Big Horn Family Medicine LLC
Organization Active NPI Family Medicine Physician · Worland, WY
NPI 1174764757 · NPPES record last updated Mar 12, 2009
Key facts
- NPI
- 1174764757
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 8034A (WY)
- Legal business name
- BIG HORN FAMILY MEDICINE LLC
- Practice address
- 316 N 10TH St
Worland, WY 82401-2307 - Phone
- (307) 347-8885
- Fax
- (307) 347-2428
- NPI assigned
- Mar 12, 2009
- Organization subpart
- No
Authorized official
- Name
- Dr. Edward Doyle Zimmerman, MD
- Title
- Owner/Physician
- Phone
- (307) 347-8885
Corporate family (same tax ID) 1
Practitioners 1
-
Edward D Zimmerman, M.D.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WY
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20090506000172 | WY | Part B Supplier - Clinic/Group Practice | 0143378943 |
Receives reassigned benefits from 1 practitioner Practice locations: Worland, WY |
National Provider Directory
- Tax ID family
- Big Horn Family Medicine
Locations
316 N 10th St
Worland, WY 82401
Phone (307) 347-4151
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician |
207Q00000X | 8034A | WY | Yes |
Addresses
Primary practice location
316 N 10TH St
Worland, WY 82401-2307
Mailing address
316 N 10TH St
Worland, WY 82401-2307
Phone (307) 347-8885
Other providers in Worland, WY
- Nicole Beddoes
- Amber Bennett
- Chisum Bennett
- Laura J Bentz
- Big Horn Family Medicine
- Big Horn Pharmacy, LLC
- Bighorn Eye Center, LLC
- Billings Dermatology PC
- Amy Borrelli
- John M. Bramble
All providers in Worland, WY · Family Medicine Physician in Wyoming
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 12, 2009. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.