BEAR RIVER UROLOGY, LLC (NPI# 1063708592) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063708592 |
| Entity Type | Organization |
| Organization Name | BEAR RIVER UROLOGY, LLC |
| Practice Address |
196 Arrowhead Dr Suite #4 Evanston WY 82930-8752 |
| Practice Telephone | 3077898721 |
| Mailing Telephone | 3077898721 |
| Enumeration Date | 2011-06-23 |
| Last Update Date | 2011-06-23 |
| Authorized Official Name | MICHAEL E VAN BIBBER (OWNER) |
| Authorized Official Telephone | 8018216717 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208800000X | Urology | TL#1572 | WY | Allopathic & Osteopathic Physicians |
| Street Address |
196 ARROWHEAD DR SUITE #4 |
| City | EVANSTON |
| State | WY |
| Zip Code | 82930-8752 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538164413 | David Segarra | Internal Medicine | 196 Arrowhead Dr, Ste 2, Evanston, WY 82930-8752 | 2005-06-16 |
| 1457725988 | Auralcare Hearing Centers of America, LLC | Clinic/Center | 196 Arrowhead Dr, Evanston, WY 82930-8752 | 2015-11-20 |
| 1902299787 | Kathy Bella | Nurse Practitioner | 196 Arrowhead Dr, Suite 1, Evanston, WY 82930-8752 | 2015-03-18 |
| 1609119734 | Alan Robert Brown | Pediatrics | 196 Arrowhead Dr, Evanston, WY 82930-8752 | 2013-03-27 |
| 1821345604 | Ann Stoddard | Community Health Worker | 196 Arrowhead Dr, Ste 2, Evanston, WY 82930-8752 | 2012-08-10 |
| 1457614331 | Cal Lee Morrow | Family Medicine | 196 Arrowhead Dr, Suite 1, Evanston, WY 82930-8752 | 2012-06-16 |
| 1619237625 | Tadge Kanjo General Surgery LLC | Surgery | 196 Arrowhead Dr, Suite 6, Evanston, WY 82930-8752 | 2012-05-23 |
| 1629342068 | Gale Mcguire | Licensed Practical Nurse | 196 Arrowhead Dr, Ste 6, Evanston, WY 82930-8752 | 2012-03-02 |
| 1437434354 | Carver Family Health, LLC | Nurse Practitioner | 196 Arrowhead Dr, Suite #4, Evanston, WY 82930-8752 | 2011-10-12 |
| 1700013661 | Eric N. Swensen | Emergency Medicine | 196 Arrowhead Dr, Suite4, Evanston, WY 82930-8752 | 2009-06-18 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598398935 | Colby Kim Gomez | Physical Therapist | 190 Arrowhead Dr, Evanston, Wy 82930, Evanston, WY 82930 | 2020-02-13 |
| 1164808382 | Marilyn Carol Edgeworth Tacoma | Registered Nurse | 1037 Morse Lee St, Evanston, WY 82930 | 2015-08-11 |
| 1699159723 | Impact Physical Therapy LLC | Clinic/Center | 96 Yellow Creek Road, Evanston, WY 82930 | 2015-07-18 |
| 1578942421 | Mark Carstensen | Case Manager/Care Coordinator | 219 7th Street, Evanston, WY 82930 | 2015-05-26 |
| 1013396241 | Jennifer Carstensen | Case Manager/Care Coordinator | 325 Arrowhead Drive, Evanston, WY 82930 | 2015-05-20 |
| 1780083782 | Christa Lena Barker | Nurse Practitioner | 191 Overthrust Road, Evanston, WY 82930 | 2014-08-15 |
| 1366865339 | Don Mckay Francom | Dentist | 170 Arrowhead Dr. Suite 1, Evanston, WY 82930 | 2014-01-28 |
| 1417228370 | Premier Surgical Center, LLC | Clinic/Center | 195 Overthrust Road, Evanston, WY 82930 | 2012-01-24 |
| 1588959324 | Mejia D Williams | Social Worker | 190 Overthrust Road, Evanston, WY 82930 | 2011-06-09 |
| 1225327000 | Richard Jay Capener | Family Medicine | 196 Arrowhead Dr Ste 1, Evanston, WY 82930 | 2011-04-01 |
| Find all providers in zip 82930 | ||||
| Taxonomy Code | 208800000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Urology |
| A urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Urology, 2007. http://www.abu.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Urology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568776417 | Lome Urology Ltd | Urology | 800 Austin St, Suite 569e, Evanston, IL 60202-3439 | 2010-08-03 |
| 1750570743 | Greater Chicago Urology | Urology | 800 Austin St, Suite 569 E, Evanston, IL 60202-3439 | 2007-10-16 |
| 1578608949 | Peter Thomas Vaselopulos | Urology | 800 Austin St, Suite 569, Evanston, IL 60202-3439 | 2007-02-21 |
| 1265577621 | Mark Jonathan Schacht | Urology | 800 Austin St, Suite 569e, Evanston, IL 60202-3439 | 2007-02-21 |
| 1871638338 | Leon Gershon Lome | Urology | 800 Austin St, Suite 457e, Evanston, IL 60202-3439 | 2007-02-21 |
| 1912059254 | Uropartners, LLC | Urology | 800 Austin St, East Tower, Ste. 363, Evanston, IL 60202-3439 | 2007-01-17 |
| 1780797969 | Charles B. Brendler | Urology | 2650 Ridge Ave, Walgreen Building Suite 2507, Evanston, IL 60201-1718 | 2006-08-15 |
| 1558375873 | Thomas C. Keeler | Urology | 1000 Central St, Suite 720, Evanston, IL 60201-1777 | 2006-07-29 |
| 1184638496 | Peter M. Colegrove | Urology | 1000 Central St, Suite 720, Evanston, IL 60201-1777 | 2006-07-29 |
| 1245257930 | Leon G Lome Md Sc | Urology | 800 Austin St, Ste 569 East Tower, Evanston, IL 60202-3439 | 2006-07-17 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.