SUBLETTE COUNTY RURAL HEALTH CARE DISTRICT (NPI# 1609827435) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1609827435 |
| Entity Type | Organization |
| Organization Name | SUBLETTE COUNTY RURAL HEALTH CARE DISTRICT |
| Other Organization Name | MARBLETON-BIG PINEY CLINIC |
| Practice Address |
103 W 3rd Street Marbleton WY 83113 |
| Mailing Address |
Po Box 787 Big Piney WY 83113-0787 |
| Practice Telephone | 3072763306 |
| Practice Fax Number | 3072763024 |
| Mailing Telephone | 3072764451 |
| Mailing Fax Number | 3072764447 |
| Enumeration Date | 2006-05-15 |
| Last Update Date | 2011-02-10 |
| Authorized Official Name | MRS. LORRAINE DIANE GATZKE (CFO) |
| Authorized Official Telephone | 3072764451 |
| Is Organization Subpart | Y |
| Parent Organization Name | SUBLETTE COUNTY RURAL HEALTH CARE DISTRICT |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WY | 121421700 | 05 |
| Other Name | Type Code |
|---|---|
| Marbleton-Big Piney Clinic | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194776930 | Sublette County Rural Health Care District | Pediatrics | 625 E Hennick, Pinedale, WY 82941 | 2006-05-15 |
| 1508817339 | Sublette County Rural Health Care District | Emergency Medical Technician, Intermediate | 635 E Hennick, Pinedale, WY 82941 | 2006-05-15 |
| Street Address |
103 W 3RD STREET |
| City | MARBLETON |
| State | WY |
| Zip Code | 83113 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093799132 | Leslie Hagenstein | Nurse Practitioner | 103 W 3rd Street, New Physical Address, Marbleton, WY 83113 | 2005-12-02 |
| 1932380839 | Selanie A. Sanone - Leavitt | Nurse Practitioner | 103 W 3rd Street, Marbleton, WY 83113 | 2007-11-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255724258 | Jason L Ray | Physician Assistant | 103 W. 3rd St., Marbleton, WY 83113 | 2015-03-15 |
| 1043629819 | Krista Louise Manning | Speech-Language Pathologist | 450 Sunshine Dr., Big Piney, WY 83113 | 2014-08-06 |
| 1912102989 | Brendan H Fitzsimmons | Family Medicine | 103 W 3rd St., Marbleton, WY 83113 | 2007-06-19 |
| 1750414538 | Scott William Houfek | Dentist | 16 West 3rd Street, Big Piney, WY 83113 | 2007-03-13 |
| 1003958018 | Robert H Bailey | Pharmacy | 501 Nichols St, Big Piney, WY 83113 | 2007-02-13 |
| 1265583082 | Carol Ann Deno | Pharmacist | 501 North Nichols St., Big Piney, WY 83113 | 2007-01-16 |
| 1760579023 | William David Mills Burnett | Family Medicine | 16 West 3rd St., Marbleton, WY 83113 | 2006-10-06 |
| 1518054782 | Lorri N Turner | Nurse Practitioner | 307 Main, Marbleton, WY 83113-0000 | 2006-10-06 |
| 1578649562 | Lincare Inc. | Durable Medical Equipment & Medical Supplies | 545 Budd Ave, Big Piney, WY 83113-0767 | 2006-10-31 |
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912102989 | Brendan H Fitzsimmons | Family Medicine | 103 W 3rd St., Marbleton, WY 83113 | 2007-06-19 |
| 1760579023 | William David Mills Burnett | Family Medicine | 16 West 3rd St., Marbleton, WY 83113 | 2006-10-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265047773 | Backcountry Dox, LLC | Family Medicine | 1320 Morado Dr, Casper, WY 82609 | 2020-09-11 |
| 1639781875 | Relymd Medical Group, LLC | Family Medicine | 1920 Thomes Ave Ste 610, Cheyenne, WY 82001-3548 | 2020-08-19 |
| 1689207722 | South Lincoln Hospital District | Family Medicine | 195 Feather Way Stop 100, Evanston, WY 82930-9352 | 2020-02-18 |
| 1366000580 | Midwest/edgerton Medical Services, Inc. | Family Medicine | 531 Peake St., Midwest, WY 82643 | 2019-06-03 |
| 1164906467 | American Medical Associates, Inc | Family Medicine | 109 E 17th St Ste 25, Cheyenne, WY 82001-4548 | 2018-09-21 |
| 1578057196 | Chere A Bohr | Family Medicine | 2508 E Fox Farm Rd Ste 512, Cheyenne, WY 82007-2559 | 2018-06-18 |
| 1427585488 | Daniel Matthew Bender | Family Medicine | 455 W Broadway Ave, Jackson, WY 83001-8639 | 2017-05-21 |
| 1043747181 | Caroline Lamar Pihl | Family Medicine | 14 Great Plains Road Wind River Family & Community Heal, Arapahoe, WY 82510 | 2017-05-19 |
| 1235503459 | South Lincoln Hospital District | Family Medicine | 195 Feather Way Ste 100, Evanston, WY 82930-9352 | 2015-11-26 |
| 1871994301 | Theresa Marie Karter | Family Medicine | 32 Sage Dr, Cody, WY 82414-8228 | 2014-09-16 |
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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.