| Full Name | |
|---|---|
| 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 |
|---|---|
Po Box 67 Poplar MT 59255-0067 Ph: (406) 768-3491 | 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 | 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 | 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 | 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 | Jennifer S Gannon |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1194721241 PECOS PAC ID: 7416958129 Enrollment ID: I20070124000140 |
| Provider Name | Karen A Nielson-salois |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1013078336 PECOS PAC ID: 8921009242 Enrollment ID: I20070129000509 |
| Provider Name | Barbara S Cohn |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1003918384 PECOS PAC ID: 9335246438 Enrollment ID: I20070524000529 |
| 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 | 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 | 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 | Kristin A Yandora |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1497922413 PECOS PAC ID: 0749352193 Enrollment ID: I20091008000653 |
| 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 | Phillip K Rector |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1952468043 PECOS PAC ID: 6204970239 Enrollment ID: I20100215000411 |
| 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 | Ethel L Moore |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1053437079 PECOS PAC ID: 3779607635 Enrollment ID: I20100830000054 |
| 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 | Martha E Burton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497828768 PECOS PAC ID: 6901093343 Enrollment ID: I20101210000062 |
| Provider Name | Garold D Spire |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1467528596 PECOS PAC ID: 5991992331 Enrollment ID: I20101210000071 |
| 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 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 | 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 | Thomas E Martin |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1093847915 PECOS PAC ID: 4284874447 Enrollment ID: I20130711000242 |
| Provider Name | Karen L Zoller |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730357377 PECOS PAC ID: 8022195361 Enrollment ID: I20130712000607 |
| Provider Name | Charles J Thurston |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1568576007 PECOS PAC ID: 6103816210 Enrollment ID: I20130801000838 |
| Provider Name | Jon A Ossen |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1174537872 PECOS PAC ID: 5991719932 Enrollment ID: I20131104000134 |
| 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 | 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 | 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 | 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 | Justin Sean Ribault |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1306070966 PECOS PAC ID: 5092022269 Enrollment ID: I20150921001835 |
| Provider Name | Pierrette Toussaint |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1396159240 PECOS PAC ID: 0749598852 Enrollment ID: I20151008002276 |
| Provider Name | Anthony P Tranchita |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1437139847 PECOS PAC ID: 1052621208 Enrollment ID: I20151030001606 |
Fort Peck Tribes Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 701 Frontage Rd, Poplar, MT 59255 Phone: 406-768-6003 | |
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 | |
Fort Peck Tribes Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 400 4th Ave W, Poplar, MT 59255 Phone: 406-768-3384 |