Beverly L Braak, M.D.

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

11310 Issued in MT

Practice address

2835 Fort Missoula Rd
203
Missoula, MT 59804-7423

Phone

(406) 327-3875

Fax

(406) 327-3876

NPI assigned

May 25, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• RCHP Billings - Missoula LLC

  • Specialist
  • Missoula, MT
  • NPI 1376946913
  NPD (past)
• The Duluth Clinic, LTD

  • Multi-Specialty Clinic/Center
  • Ashland, WI
  • NPI 1215974357
  NPD (past)
• The Duluth Clinic, LTD.

  • Community/Retail Pharmacy
  • Hinckley, MN
  • NPI 1245081066
  NPD (past)

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

{
    "created_epoch": "1148515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1427241600000",
    "number": "1922054550",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2831 FORT MISSOULA RD",
            "address_2": "203",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598047419",
            "telephone_number": "406-327-3875",
            "fax_number": "406-327-3876"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2835 FORT MISSOULA RD",
            "address_2": "203",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598047423",
            "telephone_number": "406-327-3875",
            "fax_number": "406-327-3876"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRAAK",
        "first_name": "BEVERLY",
        "middle_name": "L",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-25",
        "last_updated": "2015-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "MT",
            "license": "11310",
            "primary": true
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "WI",
            "license": "33235",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "31851000",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Boylan Counseling LLC
• Brad Thomas Boylan, LCPC
• Dana Allison Boylan, LCSW
• Joseph Francis Boyle Jr., LCSW
• Madelyn Wiley Boyle, PA-C
• Daniel Edward Braby, MD
• Braden Partners LP
• Kathleen Bradford, LCPC
• Nidhi Jeanne Bradford
• Lee Ann Bradley, RPH, PHARMD, BCPS

• Obstetrics & Gynecology Physician in Missoula, MT
• Providers in Missoula, MT by specialty
• Obstetrics & Gynecology Physician in Montana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2015; 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.