| Roundup Memorial Healthcare - Clinic | |
|
1207 Second St W Roundup MT 59072-1835 | |
| (406) 323-3337 | |
| (406) 323-3002 |
| Full Name | Roundup Memorial Healthcare - Clinic |
|---|---|
| Speciality | Clinic/Center |
| Location | 1207 Second St W, Roundup, Montana |
| Authorized Official Name and Position | Holly Wolff (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Contact | 4063232301 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Roundup Memorial Healthcare - Clinic 1207 Second St W Roundup MT 59072-1835 Ph: (406) 323-3337 | Roundup Memorial Healthcare - Clinic 1207 Second St W Roundup MT 59072-1835 Ph: (406) 323-3337 |
| NPI Number | 1902908262 |
|---|---|
| Provider Enumeration Date | 09/05/2006 |
| Last Update Date | 06/30/2020 |
| Certification Date | 06/30/2020 |
| Medicare PECOS PAC ID | 5395646707 |
|---|---|
| Medicare Enrollment ID | O20040119000371 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1902908262 | NPI | - | NPPES |
| 0720395 | Medicaid | MT |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | 10506 (Montana) | Primary |
| 282N00000X | General Acute Care Hospital | 10506 (Montana) | Secondary |
| Provider Name | Jeffry O Lindenbaum |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1679669261 PECOS PAC ID: 8628963659 Enrollment ID: I20040218000968 |
| Provider Name | Bryan J Canty |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1841309515 PECOS PAC ID: 2567359334 Enrollment ID: I20040304000600 |
| Provider Name | Douglas G Bell |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1871662817 PECOS PAC ID: 5991693780 Enrollment ID: I20040304000747 |
| Provider Name | Jonathan P Graeve |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1538271507 PECOS PAC ID: 8820986623 Enrollment ID: I20040304000848 |
| Provider Name | Dean a Bruschwein |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1568482081 PECOS PAC ID: 3375433576 Enrollment ID: I20040319000794 |
| Provider Name | Daniel F Alderman |
|---|---|
| Provider Type | Practitioner - Interventional Radiology |
| Provider Identifiers | NPI Number: 1982666442 PECOS PAC ID: 2769466580 Enrollment ID: I20040617000741 |
| Provider Name | William C Anderson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1083698740 PECOS PAC ID: 7517859184 Enrollment ID: I20040622001449 |
| Provider Name | Doyle S Coleman |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1558437277 PECOS PAC ID: 0840196424 Enrollment ID: I20050927001493 |
| Provider Name | John Scott Brandon |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1912943978 PECOS PAC ID: 4183603939 Enrollment ID: I20061005000644 |
| Provider Name | Patricia L Francisco Thomas |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1790870384 PECOS PAC ID: 0446332977 Enrollment ID: I20080123000512 |
| Provider Name | John C Sillery |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1699752709 PECOS PAC ID: 1456389402 Enrollment ID: I20081230000156 |
| Provider Name | Lisa a Kincannon-ziegler |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366612327 PECOS PAC ID: 7810942513 Enrollment ID: I20090122000700 |
| Provider Name | Zachary M Bland |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1467664235 PECOS PAC ID: 2466506340 Enrollment ID: I20090811000627 |
| Provider Name | Valeri R Russell |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1578893418 PECOS PAC ID: 6507991981 Enrollment ID: I20100526001081 |
| Provider Name | Brynn M Bixby |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1760707186 PECOS PAC ID: 6608991591 Enrollment ID: I20100915001029 |
| Provider Name | Tammy J Chambers |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407151574 PECOS PAC ID: 4688845704 Enrollment ID: I20110922000004 |
| Provider Name | George E Knight |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1306966858 PECOS PAC ID: 1052464815 Enrollment ID: I20111005000092 |
| Provider Name | Scott R Paulsen |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1538363635 PECOS PAC ID: 2365533783 Enrollment ID: I20120619000059 |
| Provider Name | Kelly Petit |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1164671061 PECOS PAC ID: 2264679950 Enrollment ID: I20130517000183 |
| Provider Name | Zoe Fugere |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255754941 PECOS PAC ID: 3779709399 Enrollment ID: I20140716002669 |
| Provider Name | Ernest V Smith |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1790979730 PECOS PAC ID: 3375589260 Enrollment ID: I20140811001833 |
| Provider Name | Sarah Cruse |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861744252 PECOS PAC ID: 8426277757 Enrollment ID: I20140917003009 |
| Provider Name | Joshua Delavan |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1245403294 PECOS PAC ID: 1456599331 Enrollment ID: I20150629003083 |
| Provider Name | Wendy S Killham |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114336351 PECOS PAC ID: 3870713001 Enrollment ID: I20150801017348 |
| Provider Name | Eric J May |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1447561360 PECOS PAC ID: 6002088697 Enrollment ID: I20160729001784 |
| Provider Name | Jeri Lynn W Casagrande |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1205273257 PECOS PAC ID: 2062652910 Enrollment ID: I20161005001327 |
| Provider Name | Cameron Grove |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1477659381 PECOS PAC ID: 9638391105 Enrollment ID: I20170626002529 |
| Provider Name | Heather I Gale |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1023329513 PECOS PAC ID: 6204068174 Enrollment ID: I20170628003349 |
| Provider Name | Sarah Elizabeth Stilwill |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1902078751 PECOS PAC ID: 5395989768 Enrollment ID: I20180105001134 |
| Provider Name | Mariah Lei White |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1871850040 PECOS PAC ID: 2163663162 Enrollment ID: I20180619002909 |
| Provider Name | Lorie Hutchison |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1417394727 PECOS PAC ID: 8527281716 Enrollment ID: I20191022000960 |
| Provider Name | Sean T Jones |
|---|---|
| Provider Type | Practitioner - Interventional Radiology |
| Provider Identifiers | NPI Number: 1790102606 PECOS PAC ID: 0143447326 Enrollment ID: I20200602001771 |
| Provider Name | Wade See |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1891107314 PECOS PAC ID: 5496084253 Enrollment ID: I20200723002547 |
| Provider Name | Andrew G Cox |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1205872918 PECOS PAC ID: 5193914562 Enrollment ID: I20200731000924 |
| Provider Name | Robert J Crouch |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1477628865 PECOS PAC ID: 7012006570 Enrollment ID: I20210303001842 |
| Provider Name | Filip Turcer |
|---|---|
| Provider Type | Practitioner - Interventional Radiology |
| Provider Identifiers | NPI Number: 1922366657 PECOS PAC ID: 9931345451 Enrollment ID: I20210525002875 |
| Provider Name | Paul F Hunt |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1841279973 PECOS PAC ID: 1456395078 Enrollment ID: I20211013002505 |
| Provider Name | Jarett Thelen |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1700204195 PECOS PAC ID: 6901150911 Enrollment ID: I20220818000601 |
| Provider Name | Trinh Nguyen |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1568816858 PECOS PAC ID: 1557654605 Enrollment ID: I20220901000874 |
| Provider Name | Kurt W Lowartz |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1821659855 PECOS PAC ID: 2062740806 Enrollment ID: I20221216001483 |
| Provider Name | Katie Lynn Zupan |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1194451153 PECOS PAC ID: 0345610895 Enrollment ID: I20221228001733 |
| Provider Name | Troy B Graybeal |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1609803162 PECOS PAC ID: 2961767736 Enrollment ID: I20230426000660 |
| Provider Name | Johnathan William Righetti |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1598260267 PECOS PAC ID: 8224384128 Enrollment ID: I20230607002041 |
| Provider Name | Robert Linville |
|---|---|
| Provider Type | Practitioner - Interventional Radiology |
| Provider Identifiers | NPI Number: 1457593279 PECOS PAC ID: 3375766181 Enrollment ID: I20240318002410 |
| Provider Name | Tyler Chase Faw |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1972338044 PECOS PAC ID: 8426582800 Enrollment ID: I20241107001229 |
| Provider Name | Tyler J Gavinski |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1891529418 PECOS PAC ID: 7810422565 Enrollment ID: I20241119001310 |
| Provider Name | Sterling T Fenwick |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1063828291 PECOS PAC ID: 8729303086 Enrollment ID: I20250602003067 |
| Provider Name | Jason L Cunningham |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285004085 PECOS PAC ID: 1759681950 Enrollment ID: I20250702001092 |
| Provider Name | William Scott Schroyer |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1770469827 PECOS PAC ID: 2163900663 Enrollment ID: I20260127002969 |
Cranberry Blossom Nutrition & Wellness, LLC Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 236 Old Divide Rd, Roundup, MT 59072 Phone: 907-240-3267 |
Frontier Health Clinic, PC Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 25 1st Ave W, Roundup, MT 59072 Phone: 406-323-4002 Fax: 406-323-4022 |