MEDICARE: KALISPELL REGIONAL MEDICAL CENTER, INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QM1300X	Multi-Specialty Clinic/Center

General Provider Information

NPI Number	:	1083200638
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KALISPELL REGIONAL MEDICAL CENTER, INC

Provider Business Mailing Address
First Line	:	500 12TH AVE W STE 1C
Second Line	:
City	:	COLUMBIA FALLS
State	:	MT
Zip	:	59912-3865
Country	:	US
Telephone Number	:	406-607-4482
Fax Number	:	406-751-8271

Provider Business Practice Location Address
First Line	:	500 12TH AVE W STE 1C
Second Line	:
City	:	COLUMBIA FALLS
State	:	MT
Zip	:	59912-3865
Country	:	US
Telephone Number	:	406-607-4482
Fax Number	:	406-751-8271

Authorized Official
Title or Position	:	CHIEF EXECUTIVE OFFICER
Name	:	CLINTON SEGER
Credential	:	MD
Telephone Number	:	406-752-1724

Provider Enumeration Date	:	12/17/2020
Last Update Date	:	03/19/2026

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