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 Rachel Savage, Rachel.Savage@mt.gov, Program Integrity Compliance Specialist.

Download Excluded or Terminated Provider list in Excel

Terminated/Excluded Provider(s) Healthcare Profession NPI Effective Date
Adams, Timothy Physician 1891706537 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 1881649952 3/20/2023 OIG Exclusion
Azure, Jack Personal Care Provider   6/20/2016 OIG Exclusion
Bailey, Joseph A. Home Health Caregiver   11/20/2014 OIG Exclusion
Baisch, Kimberly Dawn Licensed Practical Nurse   2/20/2022 OIG Exclusion
Barthel, Dorothy Nurse   4/20/2011 OIG Exclusion
Battiste, Aldo Physician 1265498802 2/9/2015 State Termination
Beaudry, Holly F. Licensed Practical Nurse   9/19/2013 OIG Exclusion
Black Eagle, Larin Pharmacy   7/20/2017 OIG Exclusion
Bohannon, Tyler Individual   3/28/2022 OIG Termination
Bonnet, Kristy J Registered 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 Home Health Aide   2/20/2014 OIG Exclusion
Christie, Martina A. Individual   9/30/2018 OIG Exclusion
Clawson, Charity Glenda Registered Nurse   1/19/2023 OIG Exclusion
Clement, Ty Licensed Clinical Professional Counselor 1346527496 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 1558678391 1/31/2023 State Termination/OIG Exclusion
Crumb, Douglas A. Denturist 1154506889 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 1073951000 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
Dupuis, Audrianna Marie RN   1/31/2025 OIG Exclusion/State Termination
Etzel, Kelly R Physician's Assistance 1639285281 4/20/2017 OIG Exclusion
Evans, Caitlin Ashley Registered Nurse   3/20/2024 OIG Exclusion
Evans, Crystal Rose LCPC 1003048299 2/20/2023 OIG Exclusion
Fiscus, Dana A. LPN   5/20/2010 OIG Exclusion
Fleming, Stanley LCPC 1376682351 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 LCPC 1508211103 8/16/2024 State Termination/OIG Exclusion
Giacoletto, Shantyl Marie Registered Nurse   10/19/2023 OIG Exclusion
Global Medical Direct DME 1396748794 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 1861843039 3/28/2022 OIG Termination
Harper, Kayla Marie Burch LCSW 1750735429 11/30/2023 OIG Exclusion
Havelka, Todd Licensed Professional Counselor   2/22/2018 State Termination
Hayes-Cook, Jessica LCPC 1427301167 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 1366881955 3/19/2020 OIG Exclusion
Hill, Mark Allen APRN 1487071908 10/20/2022 OIG Exclusion
Hodge, John C. Physician 1649570037 9/11/2023 State Termination
Hollingsworth, J. Derek Physician 1336192269 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 1730252289 2/20/2016 OIG Exclusion
Hunn, Ben Pharmacist 1588687214 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 1427222058 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
Kiewatt, Julie Ann LCPC 1669880571 2/28/2025 OIG Exclusion
a.k.a. Julie Ann Dauner        
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 1255774311 10/19/2023 OIG Exclusion
Lewis, Matthew J. Individual   7/18/2013 OIG Exclusion
Lorenz, Kevin M. Physician 1861480006 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 1427039064 1/19/2022 OIG Exclusion
Med-Care Diabetic & Medical Pharmacy/DME 1619978434 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 1992988257 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
Norwood, Braxton Alan Individual   3/31/2025 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
Peterson, Donna Lynn Registered Nurse   3/31/2025 OIG Exclusion/State Termination
Pickens, Cory L. Physician   1/1/2014 OIG Exclusion/State Termination
Pinkerton, Jaylene Rae LPN   12/31/2024 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 1114195310 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 1174531537 7/30/2015 State Termination
Sanderville, Sandra M Individual   8/20/2015 OIG Exclusion
Saunders, Alexandria LCPC 1487042339 4/23/2025 State Termination
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 1437470432 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 1376891002 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 1336537299 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 1528378072 10/31/2018 State Termination
Thomas, Killian L. LCSW 1124278973 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 1356418743 10/31/2018 State Termination
Trandahl, Dana Ann  LCPC 1356418743 1/19/2022 OIG Exclusion
Tsuber, Timofei Individual   12/19/2024 OIG Exclusion
USA Pathology and Toxicology Laboratory 1134526536 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 1487621579 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