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109 1st Ave St Ignatius MT 59865-7748 | |
(406) 745-3681 | |
(406) 745-3686 |
Full Name | |
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Speciality | Clinic/Center |
Location | 109 1st Ave, St Ignatius, Montana |
Authorized Official Name and Position | Jordan Stow (CREDENTIALING) |
Authorized Official Contact | 4063814196 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Po Box 1179 St Ignatius MT 59865-1179 Ph: () - | 109 1st Ave St Ignatius MT 59865-7748 Ph: (406) 745-3681 |
NPI Number | 1093297764 |
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Provider Enumeration Date | 08/30/2018 |
Last Update Date | 11/04/2024 |
Certification Date | 11/04/2024 |
Medicare PECOS PAC ID | 9335491612 |
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Medicare Enrollment ID | O20181015003220 |
Identifier | Type | State | Issuer |
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1093297764 | NPI | - | NPPES |
Provider Name | Julie A Fleck |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1972790830 PECOS PAC ID: 2567590540 Enrollment ID: I20100513000219 |
Provider Name | Sonya H Milheim |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1225154453 PECOS PAC ID: 1254518665 Enrollment ID: I20110613000563 |
Provider Name | Maria Mcneil Williams |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1134501117 PECOS PAC ID: 0749596716 Enrollment ID: I20150904002509 |
Provider Name | Megan N Bailey |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1831556984 PECOS PAC ID: 8426352964 Enrollment ID: I20160203003008 |
Provider Name | Maureen Spain |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1194770024 PECOS PAC ID: 9739287525 Enrollment ID: I20211213002068 |
Provider Name | Taylor Lynn Stille |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1336661677 PECOS PAC ID: 2961773353 Enrollment ID: I20211228001976 |
Provider Name | Marcus Alexandar Xaviar Ordane |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1356092233 PECOS PAC ID: 6002284957 Enrollment ID: I20221124000092 |
Provider Name | Abbi A Fetters |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1174263008 PECOS PAC ID: 9739558248 Enrollment ID: I20221205002914 |
Provider Name | Aubrey Reed |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1306468137 PECOS PAC ID: 8426415936 Enrollment ID: I20230526001416 |
Provider Name | Kaitlyn Underwood |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1528725512 PECOS PAC ID: 4082156393 Enrollment ID: I20240601000556 |
Provider Name | Debbie Cox |
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Provider Type | Practitioner - Mental Health Counselor |
Provider Identifiers | NPI Number: 1750164604 PECOS PAC ID: 5698217958 Enrollment ID: I20240709004187 |