Individual provider Active NPI

Mark Andrew Kearns, PAC

  • Medical Physician Assistant
  • Harlem, MT
National Provider Identifier
1841314705
Registry record updated Feb 1, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
363 Issued in MT
Practice address
RR 1 Box 67
Harlem, MT 59526-9705
Phone
(406) 353-3100
Fax
(406) 353-3229
NPI assigned
Mar 18, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 1, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 363 MT Primary

Addresses

Primary practice location

RR 1 Box 67
Harlem, MT 59526-9705

Mailing address

PO Box 35
Sunburst, MT 59482-0035
Phone (406) 937-3610

Other identifiers 1

IdentifierTypeStateIssuer
363OtherMTLICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050413000955 TX Practitioner - Physician Assistant 9335039965 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

669 Agency Main St
Harlem, MT 59526-9455
Phone (406) 353-3919

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
363MTMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
US Health Dept of Health & Human Services Current Accepting new patients
U S Health Dept of Health & Human Services CurrentSince Feb 1, 2005 Accepting new patients
U S Health Dept of Health & Human Services CurrentSince Feb 1, 2005 Accepting new patients
US Dept of HHS CurrentSince Feb 1, 2005 Accepting new patients
Frances Mahon Deaconess Hospital Past Accepting new patients

Locations

669 Agency Main St
Harlem, MT 59526
Phone (406) 353-3100

453 Pine Grove Rd
Hays, MT 59527
Phone (406) 353-3190

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 2

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": "1174176000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1201824000000",
    "number": "1841314705",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 35",
            "city": "SUNBURST",
            "state": "MT",
            "postal_code": "594820035",
            "telephone_number": "406-937-3610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "RR 1 BOX 67",
            "city": "HARLEM",
            "state": "MT",
            "postal_code": "595269705",
            "telephone_number": "406-353-3100",
            "fax_number": "406-353-3229"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEARNS",
        "first_name": "MARK",
        "middle_name": "ANDREW",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-18",
        "last_updated": "2008-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MT",
            "license": "363",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "363",
            "state": "MT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Harlem, MT

Sources for this page

Verify at the official NPI Registry.