Individual provider Active NPI

Juliana Christine Montooth

  • Family Medicine Physician
  • Dillingham, AK
National Provider Identifier
1760465181
Registry record updated Feb 29, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
4940 Issued in AK
Practice address
6000 Kanakanak Rd
Dillingham, AK 99576
Phone
(907) 842-5201
Fax
(907) 842-9250
NPI assigned
Nov 21, 2005
Last updated
Feb 29, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 29, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 4940 AK Primary

Addresses

Primary practice location

6000 Kanakanak Rd
Dillingham, AK 99576

Mailing address

PO Box 130
Dillingham, AK 99576-0130
Phone (907) 842-5201

Other identifiers 1

IdentifierTypeStateIssuer
MD44134MedicaidAK

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040129001151 TX Practitioner - Family Practice 4486550811 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Bristol Bay Area Health Corporation Current Accepting new patients
Bristol Bay Area Health Corporation Current Accepting new patients
Bristol Bay Area Health Corporation Current Accepting new patients
Bristol Bay Area Health Corportion Current Accepting new patients
Bristol Bay Area Health Corporation Current Accepting new patients
Bristol Bay Area Health Corporation Current Accepting new patients
Bristol Bay Area Health Corporation Current Accepting new patients
Bristol Bay Area Health Corporation Current Accepting new patients
Bristol Bay Area Health Corporation Current Accepting new patients
Bristol Bay Area Health Corporation Current Accepting new patients
Bristol Bay Area Health Corporation Current Accepting new patients
Bristol Bay Area Health Corporation Current Accepting new patients
Bristol Bay Area Health Corporation Current Accepting new patients
Bristol Bay Area Health Corporation Current Accepting new patients
Bristol Bay Area Health Corporation CurrentSince Sep 30, 2003 Accepting new patients
Bristol Bay Area Health Corporation Current Accepting new patients
Bristol Bay Area Health Corporation CurrentSince Sep 30, 2003 Accepting new patients
Bristol Bay Area Health Corporation Current Accepting new patients
Bristol Bay Area Health Corportation Current Accepting new patients
Bristol Bay Area Health Corportion Current Accepting new patients
Bristol Bay Area Health Corporation Past Accepting new patients
Alaska Medical Clinics, LLC Family Medicine Past Accepting new patients
First Care Medical Centers LLC Past Accepting new patients
Bristol Bay Area Health Corporation Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/15729/brand/1/csg/1/fhir/r4

Organizations & group practices 24

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

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1132531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1330473600000",
    "number": "1760465181",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 130",
            "city": "DILLINGHAM",
            "state": "AK",
            "postal_code": "995760130",
            "telephone_number": "907-842-5201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6000 KANAKANAK RD",
            "city": "DILLINGHAM",
            "state": "AK",
            "postal_code": "99576",
            "telephone_number": "907-842-5201",
            "fax_number": "907-842-9250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONTOOTH",
        "first_name": "JULIANA",
        "middle_name": "CHRISTINE",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-21",
        "last_updated": "2012-02-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AK",
            "license": "4940",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "MD44134",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dillingham, AK

Sources for this page

Verify at the official NPI Registry.