| Us Health Dept Of Health & Human Services | |
|
107 H Street East Poplar MT 59255 | |
| (406) 768-3491 | |
| (406) 768-3491 |
| Full Name | Us Health Dept Of Health & Human Services |
|---|---|
| Speciality | Clinic/Center |
| Location | 107 H Street East, Poplar, Montana |
| Authorized Official Name and Position | Marjorie Spotted Bird (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Contact | 4067683491 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Us Health Dept Of Health & Human Services Po Box 67 Poplar MT 59255-0067 Ph: (406) 768-3491 | Us Health Dept Of Health & Human Services 107 H Street East Poplar MT 59255 Ph: (406) 768-3491 |
| NPI Number | 1972694602 |
|---|---|
| Provider Enumeration Date | 09/27/2006 |
| Last Update Date | 12/21/2023 |
| Medicare PECOS PAC ID | 9638081623 |
|---|---|
| Medicare Enrollment ID | O20031106000399 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1972694602 | NPI | - | NPPES |
| 2210068 | Medicaid | MT | |
| 000009301 | Other | MT | BC/BS OF MONTANA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
| 344600000X | Taxi | (* (Not Available)) | Secondary |
| Provider Name | David A Mark |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1023166840 PECOS PAC ID: 4981502010 Enrollment ID: I20031226000240 |
| Provider Name | Thomas J Schreiner |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1922062967 PECOS PAC ID: 8527058338 Enrollment ID: I20040513001598 |
| Provider Name | Peggy Jo Whiteplume |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1649334905 PECOS PAC ID: 4981681962 Enrollment ID: I20040707001058 |
| Provider Name | Stephen W Wegner |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1114088259 PECOS PAC ID: 8426027137 Enrollment ID: I20040929000879 |
| Provider Name | James B Whitworth |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1629065891 PECOS PAC ID: 6507824646 Enrollment ID: I20041221000805 |
| Provider Name | John W Randall |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1982695524 PECOS PAC ID: 8820074156 Enrollment ID: I20050107000114 |
| Provider Name | Mary Clair Mcguire |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386764819 PECOS PAC ID: 6103863832 Enrollment ID: I20050413000984 |
| Provider Name | Dwayne A Booth |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1427110022 PECOS PAC ID: 9335178730 Enrollment ID: I20050805000597 |
| Provider Name | Leroy A Clark |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1578527115 PECOS PAC ID: 0446223325 Enrollment ID: I20050808001065 |
| Provider Name | Rosaline K Begay |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1134291479 PECOS PAC ID: 3274559331 Enrollment ID: I20051018000690 |
| Provider Name | Ernest J Gray |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1922168012 PECOS PAC ID: 8820017908 Enrollment ID: I20051117000630 |
| Provider Name | Michael R Tilus |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1700963873 PECOS PAC ID: 3173531415 Enrollment ID: I20060329000319 |
| Provider Name | Angel L Wilson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164430658 PECOS PAC ID: 1153327788 Enrollment ID: I20061004000583 |
| Provider Name | David H Freeman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205894417 PECOS PAC ID: 4688672850 Enrollment ID: I20061122000299 |
| Provider Name | Thomas E Shields |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1306955471 PECOS PAC ID: 2860491370 Enrollment ID: I20061211000535 |
| Provider Name | Cynthia C Chapman |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1689698722 PECOS PAC ID: 1254332901 Enrollment ID: I20070123000270 |
| Provider Name | Jennifer S Gannon |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1194721241 PECOS PAC ID: 7416958129 Enrollment ID: I20070124000140 |
| Provider Name | Barbara S Cohn |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1003918384 PECOS PAC ID: 9335246438 Enrollment ID: I20070524000529 |
| Provider Name | Shannelle S Rico |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1023078623 PECOS PAC ID: 0648231373 Enrollment ID: I20071101000703 |
| Provider Name | Mary A Gookin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104000827 PECOS PAC ID: 3476637331 Enrollment ID: I20080301000095 |
| Provider Name | Kurt S Gustavson |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1225255086 PECOS PAC ID: 6305924754 Enrollment ID: I20080424000773 |
| Provider Name | Lynelle N Noisy Hawk |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1881894152 PECOS PAC ID: 8325127822 Enrollment ID: I20080508000803 |
| Provider Name | Jerry L Foster |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053574772 PECOS PAC ID: 0042388969 Enrollment ID: I20081006000298 |
| Provider Name | Duane M Chase |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1992844906 PECOS PAC ID: 7719045806 Enrollment ID: I20081017000486 |
| Provider Name | Tarik Qasim |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1962608646 PECOS PAC ID: 1355415647 Enrollment ID: I20081203000206 |
| Provider Name | Neil A Sun Rhodes |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1184894727 PECOS PAC ID: 6709963606 Enrollment ID: I20090728000607 |
| Provider Name | Gregory M Smith |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1396758017 PECOS PAC ID: 6608920822 Enrollment ID: I20090821000258 |
| Provider Name | Thomas H Barrows |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1790795342 PECOS PAC ID: 5193870889 Enrollment ID: I20090901000665 |
| Provider Name | Bella M Gentry |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1154598746 PECOS PAC ID: 2163578295 Enrollment ID: I20090915000450 |
| Provider Name | Nicholas J Lyons |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1619105509 PECOS PAC ID: 1456407592 Enrollment ID: I20090915000536 |
| Provider Name | Lori G Byron |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1992731566 PECOS PAC ID: 2769538818 Enrollment ID: I20090915000602 |
| Provider Name | Erin E Neibauer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760621544 PECOS PAC ID: 3375689508 Enrollment ID: I20091001000429 |
| Provider Name | Deborah L Russell |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1447307830 PECOS PAC ID: 0941346555 Enrollment ID: I20091013000558 |
| Provider Name | Joni D Renbarger |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1629238365 PECOS PAC ID: 1254470602 Enrollment ID: I20091125000251 |
| Provider Name | Jenaneta S Hampton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396817516 PECOS PAC ID: 2769546472 Enrollment ID: I20091202000233 |
| Provider Name | Jacqueline Nelson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1548333206 PECOS PAC ID: 7113066929 Enrollment ID: I20091207000622 |
| Provider Name | Michael Durant Murphy |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1891812921 PECOS PAC ID: 2163559063 Enrollment ID: I20100426000225 |
| Provider Name | Jeffrey E Smith |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1427009570 PECOS PAC ID: 7517978885 Enrollment ID: I20100615000858 |
| Provider Name | Karen E Kajiwara Nelson |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1548360381 PECOS PAC ID: 9436283413 Enrollment ID: I20100812000335 |
| Provider Name | Mark S Cardinal |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1508931981 PECOS PAC ID: 0547384604 Enrollment ID: I20100826000998 |
| Provider Name | William A Calder |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1275605412 PECOS PAC ID: 1254455728 Enrollment ID: I20100907000202 |
| Provider Name | Nancy L King |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104999242 PECOS PAC ID: 7012109457 Enrollment ID: I20101004001401 |
| Provider Name | Peter J Arosemena |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1265532907 PECOS PAC ID: 1951593102 Enrollment ID: I20101007000154 |
| Provider Name | Connie M Sherer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851352736 PECOS PAC ID: 8820016975 Enrollment ID: I20101012000423 |
| Provider Name | Martha E Burton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497828768 PECOS PAC ID: 6901093343 Enrollment ID: I20101210000062 |
| Provider Name | Steven B. Sonntag |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1215005335 PECOS PAC ID: 0143127639 Enrollment ID: I20101221001071 |
| Provider Name | Kendall S Flint |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1154504199 PECOS PAC ID: 4082677364 Enrollment ID: I20110224000556 |
| Provider Name | Kelly Jo Dalton |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1932365137 PECOS PAC ID: 2668650144 Enrollment ID: I20110705000296 |
| Provider Name | Van Pho |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1740437284 PECOS PAC ID: 1052580651 Enrollment ID: I20110817000214 |
| Provider Name | Howard R. Knapp |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1861413148 PECOS PAC ID: 0941203707 Enrollment ID: I20110908002325 |
| Provider Name | Robert P Drewelow |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1073760393 PECOS PAC ID: 3375714363 Enrollment ID: I20110923000162 |
| Provider Name | Robert S Wilson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1538108204 PECOS PAC ID: 3173782950 Enrollment ID: I20120314000546 |
| Provider Name | Cheryl C Portwood |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1639246044 PECOS PAC ID: 0840394219 Enrollment ID: I20120402000260 |
| Provider Name | Jeffrey Lynn Schaffer |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1124131255 PECOS PAC ID: 8921902768 Enrollment ID: I20120611000061 |
| Provider Name | Robert H Martin |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1316954860 PECOS PAC ID: 8022008143 Enrollment ID: I20120816000632 |
| Provider Name | Lynda-marie S George |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1962471847 PECOS PAC ID: 5890730063 Enrollment ID: I20120924000435 |
| Provider Name | Carmel F Bonnaig |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1558331272 PECOS PAC ID: 1456337229 Enrollment ID: I20130212000156 |
| Provider Name | Charles J Mcmullin |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1215049788 PECOS PAC ID: 9032136270 Enrollment ID: I20130320000259 |
| Provider Name | Karen L Zoller |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730357377 PECOS PAC ID: 8022195361 Enrollment ID: I20130712000607 |
| Provider Name | Kenneth A Freeman |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1750714754 PECOS PAC ID: 4284861220 Enrollment ID: I20131218001028 |
| Provider Name | Jose R Lopez |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1922178128 PECOS PAC ID: 6901035062 Enrollment ID: I20140212001469 |
| Provider Name | Jonathan M Gilbert |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1033140686 PECOS PAC ID: 6305935511 Enrollment ID: I20140225000330 |
| Provider Name | Luz E Rodriguez |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1649332578 PECOS PAC ID: 0143450254 Enrollment ID: I20140310001971 |
| Provider Name | Alan C Ostby |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1912019951 PECOS PAC ID: 0749312734 Enrollment ID: I20140311001198 |
| Provider Name | Melanie A Walker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083948889 PECOS PAC ID: 0840479879 Enrollment ID: I20140327000941 |
| Provider Name | Wiley Wilson |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1083686430 PECOS PAC ID: 7810046257 Enrollment ID: I20140409001075 |
| Provider Name | Navtejpal Singh Kahlon |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1750715777 PECOS PAC ID: 1355577958 Enrollment ID: I20140505001436 |
| Provider Name | Tina M Berg |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1407906381 PECOS PAC ID: 7012982077 Enrollment ID: I20140718001512 |
| Provider Name | Thomas Riney |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1457341307 PECOS PAC ID: 6901863307 Enrollment ID: I20140825002357 |
| Provider Name | Laurel Matthews |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1801960471 PECOS PAC ID: 0840298766 Enrollment ID: I20140915000784 |
| Provider Name | Lisa S Sun Rhodes |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1932495686 PECOS PAC ID: 9234376096 Enrollment ID: I20140930002298 |
| Provider Name | Tyler Evans |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1912227125 PECOS PAC ID: 9335311059 Enrollment ID: I20140930002925 |
| Provider Name | Wendy S Killham |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114336351 PECOS PAC ID: 3870713001 Enrollment ID: I20141009002051 |
| Provider Name | Linda M Smith |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1770843252 PECOS PAC ID: 5294956470 Enrollment ID: I20141103000480 |
| Provider Name | Ali Mastali |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1821401258 PECOS PAC ID: 2567688179 Enrollment ID: I20141119001894 |
| Provider Name | Pauline J King |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700127743 PECOS PAC ID: 3173760220 Enrollment ID: I20141125000332 |
| Provider Name | Richard P Nery |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1114101789 PECOS PAC ID: 5193047009 Enrollment ID: I20141204000315 |
| Provider Name | Sarah Malli |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861744252 PECOS PAC ID: 8426277757 Enrollment ID: I20150107001691 |
| Provider Name | Erin M Imeson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275818270 PECOS PAC ID: 5698933893 Enrollment ID: I20150413000249 |
| Provider Name | Philip E Stein |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1669536918 PECOS PAC ID: 3577590223 Enrollment ID: I20150428000464 |
| Provider Name | Susan G Maier |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1194068262 PECOS PAC ID: 0547582645 Enrollment ID: I20150428000662 |
| Provider Name | Janet M Thurston |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235211962 PECOS PAC ID: 8628126091 Enrollment ID: I20150430000583 |
| Provider Name | Tony Underwood |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558759530 PECOS PAC ID: 5496076440 Enrollment ID: I20150603001162 |
| Provider Name | Jae Dell M Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215361787 PECOS PAC ID: 8123349610 Enrollment ID: I20150609002469 |
| Provider Name | Earl S Kimbell |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1437189305 PECOS PAC ID: 2365491230 Enrollment ID: I20150612002306 |
| Provider Name | Scott L Diering |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1083633465 PECOS PAC ID: 7719936988 Enrollment ID: I20150624002615 |
| Provider Name | Kyle Debenham |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1225067325 PECOS PAC ID: 1759341183 Enrollment ID: I20150701000753 |
| Provider Name | Armando Sanchez Burgos |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1184875296 PECOS PAC ID: 7618157678 Enrollment ID: I20150811003986 |
| Provider Name | Earle M Taylor |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1487607578 PECOS PAC ID: 8921001983 Enrollment ID: I20150827001584 |
| Provider Name | Pierrette Toussaint |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1396159240 PECOS PAC ID: 0749598852 Enrollment ID: I20151008002276 |
| Provider Name | Wally Jean |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1346654167 PECOS PAC ID: 4688982721 Enrollment ID: I20151009000241 |
| Provider Name | Janet L Erickson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730348327 PECOS PAC ID: 7719296193 Enrollment ID: I20151026002367 |
| Provider Name | Anthony P Tranchita |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1437139847 PECOS PAC ID: 1052621208 Enrollment ID: I20151030001606 |
| Provider Name | Vishal Jariwala |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1316209190 PECOS PAC ID: 6608184312 Enrollment ID: I20151107000004 |
| Provider Name | Emily Dorr Mathiak |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1790047819 PECOS PAC ID: 4688820723 Enrollment ID: I20151202002667 |
| Provider Name | Catherine G Kelly |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609280833 PECOS PAC ID: 0941521124 Enrollment ID: I20151211000697 |
| Provider Name | Dawn Underwood |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083002729 PECOS PAC ID: 3072814748 Enrollment ID: I20151222002182 |
| Provider Name | Mary E Pauzauskie |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184675399 PECOS PAC ID: 6305899600 Enrollment ID: I20160707001004 |
| Provider Name | Christina M Hernandez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265980544 PECOS PAC ID: 6800179797 Enrollment ID: I20170221000028 |
| Provider Name | Angelia M Frederick |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518409887 PECOS PAC ID: 1658648423 Enrollment ID: I20170526000215 |
| Provider Name | Georgia Matt |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1386952190 PECOS PAC ID: 5991064099 Enrollment ID: I20180118000787 |
| Provider Name | Tara Van Drunen |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1598787442 PECOS PAC ID: 1557685757 Enrollment ID: I20180713000476 |
| Provider Name | Queenta E Teko |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114451937 PECOS PAC ID: 5698022135 Enrollment ID: I20180716001637 |
| Provider Name | Mark Krich |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1144238767 PECOS PAC ID: 4789585985 Enrollment ID: I20180924000921 |
| Provider Name | Christopher Q May |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1073847695 PECOS PAC ID: 6204951544 Enrollment ID: I20181016000608 |
| Provider Name | Ming T Lin |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1427088947 PECOS PAC ID: 9133186125 Enrollment ID: I20200124000272 |
| Provider Name | Raichell Lynn Dorland-roan |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1568841658 PECOS PAC ID: 4880915735 Enrollment ID: I20200303000184 |
| Provider Name | Sarah E Hardwick |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053973198 PECOS PAC ID: 3173951951 Enrollment ID: I20200309001749 |
| Provider Name | Vikram S Shankar |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1821443276 PECOS PAC ID: 5294154894 Enrollment ID: I20201001000468 |
| Provider Name | John A Gnassi |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1629066105 PECOS PAC ID: 2365488715 Enrollment ID: I20210119001789 |
| Provider Name | Davida Hemmy |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1053724351 PECOS PAC ID: 7416172556 Enrollment ID: I20210429002729 |
| Provider Name | Richard Esham |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1801221601 PECOS PAC ID: 9638472459 Enrollment ID: I20220317000143 |
| Provider Name | Deborah Obryan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1033151824 PECOS PAC ID: 7012067002 Enrollment ID: I20220330001196 |
| Provider Name | Jeffrey Yellow Owl |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1629436639 PECOS PAC ID: 2961898945 Enrollment ID: I20220330001901 |
| Provider Name | Sara Lynn Bonanini |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801275037 PECOS PAC ID: 1759777634 Enrollment ID: I20220331002604 |
| Provider Name | Amanda Marie Sipp |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1730442765 PECOS PAC ID: 0143563163 Enrollment ID: I20220414000720 |
| Provider Name | Andrew J Langfield |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1952835092 PECOS PAC ID: 2466879358 Enrollment ID: I20220503000127 |
| Provider Name | Robert Eugene Roe |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1528173630 PECOS PAC ID: 2264588581 Enrollment ID: I20220510002154 |
| Provider Name | Michelle Daya |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1790120343 PECOS PAC ID: 4981820123 Enrollment ID: I20220520000683 |
| Provider Name | Paul S Llobet |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1518020502 PECOS PAC ID: 5193826543 Enrollment ID: I20221122002185 |
| Provider Name | Lawrence Kent Harrington |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1689662454 PECOS PAC ID: 1951770189 Enrollment ID: I20221212000286 |
| Provider Name | Yoldez A Meroueh |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1578096723 PECOS PAC ID: 7315298569 Enrollment ID: I20230314000287 |
| Provider Name | Maria Kofas |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1154860013 PECOS PAC ID: 4688048341 Enrollment ID: I20230320001363 |
| Provider Name | Derek V Chan |
|---|---|
| Provider Type | Practitioner - Dermatology |
| Provider Identifiers | NPI Number: 1932488574 PECOS PAC ID: 9032346200 Enrollment ID: I20230329000461 |
| Provider Name | Thomas M Doran |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1881004489 PECOS PAC ID: 4183948953 Enrollment ID: I20230516000512 |
| Provider Name | Rosaly Cartagena |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1841737400 PECOS PAC ID: 9931561230 Enrollment ID: I20230818000686 |
| Provider Name | Nadia Boulghassoul-pietrzykowska |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1346401528 PECOS PAC ID: 8224296157 Enrollment ID: I20231206000639 |
| Provider Name | Jimmy Gray |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1437191699 PECOS PAC ID: 6204893480 Enrollment ID: I20240305002652 |
| Provider Name | Chelsae L May |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1174144810 PECOS PAC ID: 4284046830 Enrollment ID: I20240305002744 |
| Provider Name | Anne Ruggles Pariser |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1003487687 PECOS PAC ID: 6103263314 Enrollment ID: I20240325000127 |
| Provider Name | Byron V Etta |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1174971402 PECOS PAC ID: 2961804067 Enrollment ID: I20240409003099 |
| Provider Name | Linda M Unger |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992336440 PECOS PAC ID: 9739500406 Enrollment ID: I20240503001649 |
| Provider Name | Tyler Hoyt |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1558955690 PECOS PAC ID: 3870901440 Enrollment ID: I20240717004221 |
| Provider Name | Holly M Teng |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1932737244 PECOS PAC ID: 8325460512 Enrollment ID: I20250122002382 |
| Provider Name | Norman G Kruedelbach |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1306044466 PECOS PAC ID: 9133202575 Enrollment ID: I20250123001744 |
| Provider Name | John A Giglio |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1528130036 PECOS PAC ID: 7416024120 Enrollment ID: I20250128003404 |
| Provider Name | Rebecca A Shriver |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1538376397 PECOS PAC ID: 0345770194 Enrollment ID: I20250207002313 |
| Provider Name | Sureka B Reddy |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1427256528 PECOS PAC ID: 6103014360 Enrollment ID: I20250219000347 |
| Provider Name | Christopher D Milan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1477529782 PECOS PAC ID: 1658408273 Enrollment ID: I20250221003062 |
| Provider Name | Mark Molnar |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1548618036 PECOS PAC ID: 5597057448 Enrollment ID: I20250228002222 |
| Provider Name | Maudeen Cassandra Scott |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1396149464 PECOS PAC ID: 0840503470 Enrollment ID: I20250228002338 |
| Provider Name | Gerald B Pevow |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1558611087 PECOS PAC ID: 5890089585 Enrollment ID: I20250321003124 |
| Provider Name | Bilal Sadiq |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1225529894 PECOS PAC ID: 8527315233 Enrollment ID: I20250328001677 |
| Provider Name | Kara Heist Francis |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1962081919 PECOS PAC ID: 8527449487 Enrollment ID: I20250411002097 |
| Provider Name | Danton Schudlich |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1669644290 PECOS PAC ID: 0446570667 Enrollment ID: I20250411002987 |
| Provider Name | Mandy R Blume |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134378433 PECOS PAC ID: 0244395168 Enrollment ID: I20250417001833 |
| Provider Name | Molly West Anderson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1275776080 PECOS PAC ID: 9032018981 Enrollment ID: I20250424000885 |
| Provider Name | Adam Levine |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1124127063 PECOS PAC ID: 0941244032 Enrollment ID: I20250505001295 |
| Provider Name | Alfred Holm |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1326123555 PECOS PAC ID: 4789580333 Enrollment ID: I20250516001012 |
| Provider Name | Lisa Ann Kelty |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1649210808 PECOS PAC ID: 7113207804 Enrollment ID: I20250527000526 |
Riverside Family Clinic Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 209 H St East, Poplar, MT 59255 Phone: 406-768-5171 Fax: 406-768-6161 |