MOUNTAIN MEDICINE LLC (NPI# 1134744600) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1134744600 |
| Entity Type | Organization |
| Organization Name | MOUNTAIN MEDICINE LLC |
| Practice Address |
170 Arrowhead Dr Evanston WY 82930-9307 |
| Practice Telephone | 3072672116 |
| Mailing Telephone | 3072092220 |
| Enumeration Date | 2020-06-10 |
| Last Update Date | 2020-10-06 |
| Authorized Official Name | CHET RUGER (ADMINISTRATOR) |
| Authorized Official Telephone | 3072092220 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QP2300X |
Clinic/Center Specialization: Primary Care |
Ambulatory Health Care Facilities |
| Street Address |
170 ARROWHEAD DR |
| City | EVANSTON |
| State | WY |
| Zip Code | 82930-9307 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982614723 | Kimberly S Larson | Nurse Practitioner | 170 Arrowhead Dr, Evanston, WY 82930-9266 | 2006-08-08 |
| 1962937441 | Pain Care Center LLC | Anesthesiology | 170 Arrowhead Dr, Suite 2, Evanston, WY 82930-9307 | 2017-04-21 |
| 1124184775 | D Mckay Francom Dds | Dentist | 170 Arrowhead Dr, Suite 1, Evanston, WY 82930 | 2006-12-28 |
| 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 | 261QP2300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Primary Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164044962 | Sterling Provider Group | Clinic/Center | 1952 Harrison Drive, Evanston, WY 82930 | 2020-05-14 |
| 1871853812 | Concentra Primary Care of Illinois PC | Clinic/Center | 800 Austin St, Suite 269 East Tower, Evanston, IL 60202-3439 | 2012-05-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205382819 | Stagecoach Health PC | Clinic/Center | 511 Osborne St., Baggs, WY 82321 | 2016-09-01 |
| 1316383888 | Frontier Family Practice LLC | Clinic/Center | 1123 Big Horn Ave, Worland, WY 82401-2802 | 2013-05-10 |
| 1750726212 | High Desert Healthcare LLC | Clinic/Center | 1013 East Boxelder Rd, Suite 200, Gillette, WY 82718 | 2013-05-09 |
| 1730477266 | Cowboy Urgent Care, Inc | Clinic/Center | 519 8th Street, Rawlins, WY 82301 | 2011-07-19 |
| 1164650719 | Rocky Mountain Family Medicine LLC | Clinic/Center | 5840 E 2nd St. Suite 200, Casper, WY 82601 | 2009-06-22 |
| 1639359045 | Sunrise Chiropractic Inc | Clinic/Center | 1439 Stillwater Ave Ste 5, Cheyenne, WY 82009-7367 | 2007-11-14 |
| 1396801908 | Healing Element Chiropractic LLC | Clinic/Center | 621 N 10th St E, Riverton, WY 82501-2906 | 2006-12-28 |
| 1265521363 | Medcor of Barrington, PC | Clinic/Center | One Mammoth Hot Springs, Yellowstone Nat'l Park, Mammoth, WY 82190 | 2006-10-12 |
| 1811925423 | Bhs Physician Services - Torrington | Clinic/Center | 625 Albany Ave, Torrington, WY 82240-1530 | 2006-06-30 |
| 1235170705 | St. Vincent Healthcare | Clinic/Center | 720 Lindsay Ln, Suite A, Cody, WY 82414-4103 | 2006-06-08 |
| 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.