DR. LAURENCE WILLIAM VALE DEBOER (NPI# 1043315872) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1043315872 |
| Entity Type | Individual |
| Full Name | DR. LAURENCE WILLIAM VALE DEBOER |
| Credential | M.D. |
| Practice Address |
430 Medical Arts Ct. Gillette WY 82716 |
| Practice Telephone | 3076827661 |
| Practice Fax Number | 3076827624 |
| Mailing Telephone | 3076827661 |
| Mailing Fax Number | 3076827624 |
| Enumeration Date | 2006-09-14 |
| Last Update Date | 2007-07-09 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
E0878 | TX | Allopathic & Osteopathic Physicians |
| Y | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
5853A | WY | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WY | CLIA | 53D925429 | 01 |
| WY | STATE LICENSE | 5853A | 01 |
| WA | 8380925 | 05 | |
| WY | BLUE CROSS | 303946 | 01 |
| WY | BLUE CROSS GROUP NUMBER | 00783001 | 01 |
| WY | 7088727 | 05 | |
| MEDICAL LICENSE | 638 | 01 | |
| WY | DEA | AD8949248 | 01 |
| Street Address |
430 MEDICAL ARTS CT. |
| City | GILLETTE |
| State | WY |
| Zip Code | 82716 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053822387 | Diana Lynn Ohman | Dietitian, Registered | 709 West Eighth Street, Suite 4, Gillette, WY 82716 | 2017-10-13 |
| 1821457821 | Courage To Change Counseling LLC | Community/Behavioral Health | 113 S. Gillette Ave, Gillette, WY 82716 | 2016-02-18 |
| 1003290594 | Kris Huber | Community/Behavioral Health | 905 Gurley Ave, Gillette, WY 82716 | 2015-07-14 |
| 1649516857 | Shirley L Haley | Nurse Practitioner | 1304 West 4th Street, Gillette, WY 82716 | 2012-12-14 |
| 1174867188 | Rebecca J Mader | Registered Nurse | 501 South Burma Ave., Gillette, WY 82716 | 2012-11-15 |
| 1568728228 | Kerry Elizabeth Warner | Registered Nurse | 201 S Burma Ave, Gillette, WY 82716 | 2012-04-07 |
| 1720363351 | Julie Ann Faldalen | Licensed Practical Nurse | 501 South Burma, Gillette, WY 82716 | 2011-10-14 |
| 1083937486 | Clear Creek Counseling LLC | Counselor | 801 E. 4th St., Suite 24, Gillette, WY 82716 | 2010-03-12 |
| 1821241423 | Dianna L Knox | Counselor | 500 S Burma Ave, Gillette, WY 82716 | 2008-10-28 |
| 1588826887 | Scott R Hunter | Chiropractor | 439 Prairie View Place Ste D, Dr S R Hunter, Gillette, WY 82716 | 2008-06-27 |
| Find all providers in zip 82716 | ||||
| Taxonomy Code | 207RC0000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Cardiovascular Disease |
| An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2008 [7/1/2008: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, http://www.abim.org/. American Osteopathic Board of Internal Medicine, https://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801848593 | Nicholas J Stamato | Internal Medicine | 501 S Burma Ave Ste 3500, Gillette, WY 82716-3426 | 2006-05-17 |
| 1386060903 | Campbell County Hospital District | Internal Medicine | 501 S Burma Ave, 3rd Floor North, Gillette, WY 82716-3426 | 2014-03-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982223848 | Physician Group of Utah Inc | Internal Medicine | 1577 Dewar Dr Ste 8, Rock Springs, WY 82901-5716 | 2020-04-10 |
| 1255719407 | University of Utah Adult Services | Internal Medicine | 1208 Hilltop Dr Ste 102, Rock Springs, WY 82901-5858 | 2015-05-08 |
| 1124384797 | Mansour Eltaher Khaddr | Internal Medicine | 1453a Dewar Dr, Rock Springs, WY 82901-5812 | 2012-04-08 |
| 1376686329 | Joseph Ramon Garcia | Internal Medicine | 1333 W 5th St, Ste 103, Sheridan, WY 82801-2752 | 2007-02-15 |
| 1164524823 | John Edward Glode | Internal Medicine | 1200 E 20th St Ste A, Cheyenne, WY 82001-3979 | 2006-09-02 |
| 1649387176 | Gerald Dorros | Internal Medicine | 1120 S Thunder Rd, Wilson, WY 83014 | 2006-08-23 |
| 1619903705 | Michael W. Brennan | Internal Medicine | 1333 West 5th St, Ste 103, Sheridan, WY 82801-2752 | 2006-06-23 |
| 1629019351 | Larry J Hattel | Internal Medicine | 3235 Sparks Rd, Suite 200, Cheyenne, WY 82001-6158 | 2006-06-10 |
| 1891748703 | John William Pickrell | Internal Medicine | 1230 E 1st St, Casper, WY 82601-2704 | 2006-05-19 |
| 1821041740 | Michel W Skaf | Internal Medicine | 428s Durbin St 104, Casper, WY 82601-2818 | 2006-05-19 |
| 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.