WYOMING STATE HOSPITAL (NPI# 1104811256) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104811256 |
| Entity Type | Organization |
| Organization Name | WYOMING STATE HOSPITAL |
| Practice Address |
831 Highway 150 S Pharmacy Rm 519 Evanston WY 82930-5340 |
| Mailing Address |
831 Highway 150 S Po Box 177 Evanston WY 82930-5340 |
| Practice Telephone | 3077893464 |
| Practice Fax Number | 3077893660 |
| Mailing Telephone | 3077893464 |
| Mailing Fax Number | 3077893660 |
| Enumeration Date | 2005-09-14 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MR. PABLO HERNANDEZ (SUPERINTENDENT) |
| Authorized Official Telephone | 3077893464 |
| Authorized Official Credential | M.D |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 281P00000X | Chronic Disease Hospital | 52-01138 | WY | Hospitals |
| Street Address |
831 HIGHWAY 150 S PHARMACY RM 519 |
| City | EVANSTON |
| State | WY |
| Zip Code | 82930-5340 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225505126 | Jennifer Mary Arroyo | Pharmacist | 831 Highway 150 S, Evanston, WY 82930-5340 | 2018-10-29 |
| 1558809905 | Ryan Hunsaker | Psychologist | 831 Highway 150 S, Evanston, WY 82930-5340 | 2017-02-06 |
| 1790132207 | Ashlee Jane Paramore | Occupational Therapist | 831 Highway 150 S, Evanston, WY 82930-5340 | 2016-05-16 |
| 1649640442 | Gennifer L Young | Occupational Therapist | 831 Highway 150 S, Evanston, WY 82930-5340 | 2015-10-06 |
| 1346610193 | Jolynn L Newkirk-hornecker | Counselor | 831 Highway 150 S, Evanston, WY 82930-5340 | 2015-10-05 |
| 1942670898 | Cyndi Newton Holloman | Social Worker | 831 Highway 150 S, Evanston, WY 82930-5340 | 2015-10-05 |
| 1700157948 | Eric G Roman | Clinical Nurse Specialist | 831 Highway 150 S, Evanston, WY 82930-5340 | 2012-01-19 |
| 1023394590 | James Patrick Fleenor | Clinical Nurse Specialist | 831 Highway 150 S, Evanston, WY 82930-5340 | 2011-10-28 |
| 1306175070 | Margaret B Prochaska | Dietitian, Registered | 831 Highway 150 S, Evanston, WY 82930-5340 | 2009-12-09 |
| 1811131501 | Ronna J Dillinger | Psychologist | 831 Highway 150 S, Evanston, WY 82930-5340 | 2009-04-24 |
| 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 | 281P00000X |
| Grouping | Hospitals |
| Classification | Chronic Disease Hospital |
| (1) A hospital including a physical plant and personnel that provides multidisciplinary diagnosis and treatment for diseases that have one or more of the following characteristics: is permanent; leaves residual disability; is caused by nonreversible pathological alteration; requires special training of the patient for rehabilitation; and/or may be expected to require a long period of supervision or care. In addition, patients require the safety, security, and shelter of these specialized inpatient or partial hospitalization settings. (2) A hospital that provides medical and skilled nursing services to patients with long-term illnesses who are not in an acute phase but who require an intensity of services not available in nursing homes. |
| Notes: Source: (1) Expanded from Rhea, Ott, and Shafritz, The Facts On File Dictionary of Health Care Management, New York: Facts On File Publications, 1988. |
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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.