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PROVIDENCE HEALTH & SERVICES MT
NPI 1790931517
Family Medicine in Missoula, MT

Active since August 12, 2008
3075 N RESERVE ST, SUITE Q, MISSOULA, MT 59808(406) 327-1850(406) 327-1875 Get Directions Write a Review

NPPES record last updated: May 7, 2025. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: May 7, 2025, May 13, 2024, Jul 9, 2021 (3 updates tracked since 2021).

About Providence Health & Services Mt NPPES

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

PROVIDENCE HEALTH & SERVICES MT (NPI 1790931517), doing business as Pmg Mt Grant Creek Family Med, is a healthcare organization registered as a family medicine in Missoula, Montana and active in the NPI registry since August 2008. The organization lists Donald W Anderson, Assistant Secretary Enrollment, as its authorized official.

NPPES Registry Identity

NPI1790931517
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NamePROVIDENCE HEALTH & SERVICES MT
Location Address3075 N RESERVE ST, SUITE QMissoula, MT 59808-1390
Mailing AddressPo Box 31001 - 4114Pasadena, CA 91110-4114
Phone(406) 327-1850
Fax(406) 327-1875
Organization SubpartYesParent: Providence Health & Services
Authorized OfficialDonald W AndersonAssistant Secretary Enrollment · (425) 358-9786
Enumeration DateAugust 12, 2008
Last NPPES UpdateMay 7, 20253 updates tracked since enumeration
NPPES CertifiedMay 7, 2025
✔ NPI 1790931517 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
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.
3075 N RESERVE ST, Missoula, MT 59808
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Other Names 2

Doing Business AsPmg Mt Grant Creek Family Med
Doing Business AsProvidence Medical Group Montana

Other Identifiers 1

Other8445MT · Medical License Number

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-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 ›

Other Providers at the Same Location NPPES 4

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

NEIL KAWAGUCHI OD
Optometrist
3075 N RESERVE ST
MISSOULA, MT 59808
Missoula County (406) 721-4646
JAMIE HARDING APRN
Nurse Practitioner (Family)
3075 N RESERVE ST, SUITE 2
MISSOULA, MT 59808
Missoula County (406) 327-1850
CARLA ELAINE DAVIS MD
Family Medicine
3075 N RESERVE ST, SUITE Q
MISSOULA, MT 59808
Missoula County (406) 327-1850
MELISSA KLESCHEN
Pediatrics
3075 N RESERVE ST, SUITE Q
MISSOULA, MT 59808
Missoula County (406) 327-1850

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Providence Health & Services Mt's NPI number?

The NPI number for Providence Health & Services Mt is 1790931517. It was assigned to this organization in the NPPES registry on August 12, 2008. The provider is doing business as PMG MT Grant Creek Family Med and Providence Medical Group Montana.

Where is Providence Health & Services Mt located?

Providence Health & Services Mt is located at 3075 N Reserve St Suite Q, Missoula, MT 59808. The listed phone number is (406) 327-1850.

What is Providence Health & Services Mt's specialty?

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

What insurance does Providence Health & Services Mt accept?

Health plans from Blue Cross and Blue Shield of Montana list Providence Health & Services Mt as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Providence Health & Services Mt was last updated on May 7, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.