| Prov St Joseph Med Ctr | |
|
6 13th Ave E Polson MT 59860-5315 | |
| (406) 883-5377 | |
| Not Available |
| Full Name | Prov St Joseph Med Ctr |
|---|---|
| Speciality | Family Medicine |
| Location | 6 13th Ave E, Polson, Montana |
| Authorized Official Name and Position | Donald Wayne Anderson (ASSISTNAT SECRETARY ENROLLMENT) |
| Authorized Official Contact | 4253599786 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Prov St Joseph Med Ctr Po Box 31001-4110 Pasadena CA 91110-4110 Ph: (406) 883-5377 | Prov St Joseph Med Ctr 6 13th Ave E Polson MT 59860-5315 Ph: (406) 883-5377 |
| NPI Number | 1669655528 |
|---|---|
| Provider Enumeration Date | 12/13/2007 |
| Last Update Date | 04/05/2025 |
| Certification Date | 04/05/2025 |
| Medicare PECOS PAC ID | 0446230247 |
|---|---|
| Medicare Enrollment ID | O20040910001134 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1669655528 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | () | Primary |
| Provider Name | Josh B Moser |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1548255813 PECOS PAC ID: 2961302955 Enrollment ID: I20040113000750 |
| Provider Name | Julie L Kuykendall |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1316982044 PECOS PAC ID: 6305746041 Enrollment ID: I20040119000543 |
| Provider Name | Alan W Thomas |
|---|---|
| Provider Type | Practitioner - Medical Oncology |
| Provider Identifiers | NPI Number: 1548297468 PECOS PAC ID: 9638062755 Enrollment ID: I20040203001067 |
| Provider Name | Michael J Snyder |
|---|---|
| Provider Type | Practitioner - Hematology |
| Provider Identifiers | NPI Number: 1306872999 PECOS PAC ID: 0749173490 Enrollment ID: I20040205000862 |
| Provider Name | Kenneth Carl Brewington |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1154315695 PECOS PAC ID: 6204720576 Enrollment ID: I20040209001234 |
| Provider Name | James T Maddux |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1942237326 PECOS PAC ID: 1557357605 Enrollment ID: I20040422001742 |
| Provider Name | Deborah F Sybrant |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1225064561 PECOS PAC ID: 7315912524 Enrollment ID: I20040831001260 |
| Provider Name | Phillip a Gardner |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1003843897 PECOS PAC ID: 1850356569 Enrollment ID: I20041122001102 |
| Provider Name | Kelly G Bagnell |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1558390617 PECOS PAC ID: 0244277101 Enrollment ID: I20050412000843 |
| Provider Name | Bradley D Berry |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1326083023 PECOS PAC ID: 8820038789 Enrollment ID: I20050510000653 |
| Provider Name | Linda M Ries |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1922034693 PECOS PAC ID: 1658315908 Enrollment ID: I20050616001022 |
| Provider Name | Cody L Brown |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1598837239 PECOS PAC ID: 5991736605 Enrollment ID: I20050823000333 |
| Provider Name | Tony a Fantozzi |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1346231289 PECOS PAC ID: 8224091129 Enrollment ID: I20051214000909 |
| Provider Name | Michael a Kremkau |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1417032731 PECOS PAC ID: 1355348244 Enrollment ID: I20061108000086 |
| Provider Name | Daniel L Pierce |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1669541272 PECOS PAC ID: 9436179223 Enrollment ID: I20061117000431 |
| Provider Name | Timothy W Thornton |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1083778278 PECOS PAC ID: 3072570100 Enrollment ID: I20070221000087 |
| Provider Name | Scott D Burry |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1134196298 PECOS PAC ID: 7517861396 Enrollment ID: I20070410000704 |
| Provider Name | Brooke J Lund |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1992860944 PECOS PAC ID: 9335244185 Enrollment ID: I20070424000070 |
| Provider Name | Michele a Danicich |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1053321273 PECOS PAC ID: 1759475585 Enrollment ID: I20070924000477 |
| Provider Name | Paul M Berkram |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1952469140 PECOS PAC ID: 3971678608 Enrollment ID: I20080814000767 |
| Provider Name | Simone Musco |
|---|---|
| Provider Type | Practitioner - Cardiac Electrophysiology |
| Provider Identifiers | NPI Number: 1013181833 PECOS PAC ID: 6901974252 Enrollment ID: I20081014000294 |
| Provider Name | Jeffrey C Knight |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1528102399 PECOS PAC ID: 9739274499 Enrollment ID: I20081216000369 |
| Provider Name | Charlotte R Nelson |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1033395546 PECOS PAC ID: 7911061932 Enrollment ID: I20090205000258 |
| Provider Name | Judith L Gustafson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851554471 PECOS PAC ID: 7012074180 Enrollment ID: I20090318000168 |
| Provider Name | Anthony T Young |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1780625814 PECOS PAC ID: 9133015357 Enrollment ID: I20090505000241 |
| Provider Name | Rebecca L Bontadelli |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1275729519 PECOS PAC ID: 5294802518 Enrollment ID: I20090827000848 |
| Provider Name | John D a Lakatua |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1023063070 PECOS PAC ID: 4789726878 Enrollment ID: I20100128000071 |
| Provider Name | Alexander B Jehle |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1790831329 PECOS PAC ID: 8123932456 Enrollment ID: I20100209000362 |
| Provider Name | Lorina K Massey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215187588 PECOS PAC ID: 9436293255 Enrollment ID: I20100217000664 |
| Provider Name | Jamie G Straub |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1295762714 PECOS PAC ID: 2567594633 Enrollment ID: I20100726000328 |
| Provider Name | Sarah M Scott |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1144335530 PECOS PAC ID: 6709942329 Enrollment ID: I20100825001049 |
| Provider Name | Jeffrey Haller |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1194712307 PECOS PAC ID: 0840182689 Enrollment ID: I20100917000158 |
| Provider Name | Michael C Reed |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1346396967 PECOS PAC ID: 8729187190 Enrollment ID: I20110921000644 |
| Provider Name | Peter G Vondoersten |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1619962990 PECOS PAC ID: 3173415817 Enrollment ID: I20111104000424 |
| Provider Name | Ryan D Adams |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1790952653 PECOS PAC ID: 3375695984 Enrollment ID: I20111201000697 |
| Provider Name | Timothy P Donovan |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1962581371 PECOS PAC ID: 4688576986 Enrollment ID: I20120124000829 |
| Provider Name | Jordan R Guffin |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1689985376 PECOS PAC ID: 1759530983 Enrollment ID: I20130702000861 |
| Provider Name | Elizabeth Marie Cornelius |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1619314622 PECOS PAC ID: 3173766862 Enrollment ID: I20130828000364 |
| Provider Name | Louis C Brenner |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1609205905 PECOS PAC ID: 1456589597 Enrollment ID: I20140116000967 |
| Provider Name | Wade Paul Shipley |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1962531913 PECOS PAC ID: 9931322534 Enrollment ID: I20140529001658 |
| Provider Name | Kathryn O Cockerham |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1215100839 PECOS PAC ID: 3971630898 Enrollment ID: I20140729000425 |
| Provider Name | Jocelyn Nichole Spoon |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1548427644 PECOS PAC ID: 6103958343 Enrollment ID: I20140815001090 |
| Provider Name | Amy M Johnson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386058345 PECOS PAC ID: 5496973620 Enrollment ID: I20140828002543 |
| Provider Name | Andrew David Ashford |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1124422506 PECOS PAC ID: 7911128608 Enrollment ID: I20141022000328 |
| Provider Name | Adeline Wakeman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427301589 PECOS PAC ID: 6709008204 Enrollment ID: I20141118002221 |
| Provider Name | Wendy Terese Grace |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1265743348 PECOS PAC ID: 3779720693 Enrollment ID: I20150205000716 |
| Provider Name | Benjamin Grass |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1467894121 PECOS PAC ID: 1759607492 Enrollment ID: I20150224000869 |
| Provider Name | Penny Lynn Starkel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336124072 PECOS PAC ID: 9830172501 Enrollment ID: I20150309001551 |
| Provider Name | Heidi Maria Meierbachtol |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1972994739 PECOS PAC ID: 2163741919 Enrollment ID: I20150429002435 |
| Provider Name | Nicole Sutter |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1669710406 PECOS PAC ID: 4486809357 Enrollment ID: I20150506001539 |
| Provider Name | Nichole Marie Mckinsey |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1790046035 PECOS PAC ID: 6800109075 Enrollment ID: I20150716001715 |
| Provider Name | Stephen S Campbell |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1174535132 PECOS PAC ID: 3971694738 Enrollment ID: I20151202001007 |
| Provider Name | Jedidiah Allen Petersen |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1366870206 PECOS PAC ID: 3779706551 Enrollment ID: I20151209002109 |
| Provider Name | Leah Ann Miller |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1104053859 PECOS PAC ID: 2264673078 Enrollment ID: I20160129000575 |
| Provider Name | Chad Rebo |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1164856886 PECOS PAC ID: 3173758158 Enrollment ID: I20160304001005 |
| Provider Name | Daniel Bradley Spoon |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1104021781 PECOS PAC ID: 4486790110 Enrollment ID: I20160817002475 |
| Provider Name | Nick John Furlong |
|---|---|
| Provider Type | Practitioner - Hospice/palliative Care |
| Provider Identifiers | NPI Number: 1366718579 PECOS PAC ID: 8022245935 Enrollment ID: I20160819000548 |
| Provider Name | Sadie R Russell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578914396 PECOS PAC ID: 9638465644 Enrollment ID: I20160830003018 |
| Provider Name | John Merrill Neathawk |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1134567126 PECOS PAC ID: 2668694548 Enrollment ID: I20160908000805 |
| Provider Name | Billy L Cunnington |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1710943402 PECOS PAC ID: 8921096991 Enrollment ID: I20160920002333 |
| Provider Name | Rebecca Filipowicz |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1013319391 PECOS PAC ID: 4981905502 Enrollment ID: I20160927000159 |
| Provider Name | Amy S Davis |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1497003354 PECOS PAC ID: 9830470426 Enrollment ID: I20161219001517 |
| Provider Name | Christopher J Maki |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1871806117 PECOS PAC ID: 8820307986 Enrollment ID: I20170113002478 |
| Provider Name | Darren Brockie |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1043639164 PECOS PAC ID: 3476856816 Enrollment ID: I20170717003204 |
| Provider Name | George J Corn |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1770923104 PECOS PAC ID: 3577862002 Enrollment ID: I20170718001893 |
| Provider Name | Tiama E Friend |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1528367141 PECOS PAC ID: 3870711500 Enrollment ID: I20181010001960 |
| Provider Name | Kevin Thomas Lienesch |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1356794721 PECOS PAC ID: 9133460702 Enrollment ID: I20190409000471 |
| Provider Name | Elizabeth Bassler |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1932601796 PECOS PAC ID: 6305187501 Enrollment ID: I20190417001101 |
| Provider Name | Edwin Palmer |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1922426113 PECOS PAC ID: 5496971103 Enrollment ID: I20190823001585 |
| Provider Name | Hannah Dupea |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1225488356 PECOS PAC ID: 2769744929 Enrollment ID: I20200129001835 |
| Provider Name | Ivy L Jenkins |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1104043082 PECOS PAC ID: 6507957040 Enrollment ID: I20200408003471 |
| Provider Name | Colleen Weseloh |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1962820100 PECOS PAC ID: 1456653393 Enrollment ID: I20200413003727 |
| Provider Name | Nicholas Mantini |
|---|---|
| Provider Type | Practitioner - Cardiac Electrophysiology |
| Provider Identifiers | NPI Number: 1588808646 PECOS PAC ID: 5193963205 Enrollment ID: I20200714000997 |
| Provider Name | Amy Renee Richmond |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1366975252 PECOS PAC ID: 6901150564 Enrollment ID: I20200914002416 |
| Provider Name | Jon Mcgregor |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1619925575 PECOS PAC ID: 5991785156 Enrollment ID: I20201016000294 |
| Provider Name | Merlin Bardett Fausett |
|---|---|
| Provider Type | Practitioner - Other (physician) |
| Provider Identifiers | NPI Number: 1659403038 PECOS PAC ID: 9638398266 Enrollment ID: I20201023002715 |
| Provider Name | Michelle G Merchant |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1285052134 PECOS PAC ID: 1456634823 Enrollment ID: I20201104002405 |
| Provider Name | Danielle Herbst |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285238873 PECOS PAC ID: 8123430113 Enrollment ID: I20201216000614 |
| Provider Name | Taylor M Miles |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1043665987 PECOS PAC ID: 5890032353 Enrollment ID: I20210119001571 |
| Provider Name | Megan Ransford Tullis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912503566 PECOS PAC ID: 6406260108 Enrollment ID: I20210120001813 |
| Provider Name | Michael Dumouchel |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1982902367 PECOS PAC ID: 1052572195 Enrollment ID: I20210323002574 |
| Provider Name | Cubby M Pierre |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1669964789 PECOS PAC ID: 4385995075 Enrollment ID: I20210712000608 |
| Provider Name | Aron Haire |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1396242392 PECOS PAC ID: 8527460765 Enrollment ID: I20210712001326 |
| Provider Name | Emily Anderson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1750744942 PECOS PAC ID: 1951737048 Enrollment ID: I20210726003439 |
| Provider Name | Krista Birkelo |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1649435165 PECOS PAC ID: 2163695842 Enrollment ID: I20210907002078 |
| Provider Name | Scott Mcmaster |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1134440506 PECOS PAC ID: 9638325301 Enrollment ID: I20210913002418 |
| Provider Name | Molly Anderson |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1750797676 PECOS PAC ID: 6204054471 Enrollment ID: I20211014001335 |
| Provider Name | Christopher Williams |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1871821744 PECOS PAC ID: 9335361245 Enrollment ID: I20220504002160 |
| Provider Name | Mark Dalton |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1093782138 PECOS PAC ID: 7517055890 Enrollment ID: I20220630002633 |
| Provider Name | Mitchell D Mcfarland |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1326535097 PECOS PAC ID: 9335403666 Enrollment ID: I20220826000447 |
| Provider Name | Bryan Davis |
|---|---|
| Provider Type | Practitioner - Pain Management |
| Provider Identifiers | NPI Number: 1205361276 PECOS PAC ID: 4385048396 Enrollment ID: I20220912001197 |
| Provider Name | Sherry Walter |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154301026 PECOS PAC ID: 3577529445 Enrollment ID: I20221223000187 |
| Provider Name | Arfaat Khan |
|---|---|
| Provider Type | Practitioner - Cardiac Electrophysiology |
| Provider Identifiers | NPI Number: 1538379144 PECOS PAC ID: 5496800294 Enrollment ID: I20230523002019 |
| Provider Name | Angela Clare Lemire |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1023716362 PECOS PAC ID: 5991161481 Enrollment ID: I20230526000162 |
| Provider Name | David Lincoln Hess-homeier |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1558821116 PECOS PAC ID: 3072972686 Enrollment ID: I20230629002442 |
| Provider Name | Leslie Anne Johnson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1750005989 PECOS PAC ID: 6103286158 Enrollment ID: I20230721001947 |
| Provider Name | Benjamin O Lawson |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1154717775 PECOS PAC ID: 3971896887 Enrollment ID: I20230724001294 |
| Provider Name | Matthew J Anderson |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1033641550 PECOS PAC ID: 0648518092 Enrollment ID: I20230724004049 |
| Provider Name | Joseph F Smith |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1225423239 PECOS PAC ID: 0244544450 Enrollment ID: I20230725004173 |
| Provider Name | Carrie Millstead |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598442113 PECOS PAC ID: 2961865969 Enrollment ID: I20230823003612 |
| Provider Name | Sheila R.M. Reash |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1093755183 PECOS PAC ID: 7810903747 Enrollment ID: I20230913001417 |
| Provider Name | Naomi Onaka |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1932720224 PECOS PAC ID: 0042632028 Enrollment ID: I20230928002221 |
| Provider Name | Susan C Weaselhead |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1306296249 PECOS PAC ID: 6305280066 Enrollment ID: I20240221001822 |
| Provider Name | Tyler L Johnston |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1104445253 PECOS PAC ID: 6204258023 Enrollment ID: I20240610003363 |
| Provider Name | Carl P Garabedian |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1083666127 PECOS PAC ID: 1850325820 Enrollment ID: I20240806002786 |
| Provider Name | Jason Douglas Johnson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1073044343 PECOS PAC ID: 2769754266 Enrollment ID: I20240826002278 |
| Provider Name | Melissa Robinson |
|---|---|
| Provider Type | Practitioner - Cardiac Electrophysiology |
| Provider Identifiers | NPI Number: 1831171586 PECOS PAC ID: 3476527987 Enrollment ID: I20240829003053 |
| Provider Name | Tara Van Drunen |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1598787442 PECOS PAC ID: 1557685757 Enrollment ID: I20240911001585 |
| Provider Name | Andrew C Yazman |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1376170878 PECOS PAC ID: 5193147668 Enrollment ID: I20241231000306 |
| Provider Name | Alexander Mark Busko |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1639668916 PECOS PAC ID: 3577805720 Enrollment ID: I20250130003277 |
| Provider Name | John Kim |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1124384706 PECOS PAC ID: 2860612538 Enrollment ID: I20250313001005 |
| Provider Name | Isabel Marie Makman |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1548899412 PECOS PAC ID: 0840617395 Enrollment ID: I20250604001536 |
| Provider Name | Nathaniel E Ebersole |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1144789165 PECOS PAC ID: 1153656426 Enrollment ID: I20250708004371 |
| Provider Name | Graham William Wakefield Van Schaik |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1154984581 PECOS PAC ID: 4082012927 Enrollment ID: I20250722002365 |
| Provider Name | Michael a Basnight |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1467453696 PECOS PAC ID: 0547250045 Enrollment ID: I20250724002421 |
| Provider Name | Dustyn Eugene Whitesel |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1285210948 PECOS PAC ID: 8628479961 Enrollment ID: I20250724003570 |
| Provider Name | Steven J Shrives |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1275379075 PECOS PAC ID: 2961930086 Enrollment ID: I20250827000388 |
| Provider Name | Morgan a Morton |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1073809729 PECOS PAC ID: 9931323961 Enrollment ID: I20251113002926 |
| Provider Name | Ruslana V Kurpita |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1376751156 PECOS PAC ID: 4688741077 Enrollment ID: I20260202002770 |
| Provider Name | Giang T Nguyen |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1457349839 PECOS PAC ID: 7517014087 Enrollment ID: I20260226003653 |
| Provider Name | Madonna L Gartrell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619372364 PECOS PAC ID: 7719468685 Enrollment ID: I20260227003147 |
| Provider Name | Eugene J Beville |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1093255879 PECOS PAC ID: 7911278221 Enrollment ID: I20260523000009 |
| Provider Name | Brittany L Borman |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1538700893 PECOS PAC ID: 0345676847 Enrollment ID: I20260523000023 |
St. Luke Community Clinic Polson Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 104 Rufus Ln, Polson, MT 59860 Phone: 406-883-2555 Fax: 406-883-2559 |
St. Luke Physical Therapy Ridgewater Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 107 Ridgewater Dr., Polson, MT 59860 Phone: 406-883-2666 Fax: 406-883-2667 |
Wholeness in Health House-call Clinic LLC Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 37926 Mt Highway 35, Polson, MT 59860 Phone: 406-261-5019 Fax: 406-883-6465 |
Polson Health Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 102 13th Ave E, Polson, MT 59860 Phone: 406-751-5311 Fax: 406-257-2010 |
Polson Health Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 106 Ridgewater Dr Ste A, Polson, MT 59860 Phone: 406-883-3200 Fax: 406-883-9483 |
Prov St Joseph Med Ctr Polson Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 6 13th Ave E, Polson, MT 59860 Phone: 406-883-5680 Fax: 406-883-8926 |