KENNETH HOOPER JR. (NPI# 1215349477) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1215349477 |
| Entity Type | Individual |
| Full Name | KENNETH HOOPER JR. |
| Practice Address |
345 Main Lander WY 82514-0638 |
| Mailing Address |
345 Main Po Box 638 Lander WY 82514-0638 |
| Practice Telephone | 5134607241 |
| Practice Fax Number | 3073320131 |
| Mailing Telephone | 5134607241 |
| Mailing Fax Number | 3073320131 |
| Enumeration Date | 2014-05-22 |
| Last Update Date | 2014-05-22 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 247ZC0005X |
Pathology Specialization: Clinical Laboratory Director, Non-physician |
GN-2095-10 | WY | Technologists, Technicians & Other Technical Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WY | 105726000 | 05 |
| Street Address |
345 MAIN |
| City | LANDER |
| State | WY |
| Zip Code | 82514-0638 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619527819 | Melissa Rose Pine | Registered Nurse | 29 Blackcole Road, Fort Washakie, WY 82514 | 2019-09-19 |
| 1982116794 | Madonna Lee Kienlen | Peer Specialist | 215 Ethete Road, Ft. Washakie, WY 82514 | 2017-11-02 |
| 1649789025 | Rebecca Charlene Willis | Technician, Other | Fort Washakie Healt Center Lab Ihs 29 Black Coal Drive, Fort Washakie, WY 82514 | 2017-09-28 |
| 1033553185 | Pauline Elizabeth Powers-peprah | Family Medicine | 29 Black Cole, Fort Washakie, WY 82514 | 2013-04-19 |
| 1528319373 | Amanda L Schultz | Licensed Practical Nurse | 110 Sharpnose Road, Fort Washakie, WY 82514 | 2012-09-19 |
| 1770898140 | Kelly Lynne Pretty Weasel | Clinic/Center | 29 Blackcole Dr, Fort Washakie, WY 82514 | 2010-08-10 |
| 1285950170 | Debra Kay Waters | Technician, Pathology | Black Coal Rd. Bldg. 29, Ft. Washakie, WY 82514 | 2010-04-16 |
| 1881919751 | Shoshone & Arapaho Tribal Substance Abuse Court | Clinic/Center | 215 Ethete Rd, Fort Washakie, WY 82514 | 2010-04-02 |
| 1770814253 | Christopher G Nelson | Spec/Tech, Pathology | 29 Black Coal Rd, Ft. Washakie, WY 82514 | 2010-01-22 |
| 1922339449 | Nina Williams | Spec/Tech, Pathology | Black Coal Rd Bldg 29, Ft Washakie, WY 82514 | 2010-01-22 |
| Find all providers in zip 82514 | ||||
| Taxonomy Code | 247ZC0005X |
| Grouping | Technologists, Technicians & Other Technical Service Providers |
| Classification | Pathology |
| Specialization | Clinical Laboratory Director, Non-physician |
| An individual who is state-licensed as a clinical laboratory director and meets the qualifications in the Clinical Laboratory Improvement Amendments of 1988 for non-physicians (non-MD/DO) as defined in the CFR 42 Part 493.1405. |
| Notes: Source: National Uniform Claim Committee [1/1/2007: new] |
Please comment or provide details below to improve the information on KENNETH HOOPER JR..
| 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.