Active NPI
Rusty Kemper Ede, DDS
- General Practice Dentistry
- Libby, MT
National Provider Identifier
1942980370
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 24972
- Practice address
- 320 E 2ND St
Libby, MT 59923-2010 - Phone
- (406) 283-6900
- NPI assigned
- Jul 20, 2023
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 24972 | MT | Primary |
Addresses
Primary practice location
320 E 2ND St
Libby, MT 59923-2010
Mailing address
320 E 2ND St
Libby, MT 59923-2010
Other practice location 1
102 Sandalwood Court
Troy, MT 59935
Phone (406) 283-6900
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 24972 | MT | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lincoln County Community Health Center, Inc | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Federally Qualified Health Center (FQHC)
- Troy, MT
- NPI 1417243213
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1689811200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1689811200000",
"number": "1942980370",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "320 E 2ND ST",
"city": "LIBBY",
"state": "MT",
"postal_code": "599232010"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "320 E 2ND ST",
"city": "LIBBY",
"state": "MT",
"postal_code": "599232010",
"telephone_number": "406-283-6900"
}
],
"practiceLocations": [
{
"address_1": "102 Sandalwood Court",
"address_purpose": "LOCATION",
"city": "Troy",
"state": "MT",
"postal_code": "59935",
"country_code": "US",
"telephone_number": "406-283-6900",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "EDE",
"first_name": "RUSTY",
"middle_name": "KEMPER",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2023-07-20",
"last_updated": "2023-07-20",
"certification_date": "2023-07-18",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "MT",
"license": "24972",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Libby, MT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.