Individual provider Active NPI

Robert Andrew Headley, M.D.

  • Emergency Medicine Physician
  • Missoula, MT
National Provider Identifier
1790726198
Registry record updated Jun 25, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
11641 Issued in MT
Practice address
2901 Brooks St
Missoula, MT 59801-7703
Phone
(406) 721-0918
NPI assigned
Jun 9, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 11641 MT Primary

Addresses

Primary practice location

2901 Brooks St
Missoula, MT 59801-7703

Mailing address

PO Box 7609
Missoula, MT 59807-7609
Phone (406) 721-5600

Other practice location 1

500 W Broadway St
Missoula, MT 59802-4008
Phone (406) 721-5600

Other identifiers 1

IdentifierTypeStateIssuer
011001941OtherMTMEDICARE ID- TYPE UNSPECIFIED

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address rheadley235966@wm.providencedirect.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MT
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
I20080328000632 MT Practitioner - Emergency Medicine 0840260162 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Temple University School of Medicine, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Western Montana Clinic PCGroup PAC ID 2466365002, 44 clinicians

Practice addresses (Care Compare)

500 W Broadway St
Missoula, MT 59802-4008
Phone (406) 721-5600

Hospital & facility affiliations

  • St. Patrick Hospital Hospital, Missoula, MT, CCN 270014

Merit-based Incentive Payment System (MIPS)

Final score
82.1 of 100Reported as group
Quality
86.66
Promoting interoperability
77
Improvement activities
40
Cost
72.83

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Lewis and Clark Emergency Physicians P C Emergency Medicine CurrentSince Aug 11, 2011 Accepting new patients
Western Montana Clinic PC Current Accepting new patients
Clark Fork Emergency Physicians PLLC Emergency Medicine CurrentSince May 1, 2008 Accepting new patients
Western Montana Clinic PC CurrentSince Mar 1, 2012 Accepting new patients
Six Rivers Emergency Physicians Emergency Medicine Past Accepting new patients

Locations

2475 E Broadway St
Helena, MT 59601
Phone (406) 442-2480

500 W Broadway St
Missoula, MT 59802
Phone (406) 327-1918

2901 Brooks St
Missoula, MT 59801
Phone (406) 541-2886

2827 Fort Missoula Rd
Missoula, MT 59804
Phone (406) 327-4202

Interoperability endpoints

  • Direct secure messaging: rheadley235966@wm.providencedirect.org

Organizations & group practices 5

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

Hospital & facility affiliations 4

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": "1149811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624579200000",
    "number": "1790726198",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7609",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598077609",
            "telephone_number": "406-721-5600",
            "fax_number": "406-721-3907"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2901 BROOKS ST",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598017703",
            "telephone_number": "406-721-0918"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "500 W Broadway St",
            "address_purpose": "LOCATION",
            "city": "Missoula",
            "state": "MT",
            "postal_code": "598024008",
            "country_code": "US",
            "telephone_number": "406-721-5600",
            "fax_number": "406-721-3907",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HEADLEY",
        "first_name": "ROBERT",
        "middle_name": "ANDREW",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-09",
        "last_updated": "2021-06-25",
        "certification_date": "2021-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MT",
            "license": "11641",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE ID- TYPE UNSPECIFIED",
            "identifier": "011001941",
            "state": "MT"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rheadley235966@wm.providencedirect.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "2901 Brooks St",
            "city": "Missoula",
            "state": "MT",
            "country_code": "US",
            "postal_code": "598017703",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Missoula, MT

Sources for this page

Verify at the official NPI Registry.