Providence Surgery Center
Providence Surgery Center is a healthcare organization registered as Ambulatory Surgical Clinic/Center in Missoula, MT, holding Type 2 (organization) NPI 1407860745 since 2006. The authorized official on file is Shelley Longgood, Administrator.
✓ Active NPI ✓ Valid NPI checksum
| NPI | 1407860745 |
|---|---|
| Entity type | Organization (Type 2) |
| Legal business name | Providence Surgery Center |
| Practice address | 902 N ORANGE ST, Missoula, MT, 59802 |
| Phone | 4063273300 |
| Fax | 4063273302 |
| Enumeration date | 2006-07-29 |
| Last updated in NPPES | 2024-12-31 |
Authorized official
| Name | Shelley Longgood |
|---|---|
| Title | Administrator |
| Phone | 4063273300 |
Taxonomy & classification
| Taxonomy code | Specialty | Primary | License | State |
|---|---|---|---|---|
| 261QA1903X | Ambulatory Surgical Clinic/Center | Primary | 10708 | MT |
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0350098 | Medicaid | MT | — |
Copy-ready billing details
Provider: Providence Surgery Center NPI: 1407860745 Taxonomy: 261QA1903X (Ambulatory Surgical Clinic/Center) Address: 902 N ORANGE ST, Missoula, MT, 59802
Providers at this address
| NPI | Name | Type | Specialty | Location |
|---|---|---|---|---|
| 1003821976 | Brooks Baer | Individual | Professional Counselor | Missoula, MT |
| 1619058302 | Providence Health & Services Mt | Organization | Psychiatric Hospital Unit | Missoula, MT |
| 1093830515 | Robert Munjal | Individual | Psychiatry Physician | Missoula, MT |
| 1336380161 | Providence Health & Services Mt | Organization | Infectious Disease Physician | Missoula, MT |
| 1225279227 | Kelli Gibbs | Individual | Physician Assistant | Missoula, MT |
| 1689804239 | Barbara Jacobson | Individual | Family Nurse Practitioner | Missoula, MT |
| 1427301589 | Adeline Wakeman | Individual | Psychiatric/Mental Health Nurse Practitioner | Missoula, MT |
| 1700266251 | Kristi Richards | Individual | Family Nurse Practitioner | Missoula, MT |
Verify this record
Cross-check NPI 1407860745 against the authoritative CMS record: view Providence Surgery Center on the official NPPES registry .
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes — even if the provider moves or changes specialty. Read the full guide or validate an NPI number.
Frequently asked questions
What type of organization is Providence Surgery Center?
What is a Type 2 NPI?
Source: CMS NPPES (public data). Snapshot 2026-07-11. Provider record last updated 2024-12-31.