TATUM-MERE HEALTH AND COMMUNITY SERV INC. (NPI# 1134352560) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1134352560 |
| Entity Type | Organization |
| Organization Name | TATUM-MERE HEALTH AND COMMUNITY SERV INC. |
| Other Organization Name | SOUTHWEST PAIN MANAGEMENT |
| Practice Address |
1200 College Dr Rock Springs WY 82901-5868 |
| Mailing Address |
Po Box 3228 Rock Springs WY 82902-3228 |
| Practice Telephone | 3073528329 |
| Mailing Telephone | 3073528289 |
| Enumeration Date | 2009-09-02 |
| Last Update Date | 2020-09-21 |
| Authorized Official Name | DR. BRANDON VASHON MACK (PRESIDENT) |
| Authorized Official Telephone | 3073621444 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QH0100X |
Clinic/Center Specialization: Health Service |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WY | 131487400 | 05 | |
| WY | 121146000 | 05 | |
| PTAN | W22909 | 01 |
| Other Name | Type Code |
|---|---|
| Southwest Pain Management | Doing Business As Name - Organization |
| Street Address |
1200 COLLEGE DR |
| City | ROCK SPRINGS |
| State | WY |
| Zip Code | 82901-5868 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376537845 | Cielette M Karn | Pathology | 1200 College Dr, Rock Springs, WY 82901-5868 | 2005-09-09 |
| 1730659566 | Shauna Lyn Erramouspe | Dietitian, Registered | 1200 College Dr, Rock Springs, WY 82901-5868 | 2018-12-05 |
| 1134627227 | Alisha Mackie | Registered Nurse | 1200 College Dr, Rock Springs, WY 82901-5868 | 2018-01-24 |
| 1356896773 | Josefina Ibarra | Dietitian, Registered | 1200 College Dr, Rock Springs, WY 82901-5868 | 2016-08-16 |
| 1063866085 | Alicia M Gray | Internal Medicine | 1200 College Dr, Rock Springs, WY 82901-5868 | 2016-04-15 |
| 1750769634 | University of Utah Adult Services | Internal Medicine | 1200 College Dr, Rock Springs, WY 82901-5868 | 2015-05-12 |
| 1487032363 | University of Utah Adult Services | Internal Medicine | 1200 College Dr, Rock Springs, WY 82901-5868 | 2015-05-12 |
| 1104204361 | University of Utah Adult Services | Surgery | 1200 College Dr, Rock Springs, WY 82901-5868 | 2015-05-08 |
| 1164800314 | University of Utah Adult Services | Emergency Medicine | 1200 College Dr, Rock Springs, WY 82901-5868 | 2015-05-08 |
| 1821475450 | University of Utah Adult Services | Internal Medicine | 1200 College Dr, Rock Springs, WY 82901-5868 | 2015-05-04 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568094043 | Carol Mary Iverson | Naturopath | 120 Winston Dr., Ste. 101, Rock Springs, WY 82901 | 2020-02-12 |
| 1366098691 | Nolan Jeffres | Dentist | 1151 Gateway Blvd, Suite 102, Rock Springs, WY 82901 | 2019-08-13 |
| 1588149181 | Ali Pendleton | Case Manager/Care Coordinator | 79 Winston #235, Rock Springs, WY 82901 | 2018-09-28 |
| 1982142014 | Tammy Fausett | Speech-Language Pathologist | 1105 Applewood Drive, Rock Springs, WY 82901 | 2017-02-09 |
| 1649713983 | Lori Lee Cunningham | Case Manager/Care Coordinator | 325 Archers Trl, Rock Springs, WY 82901 | 2016-11-18 |
| 1841664505 | Theresa Morrison | Case Manager/Care Coordinator | 308 Peak Road, Rock Springs, WY 82901 | 2015-11-18 |
| 1811376478 | Aspen Mountain Medical Center LLC | General Acute Care Hospital | 4401 College Ave, Rock Springs, WY 82901 | 2015-05-28 |
| 1487931416 | Stephanie Lee Dupree | Nurse Practitioner | 1204 Hilltop Dr. #107 & #108, Rock Springs, WY 82901 | 2011-11-04 |
| 1114201845 | Cowboy Urgent Care, Inc | General Practice | 1453-a Dewar Drive, Rock Springs, WY 82901 | 2011-09-29 |
| 1649564931 | Guardian Flight Inc | Ambulance | 1208 Hilltop Drive, Suite 203, Rock Springs, WY 82901 | 2011-06-03 |
| Find all providers in zip 82901 | ||||
| Taxonomy Code | 261QH0100X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Health Service |
| Definition to come... |
| Notes: [7/1/2006: modified title] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841448271 | Floyd P. Huxford D C P C | Clinic/Center | 706 Elk St, Rock Springs, WY 82901-5247 | 2008-08-27 |
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| 1922242353 | Wellness Screening | Clinic/Center | 1988 E 1st St, Suite A, Casper, WY 82601-2747 | 2009-04-29 |
| 1659566974 | Chiropractic Wellness Center, P.C. | Clinic/Center | 404 S Douglas Hwy, Gillette, WY 82716-4029 | 2007-09-10 |
| 1528052263 | Fremont Family Practice, P.C. | Clinic/Center | 1130 Major Ave, Riverton, WY 82501-2342 | 2005-09-08 |
| 1811501216 | Alden Vision LLC | Clinic/Center | 5880 E 2nd St Ste 100, Casper, WY 82609-4389 | 2020-09-02 |
| 1578949533 | Amaris Spang | Clinic/Center | 1008 E Main St, Riverton, WY 82501-3730 | 2015-07-31 |
| 1740605088 | Tailored Nutrition LLC | Clinic/Center | 37 S Main St, Sheridan, WY 82801-4221 | 2014-02-24 |
| 1659713048 | Walgreens | Clinic/Center | 1766 Coffeen Ave, Sheridan, WY 82801-5710 | 2013-07-25 |
| 1508138470 | Deines Chiropractic, LLC | Clinic/Center | 25 E Alger St, Sheridan, WY 82801-3911 | 2012-02-07 |
| 1427370873 | Banner Professional Services | Clinic/Center | 400 S 15th St, Worland, WY 82401-3531 | 2010-02-25 |
| Find all providers with the same taxonomy | ||||
| City | ROCK SPRINGS |
| Zip Code | 82901 |
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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.