BANNER HOSPITAL BASED PHYSICIANS WEST LLC (NPI# 1619464120) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1619464120 |
Entity Type | Organization |
Organization Name | BANNER HOSPITAL BASED PHYSICIANS WEST LLC |
Practice Address |
1405 Howell Ave Worland WY 82401-4127 |
Mailing Address |
2901 N Central Ave Ste 160 Phoenix AZ 85012-2702 |
Practice Telephone | 3073472555 |
Practice Fax Number | 3073479831 |
Enumeration Date | 2018-04-19 |
Last Update Date | 2018-04-19 |
Authorized Official Name | DENNIS LARAWAY (SR VP FINANCE) |
Authorized Official Telephone | 6027474000 |
Is Organization Subpart | Y |
Parent Organization Name | BANNER MEDICAL GROUP |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 261QM1300X |
Clinic/Center Specialization: Multi-Specialty |
Ambulatory Health Care Facilities |
Street Address |
1405 HOWELL AVE |
City | WORLAND |
State | WY |
Zip Code | 82401-4127 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1104854710 | Wmc Clinic | Clinic/Center | 1405 Howell Ave, Worland, WY 82401-4127 | 2006-06-30 |
1356892640 | Shantay Stallings | Physician Assistant | 1405 Howell Ave, Worland, WY 82401 | 2016-10-21 |
1386022630 | Amber Moss | Family Medicine | 1405 Howell Ave, Worland, WY 82401 | 2015-05-07 |
1740437557 | Joseph Edward Tritchler Jr. | Physician Assistant | 1405 Howell Ave, Worland, WY 82401-4127 | 2008-08-22 |
1942370879 | Mark A Flinner | Family Medicine | 1405 Howell Ave, Worland, WY 82401 | 2006-11-08 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1386284107 | Margaret Joan Mcdaniel | Registered Nurse | 1910 Sage Crossing Ave, Worland, WY 82401 | 2020-01-09 |
1902365240 | Worland Pharmacy Inc. | Pharmacy | 1095 Circle Rd, Worland, WY 82401 | 2019-03-17 |
1023547155 | Deborah J Anderson | Counselor | 401 South 23rd St, Worland, WY 82401 | 2017-06-12 |
1265808273 | Tang Mo Wong | Occupational Therapist | 1910 Howell Avenue, Worland, WY 82401 | 2015-08-12 |
1063783389 | William Jonas Tempany | Counselor | 406 S 6, Basin, WY 82401 | 2012-01-18 |
1609009133 | Sharon Eisele | Case Manager/Care Coordinator | 1216 Ti Bi Yek, Worland, WY 82401 | 2009-09-01 |
1295997013 | Benjamin B Wilde | Family Medicine | 1405 Howell, Worland, WY 82401 | 2008-07-02 |
1134390552 | Linda Kay Hausner | Registered Nurse | 401 South 23rd Street, 401 South 23rd Street, Worland, WY 82401 | 2008-03-13 |
1033302047 | Lisa Anne Stephens | Physical Therapist | 1313 Big Horn Ave, Worland, WY 82401 | 2007-08-22 |
1316147952 | Jeffries Dental, P.C. | Dentist | 3313 Paintbrush Lane, Worland, WY 82401 | 2007-07-23 |
Find all providers in zip 82401 |
Taxonomy Code | 261QM1300X |
Grouping | Ambulatory Health Care Facilities |
Classification | Clinic/Center |
Specialization | Multi-Specialty |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1104854710 | Wmc Clinic | Clinic/Center | 1405 Howell Ave, Worland, WY 82401-4127 | 2006-06-30 |
1568847705 | Washakie Medical Center | Clinic/Center | 400 S 15th St, Worland, WY 82401-3531 | 2015-07-29 |
1558601278 | Banner Health Physicians Colorado LLC | Clinic/Center | 400 S 15th St, Worland, WY 82401-3531 | 2013-02-15 |
1629316641 | Banner Hospital Based Physicians Colorado LLC | Clinic/Center | 400 S 15th St, Worland, WY 82401-3531 | 2013-01-25 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1669073516 | Banner Health Physicians West LLC | Clinic/Center | 201 14th St Ste B100, Wheatland, WY 82201-3201 | 2020-11-06 |
1528678786 | Banner Health Physicians West LLC | Clinic/Center | 2300 Gasser Rd, Riverton, WY 82501-2204 | 2020-08-03 |
1568927127 | Hope and Guidance LLC | Clinic/Center | 78 North St, Laramie, WY 82072-9579 | 2019-02-07 |
1902399389 | Serenity Counseling & Mental Health Services | Clinic/Center | 747 Patches, Carpenter, WY 82054-9403 | 2018-06-11 |
1235620204 | Graves and Associates LLC | Clinic/Center | 2020 E Grand Ave Ste 429, Laramie, WY 82070-4380 | 2018-05-24 |
1205333721 | Veronica Pedersen, Lcsw, LLC | Clinic/Center | 3712 Snyder Ave, Cheyenne, WY 82001-1163 | 2018-04-11 |
1114452166 | Pauljordanwashburnmd, LLC. | Clinic/Center | 5720 Osage Ave, 3-301, Cheyenne, WY 82009-3948 | 2017-04-27 |
1639617145 | Banner Health Physicians West LLC | Clinic/Center | 1356 Shiek St, Wheatland, WY 82201-3231 | 2017-02-03 |
1275913105 | Banner Health Physicians West LLC | Clinic/Center | 1 E Whalen Street, Guernsey, WY 82214 | 2015-06-05 |
1447661319 | Healthworks Med Group of Wyoming P C | Clinic/Center | 2723 Christensen Rd, Cheyenne, WY 82007-9662 | 2014-05-14 |
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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.