NPIMap

Organization Active NPI

McCone County Health Center Inc

Doing business as McCone Clinic

  • Medical Physician Assistant
  • Circle, MT
National Provider Identifier
1740464916
Registry record updated Jun 11, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
40 Issued in MT
Legal business name
MCCONE COUNTY HEALTH CENTER INC
Doing business as
McCone Clinic
Practice address
605 Sullivan Ave
Circle, MT 59215-0278
Phone
(406) 485-2063
Fax
(406) 485-2435
NPI assigned
Dec 24, 2007
Last updated
Jun 11, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2013

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

Authorized official

Name
Mrs. Jacque L Gardner
Title
Clinic Manager
Phone
(406) 485-2063

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician AssistantGroup: 193400000X SINGLE SPECIALTY GROUP 363AM0700X 40 MT Primary

Addresses

Primary practice location

605 Sullivan Ave
Circle, MT 59215-0278

Mailing address

PO Box 278
Circle, MT 59215-0278
Phone (406) 485-2063

Other names 1

  • McCone Clinic Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040728000458 MT Part B Supplier - Clinic/Group Practice 8921078957 Receives reassigned benefits from 17 practitioners
1 other NPI on this enrollment
Practice locations: Circle, MT

Other NPIs with the same Medicare PAC ID 2

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

Other NPIs on the same Medicare enrollment 1

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

National Provider Directory

National Provider Directory

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
McCone County Health Center IncCircle, MT, CCN 27Z305 Hospital Operational/Managerial Control (100%) Mar 31, 2005

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Practitioners & affiliated clinicians

Practitioners 17

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 17

NPI Registry JSON

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

{
    "created_epoch": "1198454400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1370908800000",
    "number": "1740464916",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 278",
            "city": "CIRCLE",
            "state": "MT",
            "postal_code": "592150278",
            "telephone_number": "406-485-2063"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "605 SULLIVAN AVE",
            "city": "CIRCLE",
            "state": "MT",
            "postal_code": "592150278",
            "telephone_number": "406-485-2063",
            "fax_number": "406-485-2435"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MCCONE COUNTY HEALTH CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-24",
        "last_updated": "2013-06-11",
        "status": "A",
        "authorized_official_last_name": "GARDNER",
        "authorized_official_first_name": "JACQUE",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "CLINIC MANAGER",
        "authorized_official_telephone_number": "406-485-2063",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physician Assistant, Medical",
            "state": "MT",
            "license": "40",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "McCone Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Circle, MT

Sources for this page

Verify at the official NPI Registry.