Active NPI
Lander Valley Medical Center LLC
Doing business as Lander Valley Medical Center Hospitalists
- Internal Medicine Physician
- Lander, WY
National Provider Identifier
1194849331
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- Legal business name
- LANDER VALLEY MEDICAL CENTER LLC
- Doing business as
- Lander Valley Medical Center Hospitalists
- Practice address
- 1320 Bishop Randall Dr
Lander, WY 82520-3939 - Phone
- (307) 335-6509
- NPI assigned
- Mar 16, 2007
- Organization subpart
- Yes
- Parent organization
- LIFE POINT HOSPITAL
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Michael B Clark
- Title
- Division President
- Phone
- (615) 565-1590
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | Primary |
Addresses
Primary practice location
1320 Bishop Randall Dr
Lander, WY 82520-3939
Mailing address
1320 Bishop Randall Dr
Lander, WY 82520-3939
Phone (801) 352-9500
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 115864300 | Medicaid | WY |
Other names 1
- Lander Valley Medical Center Hospitalists
National Provider Directory
National Provider Directory- Part of
- Lander Valley Medical Center LLC
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174003200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1262649600000",
"number": "1194849331",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1320 BISHOP RANDALL DR",
"city": "LANDER",
"state": "WY",
"postal_code": "825203939",
"telephone_number": "801-352-9500",
"fax_number": "801-352-9502"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1320 BISHOP RANDALL DR",
"city": "LANDER",
"state": "WY",
"postal_code": "825203939",
"telephone_number": "307-335-6509"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "LANDER VALLEY MEDICAL CENTER LLC",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "LIFE POINT HOSPITAL",
"enumeration_date": "2007-03-16",
"last_updated": "2010-01-05",
"status": "A",
"authorized_official_last_name": "CLARK",
"authorized_official_first_name": "MICHAEL",
"authorized_official_middle_name": "B",
"authorized_official_title_or_position": "DIVISION PRESIDENT",
"authorized_official_telephone_number": "615-565-1590"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Internal Medicine",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "115864300",
"state": "WY"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Lander Valley Medical Center Hospitalists",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Lander, WY
- Lander Medical Clinic, P.C.
- Lander Medical Clinic, PC
- Lander Regional Hospital
- Lander Valley Ambulatory Surgery Center LLC (Lander Outpatient Surgical Center)
- Lander Valley Family Practice PC
- Lander Valley Medical Center LLC (Lander Regional Hospital)
- Lander Valley Medical Center LLC
- Lander Valley Medical Center LLC (Lander Regional Hospital)
- Lander Valley Medical Center LLC (Lander Regional Hospital)
- Lander Valley Medical Center LLC (Lander Regional Hospital)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 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.