KRISTY H FADDIS (NPI# 1225366925) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1225366925 |
| Entity Type | Individual |
| Full Name | KRISTY H FADDIS |
| Practice Address |
164 Country Way Evanston WY 82930-9517 |
| Practice Telephone | 3077892875 |
| Practice Fax Number | 3077892876 |
| Mailing Telephone | 3077892875 |
| Mailing Fax Number | 3077892876 |
| Enumeration Date | 2009-11-18 |
| Last Update Date | 2009-11-18 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 385H00000X | Respite Care | 251C00000X | WY | Respite Care Facility |
| N | 385HR2055X |
Respite Care Specialization: Respite Care, Mental Illness, Child |
251C00000X | WY | Respite Care Facility |
| N | 385HR2060X |
Respite Care Specialization: Respite Care, Mental Retardation and/or Developmental Disabilities, Child |
251C00000X | WY | Respite Care Facility |
| N | 385HR2065X |
Respite Care Specialization: Respite Care, Physical Disabilities, Child |
251C00000X | WY | Respite Care Facility |
| Street Address |
164 COUNTRY WAY |
| City | EVANSTON |
| State | WY |
| Zip Code | 82930-9517 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598398935 | Colby Kim Gomez | Physical Therapist | 190 Arrowhead Dr, Evanston, Wy 82930, Evanston, WY 82930 | 2020-02-13 |
| 1164808382 | Marilyn Carol Edgeworth Tacoma | Registered Nurse | 1037 Morse Lee St, Evanston, WY 82930 | 2015-08-11 |
| 1699159723 | Impact Physical Therapy LLC | Clinic/Center | 96 Yellow Creek Road, Evanston, WY 82930 | 2015-07-18 |
| 1578942421 | Mark Carstensen | Case Manager/Care Coordinator | 219 7th Street, Evanston, WY 82930 | 2015-05-26 |
| 1013396241 | Jennifer Carstensen | Case Manager/Care Coordinator | 325 Arrowhead Drive, Evanston, WY 82930 | 2015-05-20 |
| 1780083782 | Christa Lena Barker | Nurse Practitioner | 191 Overthrust Road, Evanston, WY 82930 | 2014-08-15 |
| 1366865339 | Don Mckay Francom | Dentist | 170 Arrowhead Dr. Suite 1, Evanston, WY 82930 | 2014-01-28 |
| 1417228370 | Premier Surgical Center, LLC | Clinic/Center | 195 Overthrust Road, Evanston, WY 82930 | 2012-01-24 |
| 1588959324 | Mejia D Williams | Social Worker | 190 Overthrust Road, Evanston, WY 82930 | 2011-06-09 |
| 1225327000 | Richard Jay Capener | Family Medicine | 196 Arrowhead Dr Ste 1, Evanston, WY 82930 | 2011-04-01 |
| Find all providers in zip 82930 | ||||
| Taxonomy Code | 385H00000X |
| Grouping | Respite Care Facility |
| Classification | Respite Care |
| Definition to come. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760094411 | Shannon Christine Miller | Respite Care | 1750 New Mexico St, Green River, WY 82935-6252 | 2020-08-22 |
| 1538703715 | Personalized Support Services | Respite Care | 1704 Jim Bridger Ave, Casper, WY 82604-3184 | 2019-10-31 |
| 1609021823 | Tiffany Jean Tate | Respite Care | 2245 Coyote Loop, Wilson, WY 83014-9668 | 2008-12-02 |
| 1184882482 | Debi Kovick | Respite Care | 1805 Montana Way, Green River, WY 82935-5918 | 2008-05-23 |
| 1003080003 | Curran-seeley Foundation | Respite Care | 610 W Broadway, Suite L-1, Jackson, WY 83001-1390 | 2008-04-22 |
| 1942493879 | Suze Marie Kanack | Respite Care | 207 W Madison Ave, Riverton, WY 82501-4247 | 2007-08-23 |
| 1366586802 | Victoria Leola Green | Respite Care | 655 E Burkitt St, Sheridan, WY 82801-4401 | 2007-02-17 |
| 1710046354 | Forget-me-not Adult Day Care, Inc. | Respite Care | 503 11th St, Wheatland, WY 82201-2803 | 2006-12-08 |
| 1962647016 | Cisco John Oldani | Respite Care | 2245 Coyote Loop, Wilson, WY 83014-9668 | 2008-12-03 |
Please comment or provide details below to improve the information on KRISTY H FADDIS.
| 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.