Memorial Hospital of Carbon County

Primary specialty

Rural Health Clinic/CenterTaxonomy code 261QR1300X

License

2916A Issued in WY

Legal business name

MEMORIAL HOSPITAL OF CARBON COUNTY

Doing business as

Energy Basin Clinic

Practice address

1008 Feldspar Court
Hanna, WY 82327

Phone

(307) 325-6596

Fax

(307) 325-6597

NPI assigned

Feb 16, 2007

Last updated

Jun 15, 2017By the provider in NPPES

Organization subpart

Yes

Parent organization

MEMORIAL HOSPITAL OF CARBON COUNTYAs reported in NPPES

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

Authorized official

Name

Michelle Keplinger

Title

Cfo

Phone

(307) 324-8347

Specialties & licenses 1

Addresses

Other identifiers 4

Other names 1

• Energy Basin Clinic Doing business as

Medicare fee-for-service enrollment

Enrolled in WY

Enrollment records 1

Other NPIs on the same Medicare enrollment 4

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Memorial Hospital of Carbon County

  • General Acute Care Hospital
  • Rawlins, WY
  • NPI 1417031311

  O20040308000403

  Same enrollment
• Memorial Hospital of Carbon County

  dba Wagon Circle Family Medical Clinic

  • Family Medicine Physician
  • Rawlins, WY
  • NPI 1508900341

  O20040308000403

  Same enrollment
• Memorial Hospital of Carbon County

  • Critical Access Hospital
  • Rawlins, WY
  • NPI 1710298757

  O20040308000403

  Same enrollment
• Memorial Hospital of Carbon County

  dba Wagon Circle Orthopedic Clinic

  • Orthopaedic Surgery Physician
  • Rawlins, WY
  • NPI 1922142777

  O20040308000403

  Same enrollment

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

CLIA laboratory certificates

Part of

Memorial Hospital of Ca

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.

• Amanda Brook Jones, PA-C

  • Medical Physician Assistant
  • Rawlins, WY
  • NPI 1184200792
  NPD
• Christopher Eric Williams, M.D.

  • Family Medicine Physician
  • Elko, NV
  • NPI 1275524779
  NPD

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

{
    "created_epoch": "1171584000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1497484800000",
    "number": "1194869115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 689",
            "city": "HANNA",
            "state": "WY",
            "postal_code": "823270689",
            "telephone_number": "307-325-6596",
            "fax_number": "307-325-6597"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1008 FELDSPAR COURT",
            "city": "HANNA",
            "state": "WY",
            "postal_code": "82327",
            "telephone_number": "307-325-6596",
            "fax_number": "307-325-6597"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEMORIAL HOSPITAL OF CARBON COUNTY",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MEMORIAL HOSPITAL OF CARBON COUNTY",
        "enumeration_date": "2007-02-16",
        "last_updated": "2017-06-15",
        "status": "A",
        "authorized_official_last_name": "KEPLINGER",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "307-324-8347"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "WY",
            "license": "2916A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UMWA",
            "identifier": "1399310",
            "state": "WY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF WYOMING",
            "identifier": "00863001",
            "state": "WY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "107205600",
            "state": "WY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FEDERAL WORKERS COMP",
            "identifier": "185872500",
            "state": "WY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Energy Basin Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Julie Ann Freeman, APRN-FNP-C
• Calvin Garrison, PA
• Hanna EMS
• Julie Freeman FNP
• William Carey Lake, APRN
• Southern Wyoming Counseling LLC
• Town of Hanna (Hanna-Elmo Volunteer Fire Department/ EMS)

• Rural Health Clinic/Center in Hanna, WY
• Providers in Hanna, 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 Jun 15, 2017; 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.