Organization Active NPI

Purple Skies Health and Vitality Clinic LLC

  • Clinic/Center
  • Buffalo, WY
National Provider Identifier
1053181701
Registry record updated Aug 14, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
PURPLE SKIES HEALTH AND VITALITY CLINIC LLC
Practice address
915 W Fetterman St Unit 1
Buffalo, WY 82834-2449
Phone
(307) 752-8136
Fax
(307) 785-1096
NPI assigned
Jan 4, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 14, 2026

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

Authorized official

Name
Jennifer Rasmuson, NP-CNPI 1780178897
Title
Nurse Practitioner/Owner
Phone
(307) 221-6430

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X Primary

Addresses

Primary practice location

915 W Fetterman St Unit 1
Buffalo, WY 82834-2449

Mailing address

PO Box 975
Buffalo, WY 82834-0975
Phone (307) 221-6430

Other practice location 1

1301 Avon St Ste A
Sheridan, WY 82801-2758
Phone (307) 752-8136

Other names 1

  • Purple Skies Clinic Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240419002297 WY Part B Supplier - Clinic/Group Practice 1557700788 Receives reassigned benefits from 1 practitioner
Practice locations: Buffalo, WY; Sheridan, WY

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
53D2316736Purple Skies Health and Vitality Clinic, LLC1301 Avon Street Suite a, Sheridan, WY 82801Certificate of waiverJan 9, 2027
53D2316737Purple Skies Health and Vitality Clinic, LLC915 W Fetterman St, Ste 1, Buffalo, WY 82834Certificate of waiverMay 27, 2028

National Provider Directory

National Provider Directory

Locations

915 W Fetterman St
Unit 1
Buffalo, WY 82834

1745 S Sheridan Ave
Sheridan, WY 82801
Phone (307) 752-8136

1745 S Sheridan Ave
Ste D
Sheridan, WY 82801
Phone (307) 785-8136

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1704326400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1786665600000",
    "number": "1053181701",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 975",
            "city": "BUFFALO",
            "state": "WY",
            "postal_code": "828340975",
            "telephone_number": "307-221-6430"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "915 W FETTERMAN ST UNIT 1",
            "city": "BUFFALO",
            "state": "WY",
            "postal_code": "828342449",
            "telephone_number": "307-752-8136",
            "fax_number": "307-785-1096"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1301 Avon St Ste A",
            "address_purpose": "LOCATION",
            "city": "Sheridan",
            "state": "WY",
            "postal_code": "828012758",
            "country_code": "US",
            "telephone_number": "307-752-8136",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PURPLE SKIES HEALTH AND VITALITY CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-01-04",
        "last_updated": "2026-08-14",
        "certification_date": "2026-08-14",
        "status": "A",
        "authorized_official_last_name": "RASMUSON",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "NURSE PRACTITIONER/OWNER",
        "authorized_official_telephone_number": "307-221-6430",
        "authorized_official_credential": "NP-C"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Purple Skies Clinic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Purple Skies Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Buffalo, WY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.