NPIMap

Organization Active NPI

Powder River County

Doing business as Powder River Manor

  • Multi-Specialty Clinic/Center
  • Broadus, MT
National Provider Identifier
1801234141
Registry record updated Nov 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
Legal business name
POWDER RIVER COUNTY
Doing business as
Powder River Manor
Practice address
104 North Trautman
Broadus, MT 59317
Phone
(406) 436-2646
NPI assigned
Jun 10, 2013
Last updated
Nov 27, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2023

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

Authorized official

Name
Karen D Amende
Title
Clerk and Recorder
Phone
(406) 436-2657

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Multi-Specialty Clinic/Center 261QM1300X Primary
Physical Therapy Clinic/Center 261QP2000X

Addresses

Primary practice location

104 North Trautman
Broadus, MT 59317

Mailing address

PO Box 200
Broadus, MT 59317-0200
Phone (406) 436-2657

Other names 1

  • Powder River Manor Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MT

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140205000654 MT Part B Supplier - Physical/Occupational Therapy Group in Private Practice 2860543667 Receives reassigned benefits from 5 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Broadus, MT

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Powder River Medical Clinic5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 29

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.

View all 29

NPI Registry JSON

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

{
    "created_epoch": "1370822400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1701043200000",
    "number": "1801234141",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 200",
            "city": "BROADUS",
            "state": "MT",
            "postal_code": "593170200",
            "telephone_number": "406-436-2657"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 NORTH TRAUTMAN",
            "city": "BROADUS",
            "state": "MT",
            "postal_code": "59317",
            "telephone_number": "406-436-2646"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "POWDER RIVER COUNTY",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-06-10",
        "last_updated": "2023-11-27",
        "certification_date": "2023-11-27",
        "status": "A",
        "authorized_official_last_name": "AMENDE",
        "authorized_official_first_name": "KAREN",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "CLERK AND RECORDER",
        "authorized_official_telephone_number": "406-436-2657"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Powder River Manor",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Powder River Manor",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Broadus, MT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.