NPIMap

Organization Active NPI

Wamsutter Community Health Center26-

  • Medical Physician Assistant
  • Wamsutter, WY
National Provider Identifier
1194056127
Registry record updated Jan 15, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
279 Issued in WY
Legal business name
WAMSUTTER COMMUNITY HEALTH CENTER26-
Practice address
401 Fultz Drive
Wamsutter, WY 82336
Phone
(307) 328-0468
Fax
(307) 324-9438
NPI assigned
Jan 14, 2010
Last updated
Jan 15, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 15, 2010

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

Authorized official

Name
Marvin Wayne Couch II, MD
Title
Medical Director
Phone
(307) 324-6002

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 279 WY Primary
Family Medicine Physician 207Q00000X 5629A WY

Addresses

Primary practice location

401 Fultz Drive
Wamsutter, WY 82336

Mailing address

PO Box 208
Wamsutter, WY 82336
Phone (307) 328-0468

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1263427200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1263513600000",
    "number": "1194056127",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 208",
            "city": "WAMSUTTER",
            "state": "WY",
            "postal_code": "82336",
            "telephone_number": "307-328-0468",
            "fax_number": "307-324-9438"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 FULTZ DRIVE",
            "city": "WAMSUTTER",
            "state": "WY",
            "postal_code": "82336",
            "telephone_number": "307-328-0468",
            "fax_number": "307-324-9438"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WAMSUTTER COMMUNITY HEALTH CENTER26-",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-01-14",
        "last_updated": "2010-01-15",
        "status": "A",
        "authorized_official_last_name": "COUCH II",
        "authorized_official_first_name": "MARVIN",
        "authorized_official_middle_name": "WAYNE",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "307-324-6002",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "WY",
            "license": "279",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WY",
            "license": "5629A",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wamsutter, WY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2010; 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.