Providence Health & Services Mt

Primary specialty

Cardiovascular Disease PhysicianTaxonomy code 207RC0000X

Legal business name

PROVIDENCE HEALTH & SERVICES MT

Doing business as

PMG MT IHI Superior

Practice address

1208 6TH Ave
Superior, MT 59872-9618

Phone

(406) 822-4278

Fax

(406) 329-5606

NPI assigned

May 20, 2008

Last updated

Jun 22, 2011By the provider in NPPES

Organization subpart

Yes

Parent organization

PROVIDENCE HEALTH & SERVICESAs reported in NPPES

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

Authorized official

Name

Mrs. Teri Masters

Title

RCM Operations MGR

Phone

(406) 329-5795

Specialties & licenses 3

Addresses

Other names 1

• PMG MT IHI Superior Doing business as

Medicare fee-for-service enrollment

Enrolled in MT

Enrollment records 1

Part of

Providence Service Corporation

Practitioners 1

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.

• Michele A Danicich, MD

  • Endocrinology, Diabetes & Metabolism Physician
  • Missoula, MT
  • NPI 1053321273
  NPD

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

{
    "created_epoch": "1211241600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1308700800000",
    "number": "1902063688",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 34439",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981241439",
            "telephone_number": "406-822-4278",
            "fax_number": "406-329-5606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1208 6TH AVE",
            "city": "SUPERIOR",
            "state": "MT",
            "postal_code": "598729618",
            "telephone_number": "406-822-4278",
            "fax_number": "406-329-5606"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROVIDENCE HEALTH & SERVICES MT",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PROVIDENCE HEALTH & SERVICES",
        "enumeration_date": "2008-05-20",
        "last_updated": "2011-06-22",
        "status": "A",
        "authorized_official_last_name": "MASTERS",
        "authorized_official_first_name": "TERI",
        "authorized_official_title_or_position": "RCM OPERATIONS MGR",
        "authorized_official_telephone_number": "406-329-5795",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PMG MT IHI Superior",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Missoula Community Health Services, Inc (Mineral Community Hospital)
• Missoula Community Health Services, Inc. (Mineral Community Hospital)
• Missoula Community Health Services, Inc. (Tamarack Medical Clinic)
• Missoula Community Health Services, Inc. (Mineral Community Hospital)
• Ernesto E. Ornelas, FNP
• Megan Hattie Pugh, PA-C
• Stephanie Quick, LCSW
• April Ann Quinlan, LCPC
• Brenda KH Reynolds, NCMT, CMT, LMT
• Nancy M Smith, MSW, LCSW, LAC

• Cardiovascular Disease Physician in Superior, MT
• Providers in Superior, MT by specialty
• Cardiovascular Disease Physician in Montana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.