BLUE MOUNTAIN CLINIC, INC. - NPI 1407987548 - Family Medicine in Missoula, MT

Q: What is Blue Mountain Clinic, Inc.'s NPI number?

The NPI number for Blue Mountain Clinic, Inc. is 1407987548. It was assigned to this organization in the NPPES registry on March 8, 2007.

Q: What is Blue Mountain Clinic, Inc.'s specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

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About Blue Mountain Clinic, Inc. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

BLUE MOUNTAIN CLINIC, INC. (NPI 1407987548) is a healthcare organization registered as a family medicine in Missoula, Montana and active in the NPI registry since March 2007. The organization holds a CLIA Microscopy certificate valid through June 25, 2027 and lists Annie Hansen, Executive Director, as its authorized official.

NPPES Registry Identity

NPI1407987548

Entity TypeOrganization

Primary Taxonomy207Q00000X

Legal Business NameBLUE MOUNTAIN CLINIC, INC.

Location Address610 N CALIFORNIA STMissoula, MT 59802-3950

Mailing Address610 N California StMissoula, MT 59802-3950 · (406) 721-1946 · Fax (406) 543-9890

Phone(406) 721-1946

Fax(406) 543-9890

Organization SubpartNo

Authorized OfficialAnnie HansenExecutive Director · (406) 721-1646

Enumeration DateMarch 8, 2007

Last NPPES UpdateMay 24, 2016

✔ NPI 1407987548 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207Q00000X

License✔ Licensed in MT · 9607

Definition

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

610 N CALIFORNIA ST, Missoula, MT 59802

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Other Identifiers 2

Medicaid0218478MT

Medicare PIN000008270MT

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X MULTIPLE SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Montana.Insurance ›

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate for Provider-Performed Microscopy Procedures (PPMP) 27D0410840

Blue Mountain Clinic · Missoula, MT

Active · expires Jun 25, 2027

CLIA Number27D0410840

Laboratory TypePhysician Office

Certificate Effective DateJune 26, 2025

Certificate Expiration DateJune 25, 2027

Laboratory DirectorDr. Eric A. Ravitz

Laboratory Phone(406) 721-1646

Laboratory LocationBlue Mountain Clinic610 North California Street, Missoula, MT 59802

CLIA data matches this NPI record on: Address Name Phone

This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.

Other Providers at the Same Location NPPES 10

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. ERIC A. RAVITZ D.O.

Family Medicine