NPIMap

Organization Active NPI

Mountain Regional Services, Inc

  • Skilled Nursing Facility
  • Evanston, WY
National Provider Identifier
1013337880
Registry record updated Apr 21, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
32521 Issued in WY
Legal business name
MOUNTAIN REGIONAL SERVICES, INC
Practice address
50 Allegiance Cir
Evanston, WY 82930-3804
Phone
(307) 778-9371
Fax
(307) 789-0823
NPI assigned
Apr 21, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2014

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

Authorized official

Name
Randy Iwen
Title
Controller
Phone
(307) 789-3710

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 32521 WY Primary

Addresses

Primary practice location

50 Allegiance Cir
Evanston, WY 82930-3804

Mailing address

PO Box 6005
Evanston, WY 82931-6005
Phone (307) 789-3710

National Provider Directory

National Provider Directory
Tax ID family
Mountain Regional Services Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1398038400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1398038400000",
    "number": "1013337880",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6005",
            "city": "EVANSTON",
            "state": "WY",
            "postal_code": "829316005",
            "telephone_number": "307-789-3710",
            "fax_number": "307-789-0823"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 ALLEGIANCE CIR",
            "city": "EVANSTON",
            "state": "WY",
            "postal_code": "829303804",
            "telephone_number": "307-778-9371",
            "fax_number": "307-789-0823"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOUNTAIN REGIONAL SERVICES, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-04-21",
        "last_updated": "2014-04-21",
        "status": "A",
        "authorized_official_last_name": "IWEN",
        "authorized_official_first_name": "RANDY",
        "authorized_official_title_or_position": "CONTROLLER",
        "authorized_official_telephone_number": "307-789-3710"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "WY",
            "license": "32521",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Evanston, WY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.