Individual provider Active NPI

Mackenzie T Thomas, AGNP-C

  • General Practice Physician
  • Missoula, MT
National Provider Identifier
1760319925
Registry record updated May 4, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
NUR-APRN-LIC-289045 Issued in MT
Practice address
2230 N Reserve St Ste 110
Missoula, MT 59808-1364
Phone
(406) 926-5111
Fax
(406) 434-6323
NPI assigned
May 4, 2026
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 4, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X NUR-APRN-LIC-289045 MT Primary

Addresses

Primary practice location

2230 N Reserve St Ste 110
Missoula, MT 59808-1364

Mailing address

2036 S 13TH St W
Missoula, MT 59801-4932
Phone (406) 241-5370

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
I20260622000523 MT Practitioner - Nurse Practitioner 5597238634 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Greater Good Health PC IncGroup PAC ID 5294106027, 48 clinicians

Practice addresses (Care Compare)

2230 N Reserve St
Suite 110
Missoula, MT 59808-1364
Phone (310) 658-3775

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
NUR-APRN-LIC-289045MTMDGeneral Practice Physician

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1777852800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1777852800000",
    "number": "1760319925",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2036 S 13TH ST W",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598014932",
            "telephone_number": "406-241-5370"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2230 N RESERVE ST STE 110",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598081364",
            "telephone_number": "406-926-5111",
            "fax_number": "406-434-6323"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMAS",
        "first_name": "MACKENZIE",
        "middle_name": "T",
        "credential": "AGNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-05-04",
        "last_updated": "2026-05-04",
        "certification_date": "2026-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "MT",
            "license": "NUR-APRN-LIC-289045",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Missoula, MT

Sources for this page

Verify at the official NPI Registry.