Laurence William Vale Deboer, M.D.

Primary specialty

Cardiovascular Disease PhysicianTaxonomy code 207RC0000X

License

5853A Issued in WY

Practice address

430 Medical Arts CT.
Gillette, WY 82716

Phone

(307) 682-7661

Fax

(307) 682-7624

NPI assigned

Sep 14, 2006

Last updated

Mar 7, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Antelope Medical Consultants LLC

  • Cardiovascular Disease Physician
  • Gillette, WY
  • NPI 1124188545
  NPD (past)
• Frances Mahon Deaconess Hospital

  • Critical Access Hospital
  • Glasgow, MT
  • NPI 1689685323
  NPD (past)

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

{
    "created_epoch": "1158192000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1043315872",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "430 MEDICAL ARTS CT.",
            "city": "GILLETTE",
            "state": "WY",
            "postal_code": "82716",
            "telephone_number": "307-682-7661",
            "fax_number": "307-682-7624"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "430 MEDICAL ARTS CT.",
            "city": "GILLETTE",
            "state": "WY",
            "postal_code": "82716",
            "telephone_number": "307-682-7661",
            "fax_number": "307-682-7624"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEBOER",
        "first_name": "LAURENCE",
        "middle_name": "WILLIAM VALE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-14",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "WY",
            "license": "5853A",
            "primary": true
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "TX",
            "license": "E0878",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Thomas Clifford Davis, M.D.
• Nancy Day, LPC NCSC
• Jean-Raphael De Raoulx, LPC #2556
• Paul D Dearing, MD
• Chrissy Michael Deavor
• Robin Michelle Decastro, APRN
• Britta L Denman, DO
• Dental Care Center PC
• Wendy Depina
• Craig Deuter, LPC

• Cardiovascular Disease Physician in Gillette, WY
• Providers in Gillette, WY by specialty
• Cardiovascular Disease Physician in Wyoming

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.