| Blue Mountain Clinic, Inc. | |
|
610 N California St Missoula MT 59802-3950 | |
| (406) 721-1946 | |
| (406) 543-9890 |
| Full Name | Blue Mountain Clinic, Inc. |
|---|---|
| Speciality | Family Medicine |
| Location | 610 N California St, Missoula, Montana |
| Authorized Official Name and Position | Annie Hansen (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 4067211646 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Blue Mountain Clinic, Inc. 610 N California St Missoula MT 59802-3950 Ph: (406) 721-1946 | Blue Mountain Clinic, Inc. 610 N California St Missoula MT 59802-3950 Ph: (406) 721-1946 |
| NPI Number | 1407987548 |
|---|---|
| Provider Enumeration Date | 03/08/2007 |
| Last Update Date | 05/24/2016 |
| Medicare PECOS PAC ID | 4688600984 |
|---|---|
| Medicare Enrollment ID | O20050708000503 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1407987548 | NPI | - | NPPES |
| 0218478 | Medicaid | MT |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 9607 (Montana) | Primary |
| Provider Name | Deanna L Phinney |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1780714071 PECOS PAC ID: 5193711091 Enrollment ID: I20040424000465 |
| Provider Name | Kelly J Polus |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1689770919 PECOS PAC ID: 5698701993 Enrollment ID: I20050708000474 |
| Provider Name | Eric a Ravitz |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1215034681 PECOS PAC ID: 5597791897 Enrollment ID: I20050708000527 |
| Provider Name | Alison B Charman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669543039 PECOS PAC ID: 6204860539 Enrollment ID: I20050926000437 |
| Provider Name | Vasa Parsons |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1174056170 PECOS PAC ID: 0840566147 Enrollment ID: I20171031001916 |
| Provider Name | Claire a Frost |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1235571993 PECOS PAC ID: 3072831494 Enrollment ID: I20200114002760 |
| Provider Name | Adriana Raquel Ramos |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1568103364 PECOS PAC ID: 1850771924 Enrollment ID: I20220707000361 |
| Provider Name | Katrin Johanna Kahl |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1730664723 PECOS PAC ID: 0547681579 Enrollment ID: I20241002003127 |
Tms Revitalizes Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2809 Great Northern Loop, Ste 410, Missoula, MT 59808 Phone: 406-493-1344 Fax: 406-830-3127 |
Sentinel Health PLLC Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 6995 Linda Vista Blvd Ste 120, Missoula, MT 59803 Phone: 406-272-6151 |
Cogent Healthcare of Montana P C Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 2827 Fort Missoula Rd, Missoula, MT 59804 Phone: 406-728-4100 |
Biome Group Health, PLLC Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2831 Fort Missoula Rd. Bldg. 2, Ste. 203, Missoula, MT 59804 Phone: 480-628-3002 |
Aim Healthcare Providers Mt, PLLC Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2425 W Central Ave Ste 203&205, Missoula, MT 59801 Phone: 480-494-2465 |
Western Montana Clinic PC Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2835 Fort Missoula Rd Bldg 3, Missoula, MT 59804 Phone: 406-721-5600 |