A WYOMING PAIN CLINIC, P.C. (NPI# 1164804480) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1164804480 |
| Entity Type | Organization |
| Organization Name | A WYOMING PAIN CLINIC, P.C. |
| Other Organization Name | POWDER RIVER PAIN CLINIC |
| Practice Address |
3100 W Lakeway Rd Suite 3 Gillette WY 82718-6372 |
| Mailing Address |
8101 Stone Crest Dr Gillette WY 82718-4006 |
| Practice Telephone | 3076961475 |
| Mailing Telephone | 3076961475 |
| Enumeration Date | 2015-06-23 |
| Last Update Date | 2015-06-23 |
| Authorized Official Name | MR. JOHN MANSELL (DIRECTOR) |
| Authorized Official Telephone | 3076961475 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207L00000X | Anesthesiology | 7144A | WY | Allopathic & Osteopathic Physicians |
| N | 261QP3300X |
Clinic/Center Specialization: Pain |
7144A | WY | Ambulatory Health Care Facilities |
| Y | 207LP2900X |
Anesthesiology Specialization: Pain Medicine |
7144A | WY | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Powder River Pain Clinic | Doing Business As Name - Organization |
| Street Address |
3100 W LAKEWAY RD SUITE 3 |
| City | GILLETTE |
| State | WY |
| Zip Code | 82718-6372 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972535227 | John L. Mansell | Anesthesiology | 3100 W Lakeway Rd, Suite 3, Gillette, WY 82718-6372 | 2006-07-07 |
| 1619413044 | Powder River Physical Medicine & Rehabilitation, LLC | Physical Medicine & Rehabilitation | 3100 W Lakeway Rd, Suite 3, Gillette, WY 82718-6372 | 2017-01-09 |
| 1376885616 | Sasha Paige Rau | Registered Nurse | 3100 W Lakeway Rd, Ste 3, Gillette, WY 82718-6372 | 2013-03-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912413964 | Kaylyn Brook Bahnson | Pharmacist | 2000 South Douglas Hwy Walgreens Pharmacy, Gillette, WY 82718 | 2017-12-28 |
| 1205373073 | Cheryl Trembath | Counselor | 201 West Lakeway Rd, Suite 1004, Gillette, WY 82718 | 2017-01-31 |
| 1043769078 | Employment Testing Services | Clinical Medical Laboratory | 3805 South Douglas Hwy, Unit 1, Gillette, WY 82718 | 2016-10-03 |
| 1750730339 | Caritas Mental Health LLC | Community/Behavioral Health | 5204 Raven St, Gillette, WY 82718 | 2016-06-06 |
| 1902298029 | Jena Cowen | Day Training, Developmentally Disabled Services | 5305 Cowen Drive, Gillette, WY 82718 | 2015-02-26 |
| 1720480635 | Brenda Kay Upton | Pharmacist | 2300 S Douglas Highway, Gillette, WY 82718 | 2014-09-23 |
| 1891127825 | Bighorn Dental Clinic PC | Dentist | 4403 Running W. Drive, Gillette, WY 82718 | 2013-08-01 |
| 1750726212 | High Desert Healthcare LLC | Clinic/Center | 1013 East Boxelder Rd, Suite 200, Gillette, WY 82718 | 2013-05-09 |
| 1225224231 | County of Campbell | Public Health or Welfare | 2301 South 4j Rd, Gillette, WY 82718 | 2007-09-24 |
| 1043424336 | Lowell R Amiotte II | Anesthesiology | 3100 W Lakeway Suite 3, Northern Plains Anesthesia Associates, Gillette, WY 82718 | 2007-05-09 |
| Find all providers in zip 82718 | ||||
| Taxonomy Code | 207LP2900X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Anesthesiology |
| Specialization | Pain Medicine |
| An anesthesiologist who provides a high level of care, either as a primary physician or consultant, for patients experiencing problems with acute, chronic and/or cancer pain in both hospital and ambulatory settings. Patient care needs are also coordinated with other specialists. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Anesthesiology, 2007. http://www.theaba.org/; American Osteopathic Board of Anesthesiology, 2007, http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Anesthesiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Anesthesiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851383822 | Jed Shay | Anesthesiology | 2620 Commercial Way Ste 20, Rock Springs, WY 82901-4705 | 2005-08-16 |
| 1659378164 | Harlan Robert Ribnik | Anesthesiology | 4136 Laramie St, Suite A, Cheyenne, WY 82001-1969 | 2005-06-30 |
| 1437156809 | Pain Consultants of The Rockies, PC | Anesthesiology | 903 S Greeley Hwy, Suite A, Cheyenne, WY 82007-3057 | 2005-06-30 |
| 1962937441 | Pain Care Center LLC | Anesthesiology | 170 Arrowhead Dr, Suite 2, Evanston, WY 82930-9307 | 2017-04-21 |
| 1902180532 | Southwest Pain Management Inc | Anesthesiology | 1200 College Dr, Rock Springs, WY 82901-5868 | 2011-09-30 |
| 1023398906 | Pain Care Center, LLC | Anesthesiology | 2620 Commercial Way Ste 20, Rock Springs, WY 82901-4705 | 2011-08-23 |
| 1265726871 | Tatum-mere Health and Community Services Inc. | Anesthesiology | 1200 College Dr, Rock Springs, WY 82901-5868 | 2011-06-01 |
| 1528270782 | Rocky Mountain Pain Management LLC | Anesthesiology | 419 S Washington St, Ste 201, Casper, WY 82601-2951 | 2007-05-03 |
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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.