Cowboy Medical Group PC

Primary specialty

Rural Health Clinic/CenterTaxonomy code 261QR1300X

Legal business name

COWBOY MEDICAL GROUP PC

Practice address

1125 Charles Ave
Worland, WY 82401-4021

Phone

(307) 347-2449

NPI assigned

Dec 6, 2017

Organization subpart

No

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

Authorized official

Name

Wade T Bomengen, MD

Title

Owner

Phone

(307) 347-2449

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1512518400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1516320000000",
    "number": "1154836617",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1125 CHARLES AVE",
            "city": "WORLAND",
            "state": "WY",
            "postal_code": "824014021",
            "telephone_number": "307-347-2449"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1125 CHARLES AVE",
            "city": "WORLAND",
            "state": "WY",
            "postal_code": "824014021",
            "telephone_number": "307-347-2449"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COWBOY MEDICAL GROUP PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-12-06",
        "last_updated": "2018-01-19",
        "status": "A",
        "authorized_official_last_name": "BOMENGEN",
        "authorized_official_first_name": "WADE",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "307-347-2449",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rebeca Corona
• Carl C Cottrell, O.D.
• County of Washakie
• County of Washakie
• County of Washakie
• Cowboy Medical Group PC
• Cowboy Psychological Services PC
• Curtis Optometric Clinic
• Laura Ann Daniels, RN
• Andrea Kay Dannar, LPC

• Rural Health Clinic/Center in Worland, WY
• Providers in Worland, WY by specialty
• Rural Health Clinic/Center in Wyoming

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2018; 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.