Active NPI
Orville H Mann III, MD
- Anesthesiology Physician
- Bozeman, MT
National Provider Identifier
1790704393
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiology Physician
- License
- 9566
- Practice address
- 915 Highland Blvd
Bozeman, MT 59715-6902 - Phone
- (800) 461-3981
- Fax
- (801) 733-5872
- NPI assigned
- Jul 18, 2006
- Last updated
- Jul 9, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | 9566 | MT | Primary |
Addresses
Primary practice location
915 Highland Blvd
Bozeman, MT 59715-6902
Mailing address
88 Saber Circle
Bozeman, MT 59715
Phone (406) 522-0544
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0148784 | Medicaid | MT | |
| 1343108880000 | Other | MT | CHAMPUS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 9566 | MT | MD | Anesthesiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Intercity Radiology, PC | Past | Accepting new patients |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Specialist
- Bozeman, MT
- NPI 1356390736
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153180800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1790704393",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "88 SABER CIRCLE",
"city": "BOZEMAN",
"state": "MT",
"postal_code": "59715",
"telephone_number": "406-522-0544"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "915 HIGHLAND BLVD",
"city": "BOZEMAN",
"state": "MT",
"postal_code": "597156902",
"telephone_number": "800-461-3981",
"fax_number": "801-733-5872"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MANN",
"first_name": "ORVILLE",
"middle_name": "H",
"name_suffix": "III",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-18",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "MT",
"license": "9566",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0148784",
"state": "MT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CHAMPUS",
"identifier": "1343108880000",
"state": "MT"
}
],
"endpoints": [],
"other_names": []
}Other providers in Bozeman, MT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.