Wyo Clinic LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

WYO CLINIC LLC

Practice address

6 S 5TH St
Greybull, WY 82426-2133

Phone

(307) 209-3391

Fax

(307) 207-0392

NPI assigned

Sep 1, 2022

Organization subpart

No

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

Authorized official

Name

Dr. Jeffrey Scott, DONPI 1811964570

Title

Owner

Phone

(307) 209-3391

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in WY

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 2

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.

• Jeffrey Lee Scott, D.O.

  • Family Medicine Physician
  • Greybull, WY
  • NPI 1811964570
  Medicare reassignment Care Compare group NPD Authorized official
• Makyela Dawn Sorensen, PA-C

  • Physician Assistant
  • Greybull, WY
  • NPI 1366128019
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1661990400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1737158400000",
    "number": "1164142824",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 S 5TH ST",
            "city": "GREYBULL",
            "state": "WY",
            "postal_code": "824262133",
            "telephone_number": "307-209-3391",
            "fax_number": "307-202-4535"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6 S 5TH ST",
            "city": "GREYBULL",
            "state": "WY",
            "postal_code": "824262133",
            "telephone_number": "307-209-3391",
            "fax_number": "307-207-0392"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WYO CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-09-01",
        "last_updated": "2025-01-18",
        "certification_date": "2025-01-18",
        "status": "A",
        "authorized_official_last_name": "SCOTT",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "307-209-3391",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA",
            "identifier": "53D2270355",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nickolas Shawn Sullivan-Kern
• Brandon Winters Tolman, PHARMD
• Julie C. Vanderploeg, L.P.C.
• Randy E Waddell
• Darcie N Wisehart, MSW, LCSW

• Family Medicine Physician in Greybull, WY
• Providers in Greybull, WY by specialty
• Family Medicine Physician in Wyoming

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.