NPIMap

Individual provider Active NPI

Kari Danielle Deboo, FNP

  • Family Nurse Practitioner
  • Missoula, MT
National Provider Identifier
1780963538
Registry record updated Oct 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
100642 Issued in MT
Practice address
1930 W Broadway St Ste a
Missoula, MT 59808-1960
Phone
(406) 541-6844
Fax
(406) 541-6843
NPI assigned
Aug 11, 2011
Last updated
Oct 7, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 7, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 32166 MT
Family Nurse Practitioner 363LF0000X 100642 MT Primary

Addresses

Primary practice location

1930 W Broadway St Ste a
Missoula, MT 59808-1960

Mailing address

1930 W Broadway St Ste a
Missoula, MT 59808-1960
Phone (406) 541-6844

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120824000655 MT Practitioner - Nurse Practitioner 3971750019 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Montana Gastroenterology, PLLCGroup PAC ID 7618396318, 23 clinicians

Practice addresses (Care Compare)

1930 W Broadway St
Suite a
Missoula, MT 59808-1960
Phone (406) 541-6844

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
90.28 of 100Reported as group
Quality
94
Promoting interoperability
100
Improvement activities
40
Cost
73.6

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
100642MTMDFamily Nurse Practitioner
32166MTMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Montana Gastroenterology, PLLC CurrentSince Nov 1, 2020 Accepting new patients
Montana Endoscopy Center, PLLC PastSince Jun 1, 2020 Accepting new patients

Locations

1930 W Broadway St
Ste A
Missoula, MT 59808
Phone (406) 541-6844

500 W Broadway St
Ste A
Missoula, MT 59802
Phone (406) 284-5560

Organizations & group practices 2

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.

Hospital & facility affiliations 8

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1313020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728259200000",
    "number": "1780963538",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1930 W BROADWAY ST STE A",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598081960",
            "telephone_number": "406-541-6844",
            "fax_number": "406-541-6843"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1930 W BROADWAY ST STE A",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598081960",
            "telephone_number": "406-541-6844",
            "fax_number": "406-541-6843"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEBOO",
        "first_name": "KARI",
        "middle_name": "DANIELLE",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-08-11",
        "last_updated": "2024-10-07",
        "certification_date": "2024-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MT",
            "license": "32166",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MT",
            "license": "100642",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Missoula, MT

Sources for this page

Verify at the official NPI Registry.