Jackson Whole Family Health, Inc.

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

Legal business name

JACKSON WHOLE FAMILY HEALTH, INC.

Practice address

1110 Maple Way
Jackson, WY 83001

Phone

(307) 733-7003

Fax

(307) 734-8477

NPI assigned

Jul 3, 2007

Organization subpart

No

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

Authorized official

Name

Jackie L Ocker

Title

Office Manager

Phone

(307) 733-7003

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in WY

Enrollment records 1

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

CLIA laboratory certificates

Practitioners 2

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

• Charlotte K Mason, FNP

  • Family Nurse Practitioner
  • Jackson, WY
  • NPI 1710069273
  Medicare reassignment Care Compare group NPD
• Kimberly Ann Mellick, MSN, FNP-BC

  • Family Nurse Practitioner
  • Jackson, WY
  • NPI 1073897930
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1183420800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1053519918",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 10738",
            "city": "JACKSON",
            "state": "WY",
            "postal_code": "830020738",
            "telephone_number": "307-733-7003",
            "fax_number": "307-734-8477"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1110 MAPLE WAY",
            "city": "JACKSON",
            "state": "WY",
            "postal_code": "83001",
            "telephone_number": "307-733-7003",
            "fax_number": "307-734-8477"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JACKSON WHOLE FAMILY HEALTH, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-03",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "OCKER",
        "authorized_official_first_name": "JACKIE",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "307-733-7003"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "00581001",
            "state": "WY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jackson Hole OBGYN PC
• Jackson Hole Sports Recovery LLC
• Jackson Hole Surgery
• Jackson Pediatric Associates, LLC
• Jackson Pediatrics P.C.
• William Jackson, RPH
• James L. Derrico DDS LLC
• JBG Consulting
• Jeffrey Greenbaum MD
• James Richard Jenkins

• Family Nurse Practitioner in Jackson, WY
• Providers in Jackson, WY by specialty
• Family Nurse Practitioner in Wyoming

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.