Active NPI
Dana Headapohl
- General Practice Physician
- Missoula, MT
National Provider Identifier
1962562371
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Physician
- License
- 5335
- Practice address
- 601 W Spruce St
Suite C
Missoula, MT 59802-4057 - Phone
- (406) 329-2647
- Fax
- (406) 329-5606
- NPI assigned
- Dec 8, 2006
- Sex
- Female
- 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 Physician | 208D00000X | 5335 | MT | Primary |
Addresses
Primary practice location
601 W Spruce St
Suite C
Missoula, MT 59802-4057
Mailing address
500 W Broadway St
Missoula, MT 59802-4008
Phone (406) 329-5749
Other practice location 1
2875 Tina Ave
Missoula, MT 59808-1581
Phone (406) 329-5746
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | dheadapohl132445@wm.providencedirect.org | Direct |
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5335 | MT | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165536000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1621900800000",
"number": "1962562371",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "500 W BROADWAY ST",
"city": "MISSOULA",
"state": "MT",
"postal_code": "598024008",
"telephone_number": "406-329-5749",
"fax_number": "406-327-1697"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "601 W SPRUCE ST",
"address_2": "SUITE C",
"city": "MISSOULA",
"state": "MT",
"postal_code": "598024057",
"telephone_number": "406-329-2647",
"fax_number": "406-329-5606"
}
],
"practiceLocations": [
{
"address_1": "2875 Tina Ave",
"address_purpose": "LOCATION",
"city": "Missoula",
"state": "MT",
"postal_code": "598081581",
"country_code": "US",
"telephone_number": "406-329-5746",
"fax_number": "406-327-1697",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "HEADAPOHL",
"first_name": "DANA",
"name_prefix": "Dr.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-12-08",
"last_updated": "2021-05-25",
"certification_date": "2021-05-25",
"status": "A"
},
"taxonomies": [
{
"code": "208D00000X",
"taxonomy_group": "",
"desc": "General Practice",
"state": "MT",
"license": "5335",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "dheadapohl132445@wm.providencedirect.org",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"address_1": "2875 Tina Ave",
"city": "Missoula",
"state": "MT",
"country_code": "US",
"postal_code": "598081581",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Missoula, MT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.