Individual provider Active NPI

Angie Marie Kolar

  • Physical Therapist
  • Bozeman, MT
National Provider Identifier
1891803359
Registry record updated Oct 20, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
1963PT Issued in MT
Practice address
3406 Laramie Dr
Bozeman, MT 59718-2005
Phone
(406) 586-5694
NPI assigned
Aug 25, 2006
Last updated
Oct 20, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 20, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 1963PT MT Primary

Addresses

Primary practice location

3406 Laramie Dr
Bozeman, MT 59718-2005

Mailing address

1450 Ellis St Ste 201
Bozeman, MT 59715-8813
Phone (406) 587-0122

Other identifiers 1

IdentifierTypeStateIssuer
0006000510OtherMTBCBS PIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1963PTMTMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Bridger Orthopedic Walk in Clinic PC Physical Therapist Past Accepting new patients
Mountain Land Performance LC Physical Therapist PastSince Jun 5, 2012 Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1156464000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1476921600000",
    "number": "1891803359",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1450 ELLIS ST STE 201",
            "city": "BOZEMAN",
            "state": "MT",
            "postal_code": "597158813",
            "telephone_number": "406-587-0122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3406 LARAMIE DR",
            "city": "BOZEMAN",
            "state": "MT",
            "postal_code": "597182005",
            "telephone_number": "406-586-5694"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOLAR",
        "first_name": "ANGIE",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-25",
        "last_updated": "2016-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MT",
            "license": "1963PT",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PIN",
            "identifier": "0006000510",
            "state": "MT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bozeman, MT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2016; 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.