SOUTHWEST WYOMING ENT INC (NPI# 1730335423) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1730335423 |
| Entity Type | Organization |
| Organization Name | SOUTHWEST WYOMING ENT INC |
| Practice Address |
191 Overthrust Rd Evanston WY 82930-9261 |
| Practice Telephone | 3077898721 |
| Practice Fax Number | 3077898664 |
| Mailing Telephone | 3077898721 |
| Mailing Fax Number | 3077898664 |
| Enumeration Date | 2008-08-13 |
| Last Update Date | 2013-10-24 |
| Authorized Official Name | JASON P HAACK (OWNER) |
| Authorized Official Telephone | 3077898721 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207YS0123X |
Otolaryngology Specialization: Facial Plastic Surgery |
Allopathic & Osteopathic Physicians | ||
| Y | 207Y00000X | Otolaryngology | Allopathic & Osteopathic Physicians |
| Street Address |
191 OVERTHRUST RD |
| City | EVANSTON |
| State | WY |
| Zip Code | 82930-9261 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407832728 | Jason P Haack | Otolaryngology | 191 Overthrust Rd, Evanston, WY 82930-9261 | 2005-12-19 |
| 1669947610 | Stacy Jo Kennedy | Nurse Practitioner | 191 Overthrust Rd, Evanston, WY 82930-9261 | 2018-10-05 |
| 1194226266 | High Desert Psychology and Wellness | Clinic/Center | 191 Overthrust Rd, Evanston, WY 82930-9261 | 2018-02-23 |
| 1790172807 | Uinta Health Lab, LLC | Clinical Medical Laboratory | 191 Overthrust Rd, Evanston, WY 82930-9261 | 2015-04-16 |
| 1023404514 | Utah Podiatry Group PC | Podiatrist | 191 Overthrust Rd, Evanston, WY 82930-9261 | 2015-04-10 |
| 1962804443 | Barker Family Health, LLC | Nurse Practitioner | 191 Overthrust Rd, Evanston, WY 82930-9261 | 2014-09-16 |
| 1790067999 | Corrie Carver | Nurse Practitioner | 191 Overthrust Rd, Evanston, WY 82930-9261 | 2011-09-13 |
| 1255476131 | Adam K Fuller | Psychologist | 191 Overthrust Rd, Evanston, WY 82930-9261 | 2007-02-20 |
| 1144328949 | Jared Breck Barton | Surgery | 191 Overthrust Rd, Evanston, WY 82930-9261 | 2006-09-20 |
| 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 | 207Y00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Otolaryngology |
| An otolaryngologist-head and neck surgeon provides comprehensive medical and surgical care for patients with diseases and disorders that affect the ears, nose, throat, the respiratory and upper alimentary systems and related structures of the head and neck. An otolaryngologist diagnoses and provides medical and/or surgical therapy or prevention of diseases, allergies, neoplasms, deformities, disorders and/or injuries of the ears, nose, sinuses, throat, respiratory and upper alimentary systems, face, jaws and the other head and neck systems. Head and neck oncology, facial plastic and reconstructive surgery and the treatment of disorders of hearing and voice are fundamental areas of expertise. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Otolaryngology, 2007. http://www.aboto.org/. American Osteopathic Board of Ophthalmology and Otolaryngology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Otolaryngology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Ophthalmology and Otolaryngology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760603138 | Ear, Nose & Throat Center of Wyoming, LLC | Otolaryngology | 196 Arrowhead Dr Ste 5, Evanston, WY 82930-8752 | 2007-05-01 |
| 1770706798 | Roger Peyton Plotkin | Otolaryngology | 1319 Chicago Ave, Suite 405, Evanston, IL 60201-5303 | 2007-04-10 |
| 1225255094 | Uinta Ear, Nose & Throat, PC | Otolaryngology | 196 Arrowhead Dr, Suite 5, Evanston, WY 82930-8752 | 2007-04-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487980017 | Hart Jacobsen | Otolaryngology | 30 Pheasant Run Dr, Lander, WY 82520-9783 | 2009-11-03 |
| 1235465055 | Robert Eugene Nagy | Otolaryngology | 2359 Squaw Creek Rd, Lander, WY 82520-9624 | 2009-10-29 |
| 1922184647 | Scott N Bateman | Otolaryngology | 330 W Dow St, Sheridan, WY 82801-3829 | 2006-10-27 |
| 1205931953 | William P Gibbens | Otolaryngology | 2360 East Pershing Blvd, Cheyenne, WY 82001 | 2006-09-14 |
| 1649296914 | Randy John Folker | Otolaryngology | 424 Yellowstone Ave Ste 310, Cody, WY 82414-9310 | 2006-07-13 |
| 1699723395 | Wind River Ear, Nose & Throat, Inc | Otolaryngology | 8185 Highway 789, Lander, WY 82520-2942 | 2006-05-04 |
| 1578521886 | David Copeland Norcross | Otolaryngology | 2210 King Blvd, Casper, WY 82604 | 2006-05-03 |
| 1386601912 | Michael P Martin | Otolaryngology | 126 Quincy Rd, Cheyenne, WY 82009-4126 | 2006-04-27 |
| 1265418834 | Eugene P Podrazik | Otolaryngology | 2210 King Blvd., Casper, WY 82604 | 2005-12-15 |
| 1568443398 | Cheryl Lynn Varner | Otolaryngology | 1333 W 5th St, Ste 206, Sheridan, WY 82801-2752 | 2005-11-09 |
| 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.