Active NPI
Heavens Peak Healthcare LLC
- Nurse Practitioner
- Columbia Falls, MT
National Provider Identifier
1952881138
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- Legal business name
- HEAVENS PEAK HEALTHCARE LLC
- Practice address
- 9540 9TH St W
Columbia Falls, MT 59912 - Phone
- (406) 752-8120
- NPI assigned
- Aug 17, 2018
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Laura Chrystine Hall, CFNP
- Title
- Authorized Official
- Phone
- (406) 250-8717
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinic/Center | 261Q00000X | |||
| Nurse Practitioner | 363L00000X | Primary |
Addresses
Primary practice location
9540 9TH St W
Columbia Falls, MT 59912
Mailing address
9540 9TH St W
Columbia Falls, MT 59912
Phone (406) 752-8120
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MT
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20181212003132 | MT | Part B Supplier - Clinic/Group Practice | 5890030209 |
Receives reassigned benefits from 3 practitioners Practice locations: Columbia Falls, MT |
National Provider Directory
National Provider DirectoryLocations
1035 9th St W
Columbia Fls, MT 59912
Phone (406) 250-8717
Practitioners & affiliated clinicians
Practitioners 3
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1534464000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1534464000000",
"number": "1952881138",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9540 9TH ST W",
"city": "COLUMBIA FALLS",
"state": "MT",
"postal_code": "59912",
"telephone_number": "406-752-8120"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9540 9TH ST W",
"city": "COLUMBIA FALLS",
"state": "MT",
"postal_code": "59912",
"telephone_number": "406-752-8120"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "HEAVENS PEAK HEALTHCARE LLC",
"organizational_subpart": "NO",
"enumeration_date": "2018-08-17",
"last_updated": "2018-08-17",
"status": "A",
"authorized_official_last_name": "HALL",
"authorized_official_first_name": "LAURA",
"authorized_official_middle_name": "CHRYSTINE",
"authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
"authorized_official_telephone_number": "406-250-8717",
"authorized_official_credential": "CFNP"
},
"taxonomies": [
{
"code": "261Q00000X",
"taxonomy_group": "",
"desc": "Clinic/Center",
"state": null,
"license": null,
"primary": false
},
{
"code": "363L00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Nurse Practitioner",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Columbia Falls, MT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2018; 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.