Organization Active NPI

Total Family Health, PC

  • Family Nurse Practitioner
  • Rock Springs, WY
National Provider Identifier
1083806111
Registry record updated Jan 25, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
17189.0261 Issued in WY
Legal business name
TOTAL FAMILY HEALTH, PC
Practice address
2620 Commercial Way
Suite 051
Rock Springs, WY 82901-4755
Phone
(307) 382-2080
Fax
(307) 382-5099
NPI assigned
Aug 13, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2010

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

Authorized official

Name
Laura J Heitz, NPNPI 1013090554
Title
President
Phone
(307) 382-2080

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
Family Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LF0000X 17189.0261 WY Primary

Addresses

Primary practice location

2620 Commercial Way
Suite 051
Rock Springs, WY 82901-4755

Mailing address

2620 Commercial Way
Suite 051
Rock Springs, WY 82901-4755
Phone (307) 382-2080

Other identifiers 2

IdentifierTypeStateIssuer
118483100MedicaidWY
312190OtherBLUE CROSS BLUE SHIELD

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040318000729 WY Part B Supplier - Clinic/Group Practice 6901796358 Receives reassigned benefits from 2 practitioners
Practice locations: Rock Springs, WY

National Provider Directory

National Provider Directory

Locations

2620 Commercial Way
Ste 51
Rock Springs, WY 82901
Phone (307) 382-2080

1208 Hilltop Dr
Ste 100
Rock Springs, WY 82901
Phone (307) 382-2080

Practitioners & affiliated clinicians

Practitioners 3

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": "1186963200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1264377600000",
    "number": "1083806111",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2620 COMMERCIAL WAY",
            "address_2": "SUITE 051",
            "city": "ROCK SPRINGS",
            "state": "WY",
            "postal_code": "829014755",
            "telephone_number": "307-382-2080",
            "fax_number": "307-382-5099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2620 COMMERCIAL WAY",
            "address_2": "SUITE 051",
            "city": "ROCK SPRINGS",
            "state": "WY",
            "postal_code": "829014755",
            "telephone_number": "307-382-2080",
            "fax_number": "307-382-5099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TOTAL FAMILY HEALTH, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-13",
        "last_updated": "2010-01-25",
        "status": "A",
        "authorized_official_last_name": "HEITZ",
        "authorized_official_first_name": "LAURA",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "307-382-2080",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "WY",
            "license": "17189.0261",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "118483100",
            "state": "WY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "312190",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rock Springs, WY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.