NPIMap

Organization Active NPI

Partnership Health Center Inc

Doing business as PHC Willard

  • Federally Qualified Health Center (FQHC)
  • Missoula, MT
National Provider Identifier
1750926762
Registry record updated Mar 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
PARTNERSHIP HEALTH CENTER INC
Doing business as
PHC Willard
Practice address
901 S 6TH St W
Missoula, MT 59801-3752
Phone
(406) 258-4496
Fax
(406) 258-4732
NPI assigned
Nov 13, 2019
Last updated
Mar 3, 2025By the provider in NPPES
Organization subpart
Yes
Parent organization
PARTNERSHIP HEALTH CENTER INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 3, 2025

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

Authorized official

Name
Lara Salazar
Title
Executive Director
Phone
(406) 258-3360

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X Primary

Addresses

Primary practice location

901 S 6TH St W
Missoula, MT 59801-3752

Mailing address

401 Railroad St W
Missoula, MT 59802-4109
Phone (406) 258-4496

Other names 1

  • PHC WILLARD Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MT2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20051026000379 MT Part B Supplier - Clinic/Group Practice 6103843479 Receives reassigned benefits from 98 practitioners
6 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Missoula, MT; Seeley Lake, MT; Superior, MT
O20200115001622 MT Part A Provider - Federally Qualified Health Center (FQHC) 6103843479 Practice locations: Missoula, MT

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1750926762. Details of each certification follow.

Federally qualified health center certification: CCN 271871

Legal name
PARTNERSHIP HEALTH CENTER INC
Doing business as
PHC WILLARD
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Jan 14, 2020
Last certification
Jan 14, 2020
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Nov 1, 1992 in MT
Enrollment address
901 S 6TH St W
Missoula, MT 59801-3752

Other NPIs with the same Medicare PAC ID 14

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

View all 14

Other NPIs on the same Medicare enrollment 6

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

National Provider Directory

National Provider Directory
Tax ID family
Partnership Health Ctr18 organizations share this tax ID, including this one
Part of
Partnership Health Ctr

Other organizations with this tax ID 17

Organizations that report the same tax identification number in the National Provider Directory.

View all 17

Ownership & related parties

All disclosed owners & managing parties 15

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Kathleen Walters Individual Corporate DirectorBoard Member Jul 1, 2013
Jay Raines Individual Corporate DirectorBoard Member Jan 1, 2024
Bryan William Chalmers Individual Corporate OfficerCfo Dec 16, 2019 1%
Mark Thane Individual Corporate DirectorBoard Member Oct 1, 2019
Patricia Kero Individual Corporate DirectorBoard Member Nov 1, 2021 1%
Lara Salazar Individual Corporate OfficerCeo Oct 3, 2022 1%
W-2 Managing EmployeeCeo Oct 3, 2022 1%
Suzette Baker Individual Corporate DirectorBoard Member Apr 1, 2024 1%
Esther Tuttle Individual Corporate DirectorBoard Member Dec 1, 2024 1%
Joseph Melvin Individual Corporate DirectorBoard Member Jan 2, 2019
Kristin Petersen Individual Corporate DirectorBoard Member Sep 1, 2024
Andrea Green Individual Corporate DirectorBoard Member Mar 1, 2021 1%
Natalie Wolfram Individual Corporate DirectorBoard Member Oct 1, 2018
Holly Blaylock Individual W-2 Managing EmployeeRevenue Cycle Operations Manager Jul 15, 2015
John Crawford Individual Corporate DirectorBoard Member Feb 1, 2016
Jilayne Dunn Individual Corporate DirectorBoard Member Dec 1, 2013

Practitioners & affiliated clinicians

Practitioners 12

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.

NPI Registry JSON

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

{
    "created_epoch": "1573603200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1740960000000",
    "number": "1750926762",
    "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": "598024109",
            "telephone_number": "406-258-4496",
            "fax_number": "406-258-4578"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 S 6TH ST W",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598013752",
            "telephone_number": "406-258-4496",
            "fax_number": "406-258-4732"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PARTNERSHIP HEALTH CENTER INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PARTNERSHIP HEALTH CENTER INC",
        "enumeration_date": "2019-11-13",
        "last_updated": "2025-03-03",
        "certification_date": "2025-03-03",
        "status": "A",
        "authorized_official_last_name": "SALAZAR",
        "authorized_official_first_name": "LARA",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "406-258-3360"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PHC WILLARD",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "PHC WILLARD",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Missoula, MT

Sources for this page

Verify at the official NPI Registry.