Kalispell Diagnostic Service Inc

Primary specialty

Nephrology PhysicianTaxonomy code 207RN0300X

Legal business name

KALISPELL DIAGNOSTIC SERVICE INC

Doing business as

Greater Flathead Renal

Practice address

135 Commons Way
Kalispell, MT 59901-1900

Phone

(406) 752-7406

Fax

(406) 752-7544

NPI assigned

Sep 21, 2006

Organization subpart

No

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

Authorized official

Name

Karen D Larson

Title

Practice Administrator

Phone

(406) 752-7582

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• Greater Flathead Renal Doing business as

Locations

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

{
    "created_epoch": "1158796800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1393891200000",
    "number": "1891894317",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "135 COMMONS WAY",
            "city": "KALISPELL",
            "state": "MT",
            "postal_code": "599011900",
            "telephone_number": "406-752-7406",
            "fax_number": "406-752-7544"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "135 COMMONS WAY",
            "city": "KALISPELL",
            "state": "MT",
            "postal_code": "599011900",
            "telephone_number": "406-752-7406",
            "fax_number": "406-752-7544"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KALISPELL DIAGNOSTIC SERVICE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-21",
        "last_updated": "2014-03-04",
        "status": "A",
        "authorized_official_last_name": "LARSON",
        "authorized_official_first_name": "KAREN",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "PRACTICE ADMINISTRATOR",
        "authorized_official_telephone_number": "406-752-7582"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Nephrology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "8607",
            "state": "MT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "C43672",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Greater Flathead Renal",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Nephrology Physician in Kalispell, MT
• Providers in Kalispell, MT by specialty
• Nephrology Physician in Montana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2014; 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.