Missoula Family Medical Center, LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

4963 Issued in MT

Legal business name

MISSOULA FAMILY MEDICAL CENTER, LLC

Practice address

621 W Alder St
Missoula, MT 59802-4014

Phone

(406) 728-3111

Fax

(406) 728-3116

NPI assigned

Aug 10, 2006

Last updated

Apr 19, 2010By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Michael Robert Priddy, M.D.

Title

Partner

Phone

(406) 728-3111

Specialties & licenses 1

Addresses

Practitioners 1

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.

• Jennifer Culp, PA-C

  • Physician Assistant
  • Missoula, MT
  • NPI 1710230107
  NPD (past)

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

{
    "created_epoch": "1155168000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1271635200000",
    "number": "1760493225",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "621 W ALDER ST",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598024014",
            "telephone_number": "406-728-3111",
            "fax_number": "406-728-3116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "621 W ALDER ST",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598024014",
            "telephone_number": "406-728-3111",
            "fax_number": "406-728-3116"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MISSOULA FAMILY MEDICAL CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-10",
        "last_updated": "2010-04-19",
        "status": "A",
        "authorized_official_last_name": "PRIDDY",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "ROBERT",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "406-728-3111",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MT",
            "license": "4963",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Missoula Developmental Service Corp (MDSC)
• Missoula Doula (Missoula Doula Birth Services)
• Missoula Emergency Services Inc (Missoula Emergency Services)
• Missoula Endodontics
• Missoula Family Chiropractic LLC
• Missoula Family Medicine PLLC (Missoula Family Medicine)
• Missoula Family Therapy, LLC
• Missoula General Dentistry, P.C.
• Missoula Interfaith Collaborative
• Missoula OB-GYN Associates

• Family Medicine Physician in Missoula, MT
• Providers in Missoula, MT by specialty
• Family Medicine Physician in Montana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.