Organization Active NPI

Equality State Infection Foundation

  • Infectious Disease Physician
  • Casper, WY
National Provider Identifier
1104062314
Registry record updated Dec 18, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infectious Disease PhysicianTaxonomy code 207RI0200X
Legal business name
EQUALITY STATE INFECTION FOUNDATION
Practice address
5810 E 2ND St Ste 200
Casper, WY 82609-4330
Phone
(307) 234-8710
Fax
(307) 237-0326
NPI assigned
Dec 18, 2008
Last updated
Dec 18, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2008

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

Authorized official

Name
Ms. Lisa Marie Willette, RN
Title
Coo, Cfo
Phone
(307) 234-8710

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X NU
Registered Dietitian 133V00000X NU
Case Management Registered Nurse 163WC0400X NU
Infectious Disease Physician 207RI0200X NU Primary
Early Intervention Provider Agency 252Y00000X NU

Addresses

Primary practice location

5810 E 2ND St Ste 200
Casper, WY 82609-4330

Mailing address

5810 E 2ND St Ste 200
Casper, WY 82609-4330
Phone (307) 234-8710

National Provider Directory

National Provider Directory
Tax ID family
Equality State Infection Foundation2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

5810 E 2nd St
Ste 200
Casper, WY 82609
Phone (307) 234-8700

NPI Registry JSON

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

{
    "created_epoch": "1229558400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1229558400000",
    "number": "1104062314",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5810 E 2ND ST STE 200",
            "city": "CASPER",
            "state": "WY",
            "postal_code": "826094330",
            "telephone_number": "307-234-8710",
            "fax_number": "307-237-0326"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5810 E 2ND ST STE 200",
            "city": "CASPER",
            "state": "WY",
            "postal_code": "826094330",
            "telephone_number": "307-234-8710",
            "fax_number": "307-237-0326"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EQUALITY STATE INFECTION FOUNDATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-12-18",
        "last_updated": "2008-12-18",
        "status": "A",
        "authorized_official_last_name": "WILLETTE",
        "authorized_official_first_name": "LISA",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "COO, CFO",
        "authorized_official_telephone_number": "307-234-8710",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "163WC0400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Case Management",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "252Y00000X",
            "taxonomy_group": "",
            "desc": "Early Intervention Provider Agency",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Casper, WY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2008; 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.