RIVERTON ONCOLOGY PRACTICE,LLC (NPI# 1104065200) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104065200 |
| Entity Type | Organization |
| Organization Name | RIVERTON ONCOLOGY PRACTICE,LLC |
| Practice Address |
1035 Rose Ln Ste D Riverton WY 82501-2286 |
| Mailing Address |
Po Box 758 Post Falls ID 83877-0758 |
| Practice Telephone | 3078564688 |
| Practice Fax Number | 3078561740 |
| Mailing Telephone | 3078564688 |
| Mailing Fax Number | 3078561740 |
| Enumeration Date | 2009-02-12 |
| Last Update Date | 2009-02-12 |
| Authorized Official Name | MR. DONALD BIVACCA (PRESIDENT) |
| Authorized Official Telephone | 3078564688 |
| Is Organization Subpart | Y |
| Parent Organization Name | LIFEPOINT HOSPITALS HOLDINGS |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RH0003X |
Internal Medicine Specialization: Hematology & Oncology |
Allopathic & Osteopathic Physicians |
| Street Address |
1035 ROSE LN STE D |
| City | RIVERTON |
| State | WY |
| Zip Code | 82501-2286 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083865554 | Riverton Physician Practices LLC | Internal Medicine | 1035 Rose Ln, Suite D, Riverton, WY 82501-2286 | 2008-10-02 |
| 1912419623 | Lora Lea Koenig | Registered Nurse | 1035 Rose Ln, Riverton, WY 82501-2291 | 2017-11-03 |
| 1770990426 | Rendezvous Medical | Clinic/Center | 1035 Rose Ln, Suite D, Riverton, WY 82501-2286 | 2014-07-15 |
| 1366735466 | Rendezvous Medical | Pediatrics | 1035 Rose Ln, Suite B, Riverton, WY 82501-2286 | 2011-05-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366914889 | Community Health Center of Central Wyoming Inc | Clinic/Center | 704 Fremont Ave, Riverton, WY 82501 | 2018-12-21 |
| 1699292391 | Wind River Cares Riverton | Clinic/Center | 511 North 12 Street East, Riverton, WY 82501 | 2017-08-24 |
| 1801242268 | Jessika Ruth Waldron | Case Manager/Care Coordinator | 1519 1/2 E Pershing, Riverton, WY 82501 | 2016-05-04 |
| 1467815498 | Orren P Janis Sr. | Community Health Worker | 10369 Highway 789, 10369 Hwy 789, Riverton, WY 82501 | 2016-03-29 |
| 1194186320 | Amanda R Vroman | Counselor | 10269 Hwy 789, Riverton, WY 82501 | 2016-03-16 |
| 1770944902 | William Nolan Sage | Counselor | 10269 Hwy. 789, Riverton, WY 82501 | 2016-03-16 |
| 1962806331 | Moss Dentistry | Dentist | 203 E Main Street, Suite 205, Riverton, WY 82501 | 2014-10-14 |
| 1215339957 | Jordan Hays | Registered Nurse | 11855 Us Highway 26, Riverton, WY 82501 | 2014-09-25 |
| 1538584750 | Michaela R Sisneros | Nursing Care | 2890 Cooper Rd, Riverton, WY 82501 | 2014-02-25 |
| 1487089843 | Olivia P Washington | Registered Nurse | 43 Goes In Lodge Road, Riverton, WY 82501 | 2013-09-04 |
| Find all providers in zip 82501 | ||||
| Taxonomy Code | 207RH0003X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Hematology & Oncology |
| An internist doctor of osteopathy that specializes in the treatment of the combination of hematology and oncology disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine WAS able to obtain a Certificate of Special Qualifications in the field of Hematology and Oncology. The Certificate is NO longer offered. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2007. [7/1/2008: definiton added, source added; 7/1/2011: modified source] - Additional Resources: http://www.osteopathic.org/certification |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083865554 | Riverton Physician Practices LLC | Internal Medicine | 1035 Rose Ln, Suite D, Riverton, WY 82501-2286 | 2008-10-02 |
| 1619236791 | Riverton Physician Practices LLC | Internal Medicine | 2100 W Sunset Dr, Riverton, WY 82501-2274 | 2012-05-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366594152 | Hematology Oncology Centers of The Northern Rockies PC | Internal Medicine | 532 Val Vista St Ste 103, Sheridan, WY 82801-3655 | 2007-01-18 |
| 1215041611 | Cheyenne Hematology-oncology Services PC | Internal Medicine | 421 East 17th Street, Cheyenne Hematology-oncology Services PC, Cheyenne, WY 82001-4609 | 2006-08-19 |
| 1467418905 | Mohamed El-sayed El-tarabily | Internal Medicine | 310 E 24th St, Cheyenne, WY 82001-3126 | 2006-04-25 |
| 1467433979 | Tom Anderson | Internal Medicine | 1025 9th St, #b, Cody, WY 82414-3441 | 2005-11-10 |
| 1992707285 | Clinton Franklin Merrill Jr. | Internal Medicine | 15 Shrine Club Rd, Lander, WY 82520-8501 | 2005-06-01 |
| 1760734602 | St. Vincent Healthcare | Internal Medicine | 1025 9th St, Ste B, Cody, WY 82414-3441 | 2012-10-02 |
| 1598096182 | Natalie Alana Workman | Internal Medicine | 310 E 24th St, Cheyenne, WY 82001-3126 | 2010-01-20 |
| 1013193705 | Kellie Elizabeth Flippin | Internal Medicine | 6501 E 2nd St, Casper, WY 82609-4293 | 2008-01-14 |
| 1669526927 | Hematology Oncology Centers of The Northern Rockies PC | Internal Medicine | 777 Avenue H, Powell, WY 82435-2260 | 2007-01-23 |
| 1740337617 | Carletta Collins | Internal Medicine | 777 Avenue H, Powell, WY 82435-2260 | 2007-01-04 |
| Find all providers with the same taxonomy | ||||
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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.