Suzanne Daniell

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

MT7550 Issued in MT

Practice address

1111 Baker Ave
Glacier Medical Associates
Whitefish, MT 59937-2901

Phone

(406) 862-2515

Fax

(406) 862-4229

NPI assigned

Mar 15, 2006

Last updated

May 12, 2008By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 9

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

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.

• Frances Mahon Deaconess Hospital

  • Critical Access Hospital
  • Glasgow, MT
  • NPI 1689685323
  NPD (past)
• Logan Health - Whitefish

  dba Logan Health Rural Health Clinic- Eureka

  • Rural Health Clinic/Center
  • Eureka, MT
  • NPI 1336115849
  NPD (past)

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

{
    "created_epoch": "1142380800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1210550400000",
    "number": "1811966526",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1111 BAKER AVE",
            "address_2": "GLACIER MEDICAL ASSOCIATES",
            "city": "WHITEFISH",
            "state": "MT",
            "postal_code": "599372901",
            "telephone_number": "406-862-2515",
            "fax_number": "406-862-4229"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 BAKER AVE",
            "address_2": "GLACIER MEDICAL ASSOCIATES",
            "city": "WHITEFISH",
            "state": "MT",
            "postal_code": "599372901",
            "telephone_number": "406-862-2515",
            "fax_number": "406-862-4229"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DANIELL",
        "first_name": "SUZANNE",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-15",
        "last_updated": "2008-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MT",
            "license": "MT7550",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GLACIER MEDICAL ASSOC NPI",
            "identifier": "1104882232",
            "state": "MT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA ID#--LAB CERT",
            "identifier": "27D0411341",
            "state": "NH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FEIN",
            "identifier": "810350909",
            "state": "MT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0108836",
            "state": "MT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MONTANA STATE LICENSE",
            "identifier": "7550",
            "state": "MT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PART B GRP ID#",
            "identifier": "000008287",
            "state": "MT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE PIN#",
            "identifier": "110174719",
            "state": "MT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE GRP #",
            "identifier": "CI2709",
            "state": "MT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS/SHIELD PIN",
            "identifier": "000007591",
            "state": "MT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Benjamin David Crockett, D.D.S.
• Sierra Marie Crockford, PT
• Cycles of Life PLLC
• Jeff A Dalen, DDS
• Shelby Swant Damaskos
• Joseph Christopher De Cree, MA
• Amber Jewel Dean, DNP, PMHNP
• Renee Dean, LMT
• Allison Holloway Deaver
• Donald Alan Decker, MD

• Internal Medicine Physician in Whitefish, MT
• Providers in Whitefish, MT by specialty
• Internal Medicine Physician in Montana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.