SHOSHONE TRIBE


Address: 11 Shipton Lane, Fort Washakie, WY 82514
Phone: 3073322998

SHOSHONE TRIBE (NPI# 1790824530) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1790824530
Entity Type Organization
Organization Name SHOSHONE TRIBE
Other Organization Name WIND RIVER DIALYSIS CENTER
Practice Address 11 Shipton Lane
Fort Washakie
WY 82514
Mailing Address Po Box 998
Fort Washakie
WY 82514-0998
Practice Telephone 3073322998
Practice Fax Number 3073324955
Mailing Telephone 3073322998
Mailing Fax Number 3073324955
Enumeration Date 2007-02-06
Last Update Date 2008-04-24
Authorized Official Name MS. DIANE GARCIA (CEO, NURSE MANAGER)
Authorized Official Telephone 3073322998
Authorized Official Credential RN, BSN, CNN
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 261QE0700X Clinic/Center
Specialization: End-Stage Renal Disease (ESRD) Treatment
07-177 WY Ambulatory Health Care Facilities

Other Provider/Organization Names

Other Name Type Code
Wind River Dialysis Center Doing Business As Name - Organization

Other Data Sources

Entity Type Entity Name Entity Address
System for Award Management (SAM) Entities SHOSHONE TRIBE 111 North Rd, Mc Dermitt, NV 89421

Office Location

Street Address 11 SHIPTON LANE
City FORT WASHAKIE
State WY
Zip Code 82514

Providers in the same zip code

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 Information

Taxonomy Code 261QE0700X
Grouping Ambulatory Health Care Facilities
Classification Clinic/Center
Specialization End-Stage Renal Disease (ESRD) Treatment

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1306392261 Usrc Casper, LLC Clinic/Center 1300 Venture Way, Suite 100, Casper, WY 82609-4353 2016-08-31
1952413759 Bio-medical Applications of Wyoming LLC Clinic/Center 1739 Meadowland Drive, Cheyenne, WY 82009-5249 2006-08-31
1255304051 Evanston Hospital Corporation Clinic/Center 112 Yellow Creek Rd, Evanston, WY 82930-9266 2006-02-10
1508837865 Wyoming Kidney Center, LLC Clinic/Center 1141 Wilkins Cir, Casper, WY 82601-1332 2006-01-26
1730562372 Watt Dialysis Center LLC Clinic/Center 1401 W 5th St, Sheridan, WY 82801-2705 2015-07-01
1669818969 Big Horn Basin Regional Dialysis Center LLC Clinic/Center 424 Yellowstone Ave, Suite 150, Cody, WY 82414-9309 2013-05-14
1609932383 Billings Clinic Clinic/Center 1401 W 5th St, Sheridan, WY 82801-2705 2006-12-28
1295815744 West Park Hospital District Clinic/Center 707 Sheridan Ave, Cody, WY 82414-3409 2006-10-17
1144313255 Campbell County Hospital District Clinic/Center 501 S Burma Ave, Gillette, WY 82716-3426 2006-10-02

Competitor

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City FORT WASHAKIE
Zip Code 82514

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Dataset Information

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.

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