Organization Active NPI

Missoula Physical Therapy Inc

  • Physical Therapist
  • Missoula, MT
National Provider Identifier
1992849525
Registry record updated Dec 21, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
218PT Issued in MT
Legal business name
MISSOULA PHYSICAL THERAPY INC
Practice address
1805 Bancroft St
Missoula, MT 59801-5781
Phone
(406) 543-4890
Fax
(406) 543-4892
NPI assigned
Feb 16, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 21, 2007

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

Authorized official

Name
Edith G Smith
Title
Owner
Phone
(406) 543-4890

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X 218PT MT Primary

Addresses

Primary practice location

1805 Bancroft St
Missoula, MT 59801-5781

Mailing address

1805 Bancroft St
Missoula, MT 59801-5781
Phone (406) 543-4890

Other identifiers 1

IdentifierTypeStateIssuer
1992849525MedicaidMT

National Provider Directory

National Provider Directory

Locations

1805 Bancroft St
Missoula, MT 59801
Phone (406) 304-9904

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": "1171584000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1198195200000",
    "number": "1992849525",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1805 BANCROFT ST",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598015781",
            "telephone_number": "406-543-4890",
            "fax_number": "406-543-4892"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1805 BANCROFT ST",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598015781",
            "telephone_number": "406-543-4890",
            "fax_number": "406-543-4892"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MISSOULA PHYSICAL THERAPY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-16",
        "last_updated": "2007-12-21",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "EDITH",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "406-543-4890"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "MT",
            "license": "218PT",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1992849525",
            "state": "MT"
        }
    ],
    "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 Dec 21, 2007; 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.