NPIMap

Organization Active NPI

Elevate Rehab, LLC

  • Physical Medicine & Rehabilitation Physician
  • Lander, WY
National Provider Identifier
1003257601
Registry record updated Apr 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
Legal business name
ELEVATE REHAB, LLC
Practice address
545 E Main St Ste B
Lander, WY 82520-3470
Phone
(307) 335-3471
Fax
(307) 332-5388
NPI assigned
Jul 11, 2013
Last updated
Apr 7, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 7, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Michelle L MazurNPI 1114061611
Title
Owner
Phone
(307) 335-3471

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208100000X Primary
Physical Therapy Clinic/Center 261QP2000X
Comprehensive Outpatient Rehabilitation Facility (CORF) 261QR0401X
Customized Equipment (DME) 332BC3200X

Addresses

Primary practice location

545 E Main St Ste B
Lander, WY 82520-3470

Mailing address

545 E Main St Ste B
Lander, WY 82520-3470
Phone (307) 335-3471

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WY2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20131014000145 WY Part B Supplier - Clinic/Group Practice 4981838687 Receives reassigned benefits from 9 practitioners
Practice locations: Lander, WY
O20151023000826 WY DME Supplier - Independently-Practicing Occupational Therapist 4981838687 Practice locations: Lander, WY

National Provider Directory

National Provider Directory

Locations

155 S 6th St
Lander, WY 82520
Phone (307) 335-3471

388 Main St
Ste A
Lander, WY 82520
Phone (307) 335-3471

535 E Main St
Ste D
Lander, WY 82520
Phone (307) 335-3471

545 E Main St
#B
Lander, WY 82520
Phone (307) 335-3471

Practitioners & affiliated clinicians

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1373500800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1743984000000",
    "number": "1003257601",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "545 E MAIN ST STE B",
            "city": "LANDER",
            "state": "WY",
            "postal_code": "825203470",
            "telephone_number": "307-335-3471",
            "fax_number": "307-332-5388"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "545 E MAIN ST STE B",
            "city": "LANDER",
            "state": "WY",
            "postal_code": "825203470",
            "telephone_number": "307-335-3471",
            "fax_number": "307-332-5388"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELEVATE REHAB, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-07-11",
        "last_updated": "2025-04-07",
        "certification_date": "2025-04-07",
        "status": "A",
        "authorized_official_last_name": "MAZUR",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "307-335-3471"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR0401X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lander, WY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.