TETON DERMATOLOGY INC (NPI# 1194044750) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1194044750 |
| Entity Type | Organization |
| Organization Name | TETON DERMATOLOGY INC |
| Practice Address |
984 West Broadway Suite 4 Jackson WY 83001-0000 |
| Mailing Address |
P.o. Box 14510 Jackson WY 83002-4510 |
| Practice Telephone | 3077341800 |
| Practice Fax Number | 3077345012 |
| Mailing Telephone | 3077341800 |
| Mailing Fax Number | 3077345012 |
| Enumeration Date | 2010-05-21 |
| Last Update Date | 2014-08-04 |
| Authorized Official Name | MR. JONATHAN GLENN BAKER (OWNER) |
| Authorized Official Telephone | 3077341800 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM2500X |
Clinic/Center Specialization: Medical Specialty |
8097A | WY | Ambulatory Health Care Facilities |
| Street Address |
984 WEST BROADWAY SUITE 4 |
| City | JACKSON |
| State | WY |
| Zip Code | 83001-0000 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447233754 | Jonathan Glenn Baker | Dermatology | 984 West Broadway, Suite 4, Jackson, WY 83001-0000 | 2005-11-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861006108 | Anne Kathleen Milburn | Physical Therapist | 3620 S Park Drive, Jackson, WY 83001 | 2020-09-03 |
| 1568009637 | Katherine Pringle Ford | Case Manager/Care Coordinator | 2065 E. Limber Pine Road, Jackson, WY 83001 | 2019-12-07 |
| 1043878408 | Cossette Burnham | Physical Therapist | Four Pines Physical Therapy, 1090 S Hwy 89, Jackson, WY 83001 | 2019-05-31 |
| 1982169371 | Cynthia Buck Huyffer | Social Worker | 755a Cache Creek Drive, Jackson, WY 83001 | 2019-02-10 |
| 1093281594 | Lara Cilo | Speech-Language Pathologist | 1300 W. Valley Springs Road, Jackson, WY 83001 | 2018-10-23 |
| 1740776202 | Teton Oral and Maxillofacial Surgery | Dentist | 1160 Alpine Ln Ste 1d, Jackson, WY 83001 | 2018-07-09 |
| 1437642055 | Anna Yanchek | Physical Therapist | 1090 Us- 89, Jackson Hole, WY 83001 | 2018-06-08 |
| 1891200762 | Tyler Ross Wright | Chiropractor | 1325 Us-89, Suite 108, Jackson, WY 83001 | 2017-12-13 |
| 1073027280 | Root To Rise Counseling and Consulting, Pllc | Social Worker | 2033 Dandelion Court, Jackson, WY 83001 | 2017-11-27 |
| 1962923912 | Piper Worthington | Social Worker | 1910 High School Rd, Jackson, WY 83001 | 2017-06-29 |
| Find all providers in zip 83001 | ||||
| Taxonomy Code | 261QM2500X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Medical Specialty |
| An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer). |
| Notes: [7/1/2003: new] |
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| 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.