Excluded or Terminated Montana Medicaid Providers

When determined by the appropriate authority, that a Montana Medicaid Provider needs to be terminated or excluded from the Medicaid program under 42 CFR 1002.210, the state agency must provide notification. In accordance with Administrative Rules of Montana (ARM) 37.85.507, 42 CFR 1001.2005 and 42 CFR 1001.2006 this web site serves as notice to the state licensing agencies and others regarding these excluded and or terminated providers.

The following list is not all-inclusive for all excluded or terminated providers and should not be used solely to determine or verify a provider’s enrollment status or ability to provider services under the Montana Medicaid program.

Please check the following web sites to determine provider status:

 

For further information, please contact Jennifer Tucker,  JTucker2@mt.gov, SURS Supervisor,  and Ross Barnes, Ross.Barnes@mt.gov, Program Integrity Compliance Specialist.

Download Excluded or Terminated Provider list in Excel

 

Terminated/Excluded Provider(s) Healthcare Profession Effective Date
Adams, Timothy Physician 7/23/2024 State Termination
Alfonso, Lynett Registered Nurse 8/20/2007 OIG Exclusion
Amann (Hampton), Lori Individual 11/15/2018 OIG Exclusion
Armstrong, James Haldeman Physician 3/20/2023 OIG Exclusion
Azure, Jack Personal Care Aid 6/20/2016 OIG Exclusion
Bailey, Joseph A. Employee Home Health Agency 11/20/2014 OIG Exclusion
Baisch, Kimberly Dawn LPN 2/20/2022 OIG Exclusion
Barthel, Dorothy Nurse 4/20/2011 OIG Exclusion
Battiste, Aldo Physician 2/9/2015 State Termination
Beaudry, Holly F. LPN 9/19/2013 OIG Exclusion
Black Eagle, Larin Pharmacy 7/20/2017 OIG Exclusion
Bohannon, Tyler DME 3/28/2022 OIG Termination
Bonnet, Kristy J Nurse 2/20/2019 OIG Exclusion
Bottomley, Paul D. Business Owner 1/20/2014 OIG Exclusion
Boyle, Shane Andrew Individual 3/20/2023 OIG Exclusion
Brian, Arleda Personal Care Provider 12/19/2016 OIG Exclusion
Bryant, Connie Individual 2/20/2014 OIG Exclusion
Christie, Martina A. Individual 9/30/2018 OIG Exclusion
Clawson, Charity Glenda Individual 1/19/2023 OIG Exclusion
Clement, Ty LCSW 3/25/2021 State Termination
a.k.a. Taylor Clement      
a.k.a. Saul Clement      
a.k.a Taylor Woods Clement      
Chenowith, Lindsay Emily Registered Nurse 11/20/2022 OIG Exclusion
Coghlan, Sarah Beth Registered Nurse 6/20/2023 OIG Exclusion
Conti, Gary J. Individual 6/18/2015 OIG Exclusion
Corne, Taylor Renee Personal Care Provider 5/3/2019 OIG Exclusion
Cox, Timothy James Individual 2/20/2022 OIG Exclusion
Crowe, Katie Licensed Professional Counselor 1/31/2023 State Termination
Crumb, Douglas A. Denturist 4/20/2019 OIG Exclusion
Cureton, Debroah Personal Care Provider 3/19/2020 OIG Exclusion
Cureton, Ninfa Care Giver 11/20/2019 OIG Exclusion
Dahl, Kimberly A. LPN 9/20/2011 OIG Exclusion
Davis, Mary Pharmacist 2/20/2018 OIG Exclusion
Devito, Jacquelyn Marie APRN 3/20/2024 OIG Exclusion
Devous, Arnold Scott Individual 11/18/2021 OIG Exclusion
Diamond-Leistiko, Pamela Personal Care Provider 5/18/2017 OIG Exclusion
Digioacchino, Karyn M. LPN 9/20/2015 OIG Exclusion
Doney, Jennifer A Individual 8/23/2015 OIG Exclusion
Dunning, Leonard F. RN/EMT 2/20/2012 OIG Exclusion
Etzel, Kelly R Physician's Assistance 4/20/2017 OIG Exclusion
Evans, Caitlin Ashley Registered Nurse 3/20/2024 OIG Exclusion
Evans, Crystal Rose LCPC 2/20/2023 OIG Exclusion
Fiscus, Dana A. LPN 5/20/2010 OIG Exclusion
Fleming, Stanley LCPC 11/3/2014 State Termination
Ford, Amy L. Registered Nurse 4/20/2010 OIG Exclusion
Forrest, Donald Individual 8/20/2014 OIG Exclusion
Garner, Amy Lee Licensed Practical Nurse 1/18/2018 OIG Exclusion
Gascon, Christine LPC 8/16/2024 State Termination
Giacoletto, Shantyl Marie Registered Nurse 10/19/2023 OIG Exclusion
Global Medical Direct DME 1/21/2015 State Termination
Gonzales, Gylinda Counselor 2/18/2010 OIG Exclusion
Gregory, Jacob Individual 1/19/2022 OIG Exclusion
Gregory, Timothy Flake Individual 2/20/2022 OIG Exclusion
Grundvig, Christina A. Home Health Employee 11/20/2014 OIG Exclusion
Gunderson, Tandy G. Registered Nurse 4/20/2010 OIG Exclusion
Hamlin, Ronda W Personal Care Provider 4/3/2018 OIG Exclusion
Hanna, Elizabeth Pharmacy Technician 2/20/2018 OIG Exclusion
Harper, Janae Mid-Level 3/28/2022 OIG Termination
Harper, Kayla Marie Burch LCSW 11/30/2023 OIG Exclusion
Havelka, Todd Licensed Professional Counselor 2/22/2018 State Termination
Hayes-Cook, Jessica LCPC 6/20/2023 OIG Exclusion
Heffelfinger, Arthur L. EMT 12/19/2013 OIG Exclusion
Heller, Marcie April RN/LPN 3/19/2020 OIG Exclusion
Henrie, Donna Faye LCSW 3/19/2020 OIG Exclusion
Hill, Mark Allen APRN 10/20/2022 OIG Exclusion
Hodge, John C. Physician 9/11/2023 State Termination
Holingsworth, J. Derek Physician 11/20/2019 OIG Exclusion
Houle, John C Individual 5/18/2017 OIG Exclusion
Howard, Sarah J. Personal Care Aid 10/20/2016 OIG Exclusion
Howell, George B. Physician 2/20/2016 OIG Exclusion
Hunn, Ben Pharmacist 4/20/2015 OIG Exclusion
Iskander, Raif Wadie Individual 10/20/2022 OIG Exclusion
Iverson, Scott J EMT 5/18/2017 OIG Exclusion
Jacobs, Kathlene C. Nurse 4/20/2011 OIG Exclusion
Jacquin, Jacqueline Personal Care Provider 6/20/2019 OIG Exclusion
Jones, Gordon B. Physical Therapist 8/20/2013 OIG Exclusion
Jones, Dawn C Individual 8/20/2015 OIG Exclusion
Jones, Jimmy Ray Individual 10/20/2010 OIG Exclusion
Kambic, Ashley Mary Individual 2/20/2022 OIG Exclusion
Kim, Duk H Individual 11/25/2021 OIG Exclusion
Kriedeman, Amy S. Individual 3/20/2012 OIG Exclusion
Langlois, Michael J Registered Nurse 1/24/2019 OIG Exclusion
Lapides, David Ari Physician 10/19/2023 OIG Exclusion
Lewis, Matthew J. Individual 7/18/2013 OIG Exclusion
Lorenz, Kevin M. Physician 8/20/2013 OIG Exclusion
Longmire, Kimberly Sue Personal Care Provider 6/20/2019 OIG Exclusion
Lushin, Todd David Registered Nurse 6/20/2023 OIG Exclusion
Mancuso, Jerome Dentist 1/20/2013 OIG Exclusion
Martel, Trinity Marie Personal Care Provider 3/19/2020 OIG Exclusion
Maxvill, Jack W. Personal Care Aid 4/20/2015 OIG Exclusion
McCleery, Cameron Nurse 7/20/2011 OIG Exclusion
McGree, Patrick Joseph Physician 1/19/2022 OIG Exclusion
Med-Care Diabetic & Medical Pharmacy/DME 6/7/2016 State Termination
Meeks, Danielle Justice AKA Justin Meeks Personal Care Provider 7/30/2020 OIG Exclusion
Meeks, Heatherlynn Personal Care Provider 4/3/2018 OIG Exclusion
Meineke, Susan L. Individual 10/20/2011 OIG Exclusion
Mills, Donald Registered Nurse 12/28/2018 OIG Exclusion
Mohamed, Amr Physician 7/23/2024 State Termination
Monahan, Mary Schmidt Registered Nurse 10/20/2022 OIG Exclusion
Morsette, Theodora A. Individual 6/20/2016 OIG Exclusion
Mosness, Erin M LPN 12/19/2016 OIG Exclusion
Newbreast, Charlotte B. Individual 6/18/2015 OIG Exclusion
Norton, William T. Personal Care Provider 10/20/2016 OIG Exclusion
O’Dell Troy D. Individual 10/20/2011 OIG Exclusion
Olson, Christine N. LPN 6/17/2014 OIG Exclusion
Pace, David E. Nursing 7/20/2011 OIG Exclusion
Pace, Ethan N. Nursing 7/20/2011 OIG Exclusion
Pate, Michael W. Home Health Employee 9/19/2014 OIG Exclusion
Pate, Nateese Individual 9/19/2014 OIG Exclusion
Paxton, Robert C. Registered Nurse 1/20/2010 OIG Exclusion
Pentecost, Matthew James Individual 1/25/2023 OIG Exclusion
Pepin, Mark LPN 2/20/2016 OIG Exclusion
Pickens, Cory L. Physician 1/1/2014 OIG Exclusion/State Termination
Popoff, Reesa N. Nurse 7/20/2011 OIG Exclusion
Powell, Elizabeth J. Medical Practice Biller 11/20/2017 OIG Exclusion
Reichelt, Connie S. Registered Nurse 3/20/2012 OIG Exclusion
Riggin, Reese R. Chiropractor 9/5/2014 State Termination
Ringdahl, Donya Renee Individual 12/20/2021 OIG Exclusion
a.k.a. Hawkins, Donya Renee      
a.k.a. Rockland, Donya Renee      
Rocky Mountain Center for Oral and Facial Surgery Dental Practice 2/20/2013 OIG Exclusion
Rognstad, Amanda Jo LPN 6/20/2023 OIG Exclusion
Rosette, Timothy W Tribal Agency 7/20/2017 OIG Exclusion
Rozzell, Quentin A. Registered Nurse 9/19/2014 OIG Exclusion
Rydeen, Kristi L. LCPC 7/30/2015 State Termination
Sanderville, Sandra M Individual 8/20/2015 OIG Exclusion
Schroeder, Samantha Personal Care Provider 4/20/2017 OIG Exclusion
Schwend, Nancy Lee Personal Care Aide 6/18/2015 OIG Exclusion
Scott, Robert E. Registered Nurse 11/20/2016 OIG Exclusion
Sirucek, Lori Ann Individual 9/20/2018 OIG Exclusion
Slayton, Joanne H. LPN 4/20/2010 OIG Exclusion
Shallow, Natasha Anesthesiologist 4/23/2018 State Termination
Snyder, Gayle Lynn Registered Nurse 2/20/2013 OIG Exclusion
Sotomayor, Cathy G. Pharmacy Tech 9/20/2011 OIG Exclusion
Stanley, David Registered Nurse 8/27/2018 OIG Exclusion
Stauduhar-Brunell, Tisha LPN 8/20/2013 OIG Exclusion
Stephenson, Elizabeth Marie Individual 3/20/2023 OIG Exclusion
Stewart, Deborah Jean Individual 9/20/2021 OIG Exclusion
Stewart, Jessica Lynn Individual 9/20/2021 OIG Exclusion
Still Smoking, Dorothy Individual 6/18/2015 OIG Exclusion
Stoick, Bradley John Pharmacist 2/20/2022 OIG Exclusion
Stronger, Tristan V. Registered Nurse 8/27/2018 OIG Exclusion
Sunchild, Wilford H Individual 8/20/2015 OIG Exclusion
Svejkovsky, Tristan Nurse Practitioner 7/23/2024 State Termination
Syverson Hauge, Linda Personal Care Provider 4/3/2018 OIG Exclusion
Tabor, Katina LPN 3/20/2023 OIG Exclusion
Tadios, Fawn P Individual 5/20/2015 OIG Exclusion
Templeton, Valerie C. LPN 6/17/2010 OIG Exclusion
Thomas, Eric Physician 10/31/2018 State Termination
Thomas, Killian L. LCSW 6/17/2010 OIG Exclusion
Thomas, Tommathew T. Physician 3/20/2012 OIG Exclusion
Tope, Anna Sue Individual 3/20/2016 OIG Exclusion
Towe (Lewis), Hilda S. Individual 7/18/2013 OIG Exclusion
Trandahl, Dana Licensed Professional Counselor 10/31/2018 State Termination
Trandahl, Dana Ann  LCPC 1/19/2022 OIG Exclusion
USA Pathology and Toxicology Laboratory 1/19/2017 State Termination
Walker, Mindy P. LPN 6/17/2010 OIG Exclusion
Walters, Kristina Nichole Individual 4/20/2022 OIG Exclusion
Weber, Stanley Patrick Physician 5/3/2019 OIG Exclusion
Weller, Jennifer Lynn Nurse 5/3/2019 OIG Exclusion
Werk, Joel DME 4/2/2014 State Termination
Whetston, Allen R. Individual 6/20/2013 OIG Exclusion
White, Sheila Marie Registered Nurse 6/17/2021 OIG Exclusion
Zinda, Nichole Lynn Registered Nurse 8/16/2024 OIG Exclusion