Northern Cheyenne Tribe
Organization Active NPI Ambulance · Lame Deer, MT
NPI 1972513638 · NPPES record last updated Feb 3, 2016
Key facts
- NPI
- 1972513638
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Ambulance 341600000X
- License
- 087 (MT)
- Legal business name
- NORTHERN CHEYENNE TRIBE
- Practice address
- 22 North Cheyenne Ave
Lame Deer, MT 59043-0067 - Phone
- (406) 477-6775
- Fax
- (406) 477-6083
- NPI assigned
- Aug 8, 2006
- Organization subpart
- Yes
- Parent organization (as reported)
- NORTHERN CHEYENNE TRIBE
Authorized official
- Name
- Ms. Rachel E Larance
- Title
- 3Rd Party Billing Clerk
- Phone
- (406) 477-4911
Parent organization (reported in NPPES) 1
Other NPIs with the same Medicare PAC ID 1
Corporate family (same tax ID) 1
Practitioners 7
-
Brenda Hamilton, LCSW
-
Angela Sioux, REGISTERED NURSE
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 27D2102226 | Northern Cheyenne Ambulance Service | Certificate of waiver | Sep 16, 2027 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MT
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040202000952 | MT | Part B Supplier - Ambulance Service Supplier | 4981597275 | Practice locations: Lame Deer, MT |
National Provider Directory
- Tax ID family
- Northern Cheyenne Ambulance
- Part of
- Northern Cheyenne Ambulance
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ambulance | 341600000X | 087 | MT | Yes |
| Land Ambulance | 3416L0300X | 087 | MT |
Addresses
Primary practice location
22 North Cheyenne Ave
Lame Deer, MT 59043-0067
Mailing address
22 North Cheyenne Ave
PO Box 67
Lame Deer, MT 59043-0067
Phone (406) 477-6775
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0191-2 | Other | MT | BLUECROSS BLUESHIELD OF MT |
| 0445263 | Medicaid | MT | |
| 011002659 | Other | MT | MEDICARE PTAN - NORIDIAN |
Other names
- Northern Cheyenne Ambulance Service
Other providers in Lame Deer, MT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 3, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.