ANTELOPE MEDICAL CONSULTANTS LLC (NPI# 1124188545) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124188545 |
| Entity Type | Organization |
| Organization Name | ANTELOPE MEDICAL CONSULTANTS LLC |
| Practice Address |
430 S Medical Arts Ct Gillette WY 82716-3364 |
| Practice Telephone | 3076827661 |
| Practice Fax Number | 3076825074 |
| Mailing Telephone | 3076827661 |
| Mailing Fax Number | 3076825074 |
| Enumeration Date | 2006-12-08 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DR. LISA ANNE MALODY (OWNER) |
| Authorized Official Telephone | 3076827661 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| X | 363LF0000X |
Nurse Practitioner Specialization: Family |
18882.269 | WY | Physician Assistants & Advanced Practice Nursing Providers |
| X | 207R00000X | Internal Medicine | 5806A | WY | Allopathic & Osteopathic Physicians |
| X | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
5853A | WY | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WY | BLUE CROSS CLINIC NUMBER | 00783001 | 01 |
| WA | 7088727 | 05 |
| Street Address |
430 S MEDICAL ARTS CT |
| City | GILLETTE |
| State | WY |
| Zip Code | 82716-3364 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871524272 | Denise Richards | Physician Assistant | 430 S Medical Arts Ct, Gillette, WY 82716-3364 | 2006-07-05 |
| 1902153323 | Douglas Tew | Physician Assistant | 430 S Medical Arts Ct, Gillette, WY 82716-3364 | 2012-08-06 |
| 1124301619 | Kimberly Faucett | Pharmacist | 430 S Medical Arts Ct, Gillette, WY 82716-3364 | 2011-09-21 |
| 1407182397 | Christy Lynn Steiner | Pharmacist | 430 S Medical Arts Ct, Gillette, WY 82716-3364 | 2009-10-27 |
| 1558594952 | Danica Marie Andela | Pharmacist | 430 S Medical Arts Ct, Gillette, WY 82716-3364 | 2009-09-01 |
| 1932338431 | Janet L. Call | Nurse Practitioner | 430 S Medical Arts Ct, Gillette, WY 82716-3364 | 2009-07-07 |
| 1851535793 | Healthworks Med Group of Wyoming, PC | Clinic/Center | 430 S Medical Arts Ct, Gillette, WY 82716-3364 | 2009-04-22 |
| 1144497603 | Walgreen Co. | Durable Medical Equipment & Medical Supplies | 430 S Medical Arts Ct, Gillette, WY 82716-3364 | 2008-05-14 |
| 1902987258 | Helen Drake Iams | Family Medicine | 430 S Medical Arts Ct, Gillette, WY 82716 | 2006-10-17 |
| 1497861652 | Cynthia Marie Casey | Family Medicine | 430 S Medical Arts Ct, Gillette, WY 82716-3364 | 2006-08-21 |
| Find all providers in the same location | ||||
| 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 | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922606177 | Crysta Jean Sullivan | Nurse Practitioner | 2401 Greenway Dr, Gillette, WY 82716-2333 | 2020-10-10 |
| 1013309590 | Brenna Kirsch | Nurse Practitioner | 1402 W 4th St, Gillette, WY 82716-3328 | 2015-02-20 |
| 1326464108 | Julie Centner | Nurse Practitioner | 600 W Boxelder Rd, Gillette, WY 82718-5219 | 2014-03-17 |
| 1649516857 | Shirley L Haley | Nurse Practitioner | 1304 West 4th Street, Gillette, WY 82716 | 2012-12-14 |
| 1417569732 | Nikole Marie Lawrence | Nurse Practitioner | 501 S Burma Ave, Gillette, WY 82716-3426 | 2020-08-18 |
| 1528612207 | Aoc Medical LLC | Nurse Practitioner | 201 W Lakeway Rd Ste 200, Gillette, WY 82718-6341 | 2019-07-30 |
| 1902370778 | Candi Hallermann | Nurse Practitioner | 501 S Burma Ave, Gillette, WY 82716-3426 | 2019-01-15 |
| 1669972238 | Lori Ann Mcinerney | Nurse Practitioner | 501 S Burma Ave, Gillette, WY 82716-3426 | 2018-02-20 |
| 1104345404 | Amy Elizabeth Hawk | Nurse Practitioner | 501 S Burma Ave, Gillette, WY 82716-3426 | 2017-09-18 |
| 1235656489 | Anne Marie Jones | Nurse Practitioner | 501 S Burma Ave, Gillette, WY 82716-3426 | 2017-08-28 |
| Find all providers in GILLETTE | ||||
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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.