Broc White (NPI# 1073856225, PAC ID# 9133341886) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is FAMILY MEDICINE.
| Nation Provider ID (NPI) | 1073856225 |
| PAC ID by PECOS | 9133341886 |
| Professional Enrollment ID | I20160722002444 |
| Full Name | Broc White |
| Organization Legal Name | LANDER MEDICAL CLINIC P C |
| Address |
1620 Riverview Rd Riverton WY 82501-5906 |
| Phone Number | 3078566591 |
| Gender | M |
| Medical School | SAINT LOUIS UNIVERSITY SCHOOL OF MEDICINE |
| Graduation Year | 2013 |
| Primary Specialty | FAMILY MEDICINE |
| Group Practice PAC ID | 1355323940 |
| Number of Group Practice Members | 23 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 530008 | SAGEWEST HEALTH CARE |
| Address | Phone | Organization |
|---|---|---|
| 745 Buena Vista Dr, Lander, WY 82520-3431 | 3073322941 | LANDER MEDICAL CLINIC P C |
| 1620 Riverview Rd, Riverton, WY 82501-5906 | 3078566591 | LANDER MEDICAL CLINIC P C |
| Organization Legal Name | LANDER MEDICAL CLINIC P C |
| Physicians | 26 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Amanda Taglioli | Physician Assistant | Lander Medical Clinic P C | 1620 Riverview Rd, Riverton, WY 82501-5906 |
| Jeffrey J Anderson | Obstetrics/gynecology | Lander Medical Clinic P C | 745 Buena Vista Dr, Lander, WY 82520-3431 |
| Shirley Evelyn Schatza | Nurse Practitioner | Lander Medical Clinic P C | 1620 Riverview Rd, Riverton, WY 82501-5906 |
| Kristine Marie Cardinal | Nurse Practitioner | Lander Medical Clinic P C | 1620 Riverview Rd, Riverton, WY 82501-5906 |
| Brian Dale Gee | Family Medicine | Lander Medical Clinic P C | 1620 Riverview Rd, Riverton, WY 82501-5906 |
| Clinton Mcmahill | Internal Medicine | Lander Medical Clinic P C | 1620 Riverview Rd, Riverton, WY 82501-5906 |
| Kacie Mckenna Gallo | Family Medicine | Lander Medical Clinic P C | 1620 Riverview Rd, Riverton, WY 82501-5906 |
| Cheryl A Wise | Psychologist, Clinical | Lander Medical Clinic P C | 745 Buena Vista Dr, Lander, WY 82520-3431 |
| Michael Robert Swenson | Neurology | Lander Medical Clinic P C | 745 Buena Vista Dr, Lander, WY 82520-3431 |
| Anna Otis Felton | Nurse Practitioner | Lander Medical Clinic P C | 745 Buena Vista Dr, Lander, WY 82520-3431 |
| Street Address |
1620 RIVERVIEW RD |
| City | RIVERTON |
| State | WY |
| Zip | 82501-5906 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Amanda Taglioli | Physician Assistant | Lander Medical Clinic P C | 1620 Riverview Rd, Riverton, WY 82501-5906 |
| Shirley Evelyn Schatza | Nurse Practitioner | Lander Medical Clinic P C | 1620 Riverview Rd, Riverton, WY 82501-5906 |
| Kristine Marie Cardinal | Nurse Practitioner | Lander Medical Clinic P C | 1620 Riverview Rd, Riverton, WY 82501-5906 |
| Brian Dale Gee | Family Medicine | Lander Medical Clinic P C | 1620 Riverview Rd, Riverton, WY 82501-5906 |
| Clinton Mcmahill | Internal Medicine | Lander Medical Clinic P C | 1620 Riverview Rd, Riverton, WY 82501-5906 |
| Kacie Mckenna Gallo | Family Medicine | Lander Medical Clinic P C | 1620 Riverview Rd, Riverton, WY 82501-5906 |
| Heather A Sanders | Physician Assistant | Lander Medical Clinic P C | 1620 Riverview Rd, Riverton, WY 82501-5906 |
| Ryan Firth | Pediatric Medicine | Lander Medical Clinic P C | 1620 Riverview Rd, Riverton, WY 82501-5906 |
| Regina Chase Ommen | Certified Nurse Midwife (cnm) | Lander Medical Clinic P C | 1620 Riverview Rd, Riverton, WY 82501-5906 |
| Eric M Ridgway | Family Medicine | Lander Medical Clinic P C | 1620 Riverview Rd, Riverton, WY 82501-5906 |
| Find all physicians in the same address | |||
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Starrla R Bartlett Rone | Physician Assistant | Wyoming Health Medical Group LLC | 2300 Gasser Rd, Riverton, WY 82501-2204 |
| Casey L Cotant | Nephrology | Wyoming Health Medical Group LLC | 2300 Gasser Rd, Riverton, WY 82501-2204 |
| Sarah M Adsit | Physician Assistant | Wyoming Health Medical Group LLC | 2300 Gasser Rd, Riverton, WY 82501-2204 |
| Robert T Neff | Nephrology | Wyoming Health Medical Group LLC | 2300 Gasser Rd, Riverton, WY 82501-2204 |
| Cody E Mcvay | Nurse Practitioner | Wyoming Health Medical Group LLC | 2300 Gasser Rd, Riverton, WY 82501-2204 |
| Maryanne A Hannaney | Obstetrics/gynecology | Wind River Obstetrics and Gynecology LLC | 2300 Gasser Rd, Riverton, WY 82501-2204 |
| Joseph Michael Sturdivant | Hospitalist | Riverton Physician Practices, LLC | 2100 W Sunset Dr, Riverton, WY 82501-2274 |
| Kevin R Mahoney | Family Medicine | Northwest Emergency Physicians LLC | 2100 W Sunset Dr, Riverton, WY 82501-2274 |
| Grant W Berry | Emergency Medicine | Northwest Emergency Physicians LLC | 2100 W Sunset Dr, Riverton, WY 82501-2274 |
| Brad David Oliverson | Emergency Medicine | Northwest Emergency Physicians LLC | 2100 W Sunset Dr, Riverton, WY 82501-2274 |
| Find all physicians in zip 82501 | |||
| City | RIVERTON |
| Zip Code | 82501 |
| Specialty | FAMILY MEDICINE |
| City + Specialty | RIVERTON + FAMILY MEDICINE |
Please comment or provide details below to improve the information on Broc White.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.