NPIMap

Organization Active NPI

Wellness Wagon

  • Clinic/Center
  • Lingle, WY
National Provider Identifier
1063005940
Registry record updated Jul 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
WELLNESS WAGON
Practice address
208 Main St #12
Lingle, WY 82223
Phone
(970) 371-9038
NPI assigned
Feb 11, 2021
Last updated
Jul 20, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 20, 2023

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

Authorized official

Name
Jennifer Boxberger, FNPNPI 1730682295
Title
Owner
Phone
(970) 371-9038

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

208 Main St #12
Lingle, WY 82223

Mailing address

PO Box 2417
Cheyenne, WY 82003-2417
Phone (307) 638-0300

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1613001600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1689811200000",
    "number": "1063005940",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2417",
            "city": "CHEYENNE",
            "state": "WY",
            "postal_code": "820032417",
            "telephone_number": "307-638-0300",
            "fax_number": "307-658-0394"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "208 MAIN ST #12",
            "city": "LINGLE",
            "state": "WY",
            "postal_code": "82223",
            "telephone_number": "970-371-9038"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WELLNESS WAGON",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-02-11",
        "last_updated": "2023-07-20",
        "certification_date": "2023-07-17",
        "status": "A",
        "authorized_official_last_name": "BOXBERGER",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "970-371-9038",
        "authorized_official_credential": "FNP"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lingle, WY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2023; 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.