HEALTHY LIFESTYLE MEDICINE (NPI# 1912478819) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1912478819 |
| Entity Type | Organization |
| Organization Name | HEALTHY LIFESTYLE MEDICINE |
| Practice Address |
6015 Sycamore Rd Cheyenne WY 82009-4347 |
| Practice Telephone | 3078232968 |
| Mailing Telephone | 3078232968 |
| Enumeration Date | 2018-12-17 |
| Last Update Date | 2018-12-20 |
| Authorized Official Name | KRISTINE VAN KIRK (OWNER/PROVIDER) |
| Authorized Official Telephone | 3078232968 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2083B0002X |
Preventive Medicine Specialization: Obesity Medicine |
Allopathic & Osteopathic Physicians | ||
| Y | 207QA0505X |
Family Medicine Specialization: Adult Medicine |
Allopathic & Osteopathic Physicians |
| Street Address |
6015 SYCAMORE RD |
| City | CHEYENNE |
| State | WY |
| Zip Code | 82009-4347 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306981592 | Larry H Mcgarvin | Dentist | 6015 Sycamore Rd, Cheyenne, WY 82009-4347 | 2007-02-21 |
| 1225699184 | Benjamin Escobedo | Dentist | 6015 Sycamore Rd, Cheyenne, WY 82009-4347 | 2019-06-21 |
| 1023553799 | North Cheyenne Medical | Family Medicine | 6015 Sycamore Rd, 1st Floor, Cheyenne, WY 82009-4347 | 2017-01-04 |
| 1659815173 | Ziad Skaf | Family Medicine | 6015 Sycamore Rd, 1st Floor, Cheyenne, WY 82009-4347 | 2016-12-19 |
| 1861872707 | Mark D Rinne Dds, PC | Dentist | 6015 Sycamore Rd, Cheyenne, WY 82009-4347 | 2015-06-05 |
| 1073819793 | North Cheyenne Family Medicine | Family Medicine | 6015 Sycamore Rd, 1st Floor, Cheyenne, WY 82009-4330 | 2011-01-27 |
| 1003078148 | Kristine K Van Kirk | Family Medicine | 6015 Sycamore Rd, Cheyenne, WY 82009-4347 | 2008-06-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659840841 | King & Associates LLC | Private Vehicle | 2232 Dell Range Blvd 245 #3083 Cheyenne, Cheyenne, WY 82009 | 2018-11-16 |
| 1710495700 | Wyoming Endoscopy Center LLC | Clinic/Center | 7220 Comons Circle, Cheyenne, WY 82009 | 2018-01-12 |
| 1912442682 | Lindsey Thurmes Mccoy | Dietitian, Registered | 2232 Dell Range Blvd Ste 282, Cheyenne, WY 82009 | 2017-01-04 |
| 1306380696 | Alexandra Gill | Social Worker | 3304 East 1-80 Service Rd., Cheyenne, WY 82009 | 2016-12-06 |
| 1104213859 | Jennifer Schwartz | Specialist | 2601 Plain View Rd, Cheyenne, WY 82009 | 2015-04-21 |
| 1861830465 | Tyler Boyd | Dentist | 7209 Commons Cir Unit A, Cheyenne, WY 82009 | 2013-06-05 |
| 1639513351 | Gene E Darnell | Pharmacist | 3702 Del Range Blvd, Cheyenne, WY 82009 | 2013-04-24 |
| 1376891952 | Robert R Kanard | Internal Medicine | 714 Edward Dr, Cheyenne, WY 82009 | 2012-08-29 |
| 1639443336 | Jennifer Alam | Case Manager/Care Coordinator | 3304 E. I80 Service Rd, Cheyenne, WY 82009 | 2012-02-28 |
| 1376815357 | Christina Kay Brown | Licensed Practical Nurse | 3304 E I80 Service Rd, Cheyenne, WY 82009 | 2012-02-06 |
| Find all providers in zip 82009 | ||||
| Taxonomy Code | 207QA0505X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Specialization | Adult Medicine |
| Definition to come. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003078148 | Kristine K Van Kirk | Family Medicine | 6015 Sycamore Rd, Cheyenne, WY 82009-4347 | 2008-06-30 |
| 1346336500 | Joanie Marie Deatrich | Family Medicine | 2360 E Pershing Blvd, Cheyenne, WY 82001-5356 | 2006-10-05 |
| 1467417535 | Milford Eugene Thieszen | Family Medicine | 2360 E Pershing Blvd, Cheyenne, WY 82001-5356 | 2006-04-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023078128 | Robert D. Langer | Family Medicine | 555 E. Broadway, Suite 108, Jackson, WY 83001 | 2006-03-24 |
| 1649573221 | Burke & Burke, Md, PC | Family Medicine | 940 E 3rd St, Suite # 202, Casper, WY 82601-3237 | 2010-12-21 |
| 1699838862 | Howard T Willson | Family Medicine | 388 South Us Hwy 20, Basin, WY 82410-8902 | 2006-12-19 |
Please comment or provide details below to improve the information on HEALTHY LIFESTYLE MEDICINE.
| 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.