NPIMap

Organization Active NPI

Origin Health LLC

  • Maternal & Fetal Medicine Physician
  • Missoula, MT
National Provider Identifier
1841835113
Registry record updated Jun 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Maternal & Fetal Medicine PhysicianTaxonomy code 207VM0101X
Legal business name
ORIGIN HEALTH LLC
Practice address
2831 Fort Missoula Rd Ste 232
Missoula, MT 59804-7479
Phone
(406) 523-5650
Fax
(406) 303-4041
NPI assigned
Nov 11, 2019
Last updated
Jun 23, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2020

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

Authorized official

Name
Mr. Stephen G Loosli, MSCNPI 1538710553
Title
Executive Director
Phone
(208) 557-9898

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 7

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X
Critical Care Medicine (Obstetrics & Gynecology) Physician 207VC0200X
Gynecology Physician 207VG0400X
Maternal & Fetal Medicine Physician 207VM0101X Primary
Obstetrics Physician 207VX0000X
Diagnostic Ultrasound Physician 2085U0001X
Sonography Radiologic Technologist 2471S1302X

Addresses

Primary practice location

2831 Fort Missoula Rd Ste 232
Missoula, MT 59804-7479

Mailing address

2831 Fort Missoula Rd Ste 232
Missoula, MT 59804-7479
Phone (406) 523-5650

Other practice location 1

2600 Winne Ave Ste E
Helena, MT 59601-4900
Phone (406) 558-2300

Other practice location 2

770 W Reserve Dr Ste 3
Kalispell, MT 59901-2158
Phone (406) 751-3003

Other practice location 3

1400 29th St S Ste 101
Great Falls, MT 59405-5316
Phone (406) 205-1999

Other practice location 4

225 S Clark St
Butte, MT 59701-1515
Phone (406) 221-1195

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200903001640 MT Part B Supplier - Clinic/Group Practice 8325465487 Receives reassigned benefits from 16 practitioners
Practice locations: Butte, MT; Great Falls, MT; Helena, MT; Kalispell, MT; Missoula, MT

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
27D2327185Origin Health LLC Butte225 S Clark St, Butte, MT 59701Provider-performed microscopyJul 16, 2027

National Provider Directory

National Provider Directory
Tax ID family
Origin Health LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Locations

2600 Winne Ave
Ste E
Helena, MT 59601
Phone (406) 442-8062

2831 Fort Missoula Rd
Ste 232
Missoula, MT 59804
Phone (406) 523-5650

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/21046/brand/1/csg/1/fhir/r4

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 17

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 17

NPI Registry JSON

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

{
    "created_epoch": "1573430400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1592870400000",
    "number": "1841835113",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2831 FORT MISSOULA RD STE 232",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598047479",
            "telephone_number": "406-523-5650",
            "fax_number": "406-303-4041"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2831 FORT MISSOULA RD STE 232",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598047479",
            "telephone_number": "406-523-5650",
            "fax_number": "406-303-4041"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2600 Winne Ave Ste E",
            "address_purpose": "LOCATION",
            "city": "Helena",
            "state": "MT",
            "postal_code": "596014900",
            "country_code": "US",
            "telephone_number": "406-558-2300",
            "fax_number": "406-430-0130",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "770 W Reserve Dr Ste 3",
            "address_purpose": "LOCATION",
            "city": "Kalispell",
            "state": "MT",
            "postal_code": "599012158",
            "country_code": "US",
            "telephone_number": "406-751-3003",
            "fax_number": "406-607-6160",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1400 29th St S Ste 101",
            "address_purpose": "LOCATION",
            "city": "Great Falls",
            "state": "MT",
            "postal_code": "594055316",
            "country_code": "US",
            "telephone_number": "406-205-1999",
            "fax_number": "406-604-0300",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "225 S Clark St",
            "address_purpose": "LOCATION",
            "city": "Butte",
            "state": "MT",
            "postal_code": "597011515",
            "country_code": "US",
            "telephone_number": "406-221-1195",
            "fax_number": "406-792-1750",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "ORIGIN HEALTH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-11-11",
        "last_updated": "2020-06-23",
        "certification_date": "2020-06-23",
        "status": "A",
        "authorized_official_last_name": "LOOSLI",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "208-557-9898",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MSC"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207VC0200X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Critical Care Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207VG0400X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207VM0101X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Maternal & Fetal Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207VX0000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Obstetrics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2085U0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Ultrasound",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2471S1302X",
            "taxonomy_group": "",
            "desc": "Radiologic Technologist, Sonography",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Missoula, MT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.