Individual provider Active NPI

Katherine M Pellett, APRN, NP

  • Adult Health Nurse Practitioner
  • Great Falls, MT
National Provider Identifier
1932233632
Registry record updated Jan 29, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
24541 Issued in MT
Practice address
115 4TH St S
Community Health Care Center
Great Falls, MT 59401-3618
Phone
(406) 454-6973
NPI assigned
Mar 15, 2007
Last updated
Jan 29, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 29, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 24541 MT Primary

Addresses

Primary practice location

115 4TH St S
Community Health Care Center
Great Falls, MT 59401-3618

Mailing address

115 4TH St S
Community Health Care Center
Great Falls, MT 59401-3618
Phone (406) 454-6973

Other identifiers 2

IdentifierTypeStateIssuer
374680OtherMTBCBS MT
9971418MedicaidMT

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MT
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050408000998 MT Practitioner - Nurse Practitioner 8527005719 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
24541MTMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
County of Cascade CurrentSince Dec 3, 2014 Accepting new patients
Indian Family Health Clinic of Great Falls Inc Past Accepting new patients

Locations

115 4th St S
Great Falls, MT 59401
Phone (406) 268-9721

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": "1173916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1485648000000",
    "number": "1932233632",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 4TH ST S",
            "address_2": "COMMUNITY HEALTH CARE CENTER",
            "city": "GREAT FALLS",
            "state": "MT",
            "postal_code": "594013618",
            "telephone_number": "406-454-6973"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 4TH ST S",
            "address_2": "COMMUNITY HEALTH CARE CENTER",
            "city": "GREAT FALLS",
            "state": "MT",
            "postal_code": "594013618",
            "telephone_number": "406-454-6973"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PELLETT",
        "first_name": "KATHERINE",
        "middle_name": "M",
        "credential": "APRN, NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-15",
        "last_updated": "2017-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MT",
            "license": "24541",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS MT",
            "identifier": "374680",
            "state": "MT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9971418",
            "state": "MT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Great Falls, MT

Sources for this page

Verify at the official NPI Registry.