-
- Urology Physician
- Missoula, MT
- NPI 1770779225
-
- Physician Assistant
- Missoula, MT
- NPI 1528625969
-
- Urology Physician
- Missoula, MT
- NPI 1215932926
-
- Urology Physician
- Missoula, MT
- NPI 1912940693
-
- Medical Physician Assistant
- Billings, MT
- NPI 1205947397
-
- Physician Assistant
- Missoula, MT
- NPI 1316049695
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1136851200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1303344000000",
"number": "1720067705",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2875 TINA AVE",
"address_2": "SUITE 101",
"city": "MISSOULA",
"state": "MT",
"postal_code": "59808",
"telephone_number": "406-728-3366",
"fax_number": "406-329-2896"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2875 TINA",
"address_2": "SUITE 101",
"city": "MISSOULA",
"state": "MT",
"postal_code": "598081308",
"telephone_number": "406-728-3366",
"fax_number": "406-329-2896"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "FIVE VALLEYS UROLOGY",
"organizational_subpart": "NO",
"enumeration_date": "2006-01-10",
"last_updated": "2011-04-21",
"status": "A",
"authorized_official_last_name": "O'CONNOR",
"authorized_official_first_name": "JOHN",
"authorized_official_middle_name": "TERRY",
"authorized_official_title_or_position": "PRACTICE ADMINISTRATOR",
"authorized_official_telephone_number": "406-728-3366",
"authorized_official_name_prefix": "Mr."
},
"taxonomies": [
{
"code": "208800000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Urology",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Missoula, MT
- Dana Louise Fitz Gale, MS, CCC-SLP
- Tessa Craft Fitzpatrick, PT
- Thomas Fitzpatrick
- Five Valleys Home Health, LLC (Home Instead Missoula Montana)
- Five Valleys Occupational Therapy, LLC
- James Vanard Fix, CST
- Wendy Lynn Flansburg, PMHNP-BC
- Fred Fleming, M.D.
- Matthew Randall Fleming, PA-C
- Lindsey Flint, DPT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- 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.