Individual provider Active NPI

Carolyn J Jones, APRN

  • Adult Health Nurse Practitioner
  • Missoula, MT
National Provider Identifier
1720090400
Registry record updated Jan 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
NUR-APRN-LIC-100490 Issued in MT
Practice address
500 W Broadway St
Missoula, MT 59802-4008
Phone
(406) 329-5615
Fax
(406) 329-5606
NPI assigned
Aug 12, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 29, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X NUR-APRN-LIC-100490 MT Primary
Nurse Practitioner 363L00000X 27917 MT

Addresses

Primary practice location

500 W Broadway St
Missoula, MT 59802-4008

Mailing address

PO Box 12
Liberty Lake, WA 99019-0012
Phone (406) 329-5615

Other practice location 1

2827 Fort Missoula Rd
Missoula, MT 59804-7408
Phone (406) 728-4100

Other names 1

  • Carolyn J Bellamah Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address cbellamah140799@wm.providencedirect.org Direct

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: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040202001225 MT Practitioner - Nurse Practitioner 7618860958 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Providence Health and Services MtGroup PAC ID 6608786306, 358 clinicians

Practice addresses (Care Compare)

500 W Broadway St
Missoula, MT 59802-4003

500 W Broadway St
Missoula, MT 59802-4096

500 W Broadway St 3Rd FL
Missoula, MT 59802-4096

Hospital & facility affiliations

  • St. Patrick Hospital Hospital, Missoula, MT, CCN 270014
  • St Peters Health Hospital, Helena, MT, CCN 270003
  • Steele Memorial Medical Center Hospital, Salmon, ID, CCN 131305
  • Community Medical Center Hospital, Missoula, MT, CCN 270023

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
27917MTMDNurse Practitioner
NUR-APRN-LIC-100490MTMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Health & Services Mt Nurse Practitioner CurrentSince Oct 25, 2014 Accepting new patients
Providence Health & Services Mt Current Accepting new patients
St Patrick Hosp and Health Sci Ctr CurrentSince Oct 25, 2014 Accepting new patients

Locations

500 W Broadway St
Ste 320
Missoula, MT 59802
Phone (406) 329-2945

2827 Fort Missoula Rd
Missoula, MT 59804
Phone (406) 327-4202

500 W Broadway St
Missoula, MT 59802
Phone (406) 327-1918

Interoperability endpoints

  • Direct secure messaging: cbellamah140799@wm.providencedirect.org

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 10

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": "1155340800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706486400000",
    "number": "1720090400",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 12",
            "city": "LIBERTY LAKE",
            "state": "WA",
            "postal_code": "990190012",
            "telephone_number": "406-329-5615"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 W BROADWAY ST",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598024008",
            "telephone_number": "406-329-5615",
            "fax_number": "406-329-5606"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2827 Fort Missoula Rd",
            "address_purpose": "LOCATION",
            "city": "Missoula",
            "state": "MT",
            "postal_code": "598047408",
            "country_code": "US",
            "telephone_number": "406-728-4100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JONES",
        "first_name": "CAROLYN",
        "middle_name": "J",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-12",
        "last_updated": "2024-01-29",
        "certification_date": "2024-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MT",
            "license": "NUR-APRN-LIC-100490",
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MT",
            "license": "27917",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cbellamah140799@wm.providencedirect.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "500 W Broadway St",
            "city": "Missoula",
            "state": "MT",
            "country_code": "US",
            "postal_code": "598024008",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "CAROLYN",
            "last_name": "BELLAMAH",
            "middle_name": "J",
            "credential": "APRN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Missoula, MT

Sources for this page

Verify at the official NPI Registry.