NPIMap

Organization Active NPI

Volunteers of America Northern Rockies

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Sundance, WY
National Provider Identifier
1124302005
Registry record updated Apr 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X
Legal business name
VOLUNTEERS OF AMERICA NORTHERN ROCKIES
Practice address
420 1/2 Main St
Sundance, WY 82729
Phone
(307) 283-3636
Fax
(307) 283-2898
NPI assigned
Oct 10, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2023

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

Authorized official

Name
Kelly Buckingham
Title
VP of It and Compliance
Phone
(307) 684-5531

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X WY Primary

Addresses

Primary practice location

420 1/2 Main St
Sundance, WY 82729

Mailing address

521 W Lott St
Buffalo, WY 82834-1642
Phone (307) 751-7440

Other identifiers 1

IdentifierTypeStateIssuer
106076707MedicaidWY

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220110002012 WY Part B Supplier - Clinic/Group Practice 1355733015 Receives reassigned benefits from 32 practitioners
20 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Newcastle, WY; Wheatland, WY; Torrington, WY; Sundance, WY; Sheridan, WY; Riverton, WY; Laramie, WY; Gillette, WY…

Other NPIs on the same Medicare enrollment 20

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 20

National Provider Directory

National Provider Directory
Tax ID family
Volunteers of America Northern Rockies43 organizations share this tax ID, including this one

Other organizations with this tax ID 42

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

View all 42

Practitioners & affiliated clinicians

Practitioners 5

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": "1318204800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1680307200000",
    "number": "1124302005",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "521 W LOTT ST",
            "city": "BUFFALO",
            "state": "WY",
            "postal_code": "828341642",
            "telephone_number": "307-751-7440",
            "fax_number": "307-283-2898"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 1/2 MAIN ST",
            "city": "SUNDANCE",
            "state": "WY",
            "postal_code": "82729",
            "telephone_number": "307-283-3636",
            "fax_number": "307-283-2898"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VOLUNTEERS OF AMERICA NORTHERN ROCKIES",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-10-10",
        "last_updated": "2023-04-01",
        "certification_date": "2023-04-01",
        "status": "A",
        "authorized_official_last_name": "BUCKINGHAM",
        "authorized_official_first_name": "KELLY",
        "authorized_official_title_or_position": "VP OF IT AND COMPLIANCE",
        "authorized_official_telephone_number": "307-684-5531"
    },
    "taxonomies": [
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": "WY",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "106076707",
            "state": "WY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sundance, WY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2023; 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.