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:
| Terminated/Excluded Provider(s)
|
Healthcare Profession
|
Effective Date
|
| Alfonso, Lynett
|
Registered Nurse
|
08/20/2007
|
OIG Exclusion
|
| Amann (Hampton), Lori
|
Individual
|
11/15/2018
|
OIG Exclusion
|
| Azure, Jack
|
Personal Care Aid
|
06/20/2016
|
OIG Exclusion
|
| Bailey, Joseph A.
|
Employee Home Health Agency
|
11/20/2014
|
OIG Exclusion
|
| Barthel, Dorothy
|
Nurse
|
04/20/2011
|
OIG Exclusion
|
| Battiste, Aldo
|
Physician
|
02/09/2015
|
State Termination
|
| Beaudry, Holly F.
|
LPN
|
09/19/2013
|
OIG Exclusion
|
| Black Eagle, Larin
|
Pharmacy
|
7/20/2017
|
OIG Exclusion
|
| Bottomley, Paul D.
|
Business Owner
|
01/20/2014
|
OIG Exclusion
|
| Brian, Arleda
|
Personal Care Provider
|
12/19/2016
|
OIG Exclusion
|
| Bryant, Connie
|
Individual
|
02/20/2014
|
OIG Exclusion
|
| Buckland, Krystel
|
Pharmacist
|
05/20/2014
|
OIG Exclusion
|
| Centrad Healthcare LLC
|
DME
|
10/06/2016
|
State Termination
|
| Christie, Martina A.
|
Individual
|
09/30/2018
|
OIG Exclusion
|
| Criswell, Kevin R.
|
Physical Therapist
|
01/26/2015
|
State Termination
|
| Confirmatrix Laboratory Inc
|
Laboratory
|
03/22/2018
|
State Termination
|
| Conti, Gary J.
|
Individual
|
06/18/2015
|
OIG Exclusion
|
| Dahl, Kimberly A.
|
LPN
|
09/20/2011
|
OIG Exclusion
|
| Davis, Mary
|
Pharmacist
|
02/20/2018
|
OIG Exclusion
|
| Diamond-Leistiko, Pamela
|
Personal Care Provider
|
5/18/2017
|
OIG Exclusion
|
| Digioacchino, Karyn M.
|
LPN
|
09/20/2015
|
OIG Exclusion
|
| Doney, Jennifer A
|
Individual
|
08/23/2015
|
OIG Exclusion
|
| Dunning, Leonard F.
|
RN/EMT
|
02/20/2012
|
OIG Exclusion
|
| Etzel, Kelly R
|
Physician's Assistance
|
4/20/2017
|
OIG Exclusion
|
| Fiscus, Dana A.
|
LPN
|
05/20/2010
|
OIG Exclusion
|
| Fleming, Stanley
|
LCPC
|
11/03/2014
|
State Termination
|
| Ford, Amy L.
|
Registered Nurse
|
04/20/2010
|
OIG Exclusion
|
| Forrest, Donald
|
Individual
|
08/20/2014
|
OIG Exclusion
|
| Garner, Amy Lee
|
Licensed Practical Nurse
|
01/18/2018
|
OIG Exclusion
|
| Global Medical Direct
|
DME
|
01/21/2015
|
State Termination
|
| Gonzales, Gylinda
|
Counselor
|
02/18/2010
|
OIG Exclusion
|
| Grundvig, Christina A.
|
Home Health Employee
|
11/20/2014
|
OIG Exclusion
|
| Gunderson, Tandy G.
|
Registered Nurse
|
04/20/2010
|
OIG Exclusion
|
| Hamlin, Ronda W
|
Personal Care Provider
|
04/03/2018
|
OIG Exclusion
|
| Hanna, Elizabeth
|
Pharmacy Technician
|
02/20/2018
|
OIG Exclusion
|
| Havelka, Todd
|
Licensed Professional Counselor
|
02/22/2018
|
State Termination
|
| Heffelfinger, Arthur L.
|
EMT
|
12/19/2013
|
OIG Exclusion
|
| Houle, John C
|
Individual
|
05/18/2017
|
OIG Exclusion
|
| Howard, Sarah J.
|
Personal Care Aid
|
10/20/2016
|
OIG Exclusion
|
| Howell, George B.
|
Physician
|
02/20/2016
|
OIG Exclusion
|
| Hunn, Ben
|
Pharmacist
|
04/20/2015
|
OIG Exclusion
|
| Hunter Burns Construction
|
Government Contractor
|
09/20/2015
|
OIG Exclusion
|
| Iverson, Scott J
|
EMT
|
5/18/2017
|
OIG Exclusion
|
| Jacobs, Kathlene C.
|
Nurse
|
04/20/2011
|
OIG Exclusion
|
| Jones, Gordon B.
|
Physical Therapist
|
08/20/2013
|
OIG Exclusion
|
| Jones, Dawn C
|
Individual
|
08/20/2015
|
OIG Exclusion
|
| Jones, Jimmy Ray
|
Individual
|
10/20/2010
|
OIG Exclusion
|
| Karjala, Freda A
|
LPN
|
04/20/2015
|
OIG Exclusion
|
| Kriedeman, Amy S.
|
Individual
|
03/20/2012
|
OIG Exclusion
|
| Lewis, Matthew J.
|
Individual
|
07/18/2013
|
OIG Exclusion
|
| Lorenz, Kevin M.
|
Physician
|
08/20/2013
|
OIG Exclusion
|
| McCleery, Cameron
|
Nurse
|
07/20/2011
|
OIG Exclusion
|
| Mancuso, Jerome
|
Dentist
|
01/20/2013
|
OIG Exclusion
|
| Maxvill, Jack W.
|
Personal Care Aid
|
04/20/2015
|
OIG Exclusion
|
| Med-Care Diabetic & Medical
|
Pharmacy/DME
|
06/07/2016
|
State Termination
|
| Meeks, Heatherlynn
|
Personal Care Provider
|
04/03/2018
|
OIG Exclusion
|
| Meineke, Susan L.
|
Individual
|
10/20/2011
|
OIG Exclusion
|
| Morsette, Theodora A.
|
Individual
|
06/20/2016
|
OIG Exclusion
|
| Mosness, Erin M
|
LPN
|
12/19/2016
|
OIG Exclusion
|
| Newbreast, Charlotte B.
|
Individual
|
06/18/2015
|
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
|
06/17/2014
|
OIG Exclusion
|
| Pace, David E.
|
Nursing
|
07/20/2011
|
OIG Exclusion
|
| Pace, Ethan N.
|
Nursing
|
07/20/2011
|
OIG Exclusion
|
| Pate, Michael W.
|
Home Health Employee
|
09/19/2014
|
OIG Exclusion
|
| Pate, Nateese
|
Individual
|
09/19/2014
|
OIG Exclusion
|
| Paxton, Robert C.
|
Registered Nurse
|
01/20/2010
|
OIG Exclusion
|
| Pepin, Mark
|
LPN
|
02/20/2016
|
OIG Exclusion
|
| Pickens, Cory L.
|
Physician
|
01/01/2014
|
OIG Exclusion/State Termination
|
| Popoff, Reesa N.
|
Nurse
|
07/20/2011
|
OIG Exclusion
|
| Powell, Elizabeth J.
|
Medical Practice Biller
|
11/20/2017
|
OIG Exclusion
|
| Reichelt, Connie S.
|
Registered Nurse
|
03/20/2012
|
OIG Exclusion
|
| Riggin, Reese R.
|
Chiropractor
|
09/05/2014
|
State Termination
|
| Rocky Mountain Center for Oral and Facial Surgery
|
Dental Practice
|
2/20/2013
|
OIG Exclusion
|
| Rosette, Timothy W
|
Tribal Agency
|
7/20/2017
|
OIG Exclusion
|
| Rozzell, Quentin A.
|
Registered Nurse
|
09/19/2014
|
OIG Exclusion
|
| Rydeen, Kristi L.
|
LCPC
|
07/30/2015
|
State Termination
|
| Sanderville, Sandra M
|
Individual
|
08/20/2015
|
OIG Exclusion
|
| Schroeder, Samantha
|
Personal Care Provider
|
4/20/2017
|
OIG Exclusion
|
| Schwend, Nancy Lee
|
Personal Care Aide
|
06/18/2015
|
OIG Exclusion
|
| Scott, Robert E.
|
Registered Nurse
|
11/20/2016
|
OIG Exclusion
|
| Siruck, Lori Ann
|
Individual
|
09/20/2018
|
OIG Exclusion
|
| Slayton, Joanne H.
|
LPN
|
04/20/2010
|
OIG Exclusion
|
| Shallow, Natasha
|
Anesthesiologist
|
04/23/2018
|
State Termination
|
| Snyder, Gayle Lynn
|
Registered Nurse
|
02/20/2013
|
OIG Exclusion
|
| Sotomayor, Cathy G.
|
Pharmacy Tech
|
09/20/2011
|
OIG Exclusion
|
| Stanley, David
|
Registered Nurse
|
08/27/2018
|
OIG Exclusion
|
| Stauduhar-Brunell, Tisha
|
LPN
|
08/20/2013
|
OIG Exclusion
|
| Still Smoking, Dorothy
|
Individual
|
06/18/2015
|
OIG Exclusion
|
| Stronger, Tristan V.
|
Registered Nurse
|
08/27/2018
|
OIG Exclusion
|
| Sunchild, Wilford H
|
Individual
|
08/20/2015
|
OIG Exclusion
|
| Syverson Hauge, Linda
|
Personal Care Provider
|
04/03/2018
|
OIG Exclusion
|
| Tadios, Fawn P
|
Individual
|
5/20/2015
|
OIG Exclusion
|
| Templeton, Valerie C.
|
LPN
|
06/17/2010
|
OIG Exclusion
|
| Thomas, Eric
|
Physician
|
10/31/2018
|
State Termination
|
| Thomas, Killian L.
|
LCSW
|
06/17/2010
|
OIG Exclusion
|
| Thomas, Tommathew T.
|
Physician
|
03/20/2012
|
OIG Exclusion
|
| Tope, Anna Sue
|
Individual
|
03/20/2016
|
OIG Exclusion
|
| Towe (Lewis), Hilda S.
|
Individual
|
07/18/2013
|
OIG Exclusion
|
| Trandahl, Dana
|
Licensed Professional Counselor
|
10/31/2018
|
State Termination
|
| USA Pathology and Toxicology
|
Laboratory
|
01/19/2017
|
State Termination
|
| Walker, Mindy P.
|
LPN
|
06/17/2010
|
OIG Exclusion
|
| Werk, Joel
|
DME
|
04/02/2014
|
State Termination
|
| Whetston, Allen R.
|
Individual
|
06/20/2013
|
OIG Exclusion
|
| White, Gary A.
|
Optometrist
|
03/02/2018
|
State Termination
|