Individual provider Active NPI

Mike Kim Tran, DPT, CSCS

  • Physical Therapist
  • Missoula, MT
National Provider Identifier
1992016679
Registry record updated Jun 28, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
2313 Issued in MT
Practice address
2360 Mullan Rd
Missoula, MT 59808-1811
Phone
(406) 542-0808
NPI assigned
Jun 28, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 2313 MT Primary

Addresses

Primary practice location

2360 Mullan Rd
Missoula, MT 59808-1811

Mailing address

2360 Mullan Rd
Missoula, MT 59808-1811

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

State licenses

LicenseStateTypeSpecialty
2313MTMDPublic Health Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Marcus Daly Memorial Hospital Corporation Current Accepting new patients
Marcus Daly Memorial Hospital Corporation CurrentSince Jun 25, 2023 Accepting new patients
Marcus Daly Memorial Hospital Corporation CurrentSince Jun 25, 2023 Accepting new patients

Locations

1224 W Main St
Hamilton, MT 59840
Phone (406) 375-4823

1200 Westwood Dr
Hamilton, MT 59840
Phone (406) 363-2211

Organizations & group practices 3

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1277683200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1277683200000",
    "number": "1992016679",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2360 MULLAN RD",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598081811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2360 MULLAN RD",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598081811",
            "telephone_number": "406-542-0808"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRAN",
        "first_name": "MIKE",
        "middle_name": "KIM",
        "credential": "DPT, CSCS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-06-28",
        "last_updated": "2010-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MT",
            "license": "2313",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "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 Jun 28, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.