Daniel W Moullet, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

MD00034152 Issued in WA

Practice address

107 6TH Ave SW
Ronan, MT 59864-2634

Phone

(406) 676-4441

Fax

(406) 676-0835

NPI assigned

Oct 12, 2005

Last updated

Sep 13, 2013By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Okanogan County Public Hospital Dist No 4

  • Critical Access Hospital
  • Tonasket, WA
  • NPI 1164580700
  NPD (past)

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

{
    "created_epoch": "1129075200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1379030400000",
    "number": "1790773802",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 E COLUMBIA AVE",
            "city": "COLVILLE",
            "state": "WA",
            "postal_code": "991143354",
            "telephone_number": "509-684-3701",
            "fax_number": "509-684-5817"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 6TH AVE SW",
            "city": "RONAN",
            "state": "MT",
            "postal_code": "598642634",
            "telephone_number": "406-676-4441",
            "fax_number": "406-676-0835"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOULLET",
        "first_name": "DANIEL",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-12",
        "last_updated": "2013-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "MD00034152",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mission Mountain Home Care LLC
• Mission Valley Eye Center, Inc. (Ronan Eye Clinic)
• Mission Valley Wellness, PLLC
• Char-El Teresa Montana, LCPC
• James Michael Moore, L. AC.,
• Mountain View Care Center, Inc
• Kristin A. Murphy, R.N.
• Justin C Newton, LCPC
• Mary Katherine Nissen, LCSW
• Alexander J. Nutt, M.D.

• Family Medicine Physician in Ronan, MT
• Providers in Ronan, 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 Sep 13, 2013; 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.