Organization Active NPI

Dr. Beverly L. Braak, P.C.

  • Medical Specialty Clinic/Center
  • Missoula, MT
National Provider Identifier
1770724874
Registry record updated Mar 19, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Specialty Clinic/CenterTaxonomy code 261QM2500X
License
11310 Issued in MT
Legal business name
DR. BEVERLY L. BRAAK, P.C.
Practice address
2831 Fort Missoula Rd BLDG 2
Suite 203
Missoula, MT 59804-7419
Phone
(406) 327-3875
Fax
(406) 327-3876
NPI assigned
Mar 19, 2009
Last updated
Mar 19, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 19, 2009

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

Authorized official

Name
Dr. Beverly Lynn Braak, M.D.NPI 1922054550
Title
Owner
Phone
(406) 327-3875

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Specialty Clinic/Center 261QM2500X 11310 MT Primary

Addresses

Primary practice location

2831 Fort Missoula Rd BLDG 2
Suite 203
Missoula, MT 59804-7419

Mailing address

2831 Fort Missoula Rd BLDG 2
Suite 203
Missoula, MT 59804-7419
Phone (406) 327-3875

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1237420800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1237420800000",
    "number": "1770724874",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2831 FORT MISSOULA RD BLDG 2",
            "address_2": "SUITE 203",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598047419",
            "telephone_number": "406-327-3875",
            "fax_number": "406-327-3876"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2831 FORT MISSOULA RD BLDG 2",
            "address_2": "SUITE 203",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598047419",
            "telephone_number": "406-327-3875",
            "fax_number": "406-327-3876"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR. BEVERLY L. BRAAK, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-03-19",
        "last_updated": "2009-03-19",
        "status": "A",
        "authorized_official_last_name": "BRAAK",
        "authorized_official_first_name": "BEVERLY",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "406-327-3875",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "MT",
            "license": "11310",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Missoula, MT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2009; 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.