NPIMap

Organization Active NPI

Fallon Medical Complex, Inc

  • Physical Therapy Clinic/Center
  • Baker, MT
National Provider Identifier
1861558330
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
Legal business name
FALLON MEDICAL COMPLEX, INC
Practice address
202 South 4TH Street West
Baker, MT 59313-0820
Phone
(406) 778-5103
Fax
(406) 778-5155
NPI assigned
Dec 29, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Selena R Nelson
Title
Cfo
Phone
(406) 778-5103

Specialties & licenses 1

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

Addresses

Primary practice location

202 South 4TH Street West
Baker, MT 59313-0820

Mailing address

PO Box 820
Baker, MT 59313-0820
Phone (406) 778-5103

Other identifiers 2

IdentifierTypeStateIssuer
60093OtherMTBCBS PHYSICAL THERAPY
3400816MedicaidMT

Other names 1

  • Physical Therapy Other name

National Provider Directory

National Provider Directory
Tax ID family
FMC Dba Community Clini8 organizations share this tax ID, including this one

Other organizations with this tax ID 7

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

NPI Registry JSON

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

{
    "created_epoch": "1167350400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1861558330",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 820",
            "city": "BAKER",
            "state": "MT",
            "postal_code": "593130820",
            "telephone_number": "406-778-5103",
            "fax_number": "406-778-5155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "202 SOUTH 4TH STREET WEST",
            "city": "BAKER",
            "state": "MT",
            "postal_code": "593130820",
            "telephone_number": "406-778-5103",
            "fax_number": "406-778-5155"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FALLON MEDICAL COMPLEX, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-29",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "NELSON",
        "authorized_official_first_name": "SELENA",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "406-778-5103"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PHYSICAL THERAPY",
            "identifier": "60093",
            "state": "MT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3400816",
            "state": "MT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Physical Therapy",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Baker, MT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.