Western Trails Family Medicine, LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

WESTERN TRAILS FAMILY MEDICINE, LLC

Practice address

1463 17TH Ave
Mitchell, NE 69357-1429

Phone

(308) 623-1313

Fax

(308) 623-1313

NPI assigned

Apr 22, 2015

Last updated

Apr 22, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. John Wesly Bowlin, PT, DPTNPI 1063719144

Title

President

Phone

(308) 623-1313

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NE

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

Practitioners 6

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.

• Steve Clair Boyer, M.D.

  • Family Medicine Physician
  • Mullen, NE
  • NPI 1730104886
  Medicare reassignment Care Compare group NPD
• Peter C. Meyer, M.D.

  • Emergency Medical Services (Emergency Medicine) Physician
  • Scottsbluff, NE
  • NPI 1285647842
  Medicare reassignment Care Compare group NPD
• Michelle K Hunter, PA-C

  • Physician Assistant
  • Scottsbluff, NE
  • NPI 1649287939
  Medicare reassignment Care Compare group
• Christopher Wiles, NP

  • Family Nurse Practitioner
  • Springfield, MO
  • NPI 1104371467

  NE

  Medicare reassignment NPD
• John Wesly Bowlin, DPT

  • Physical Therapist
  • Mitchell, NE
  • NPI 1063719144
  NPD Authorized official
• Ryan N Bowlin, D.C.

  • Chiropractor
  • Mitchell, NE
  • NPI 1700931326
  NPD (past)

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

{
    "created_epoch": "1429660800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1429660800000",
    "number": "1205223740",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1463 17TH AVE",
            "city": "MITCHELL",
            "state": "NE",
            "postal_code": "693571429",
            "telephone_number": "308-623-1313",
            "fax_number": "308-623-1315"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1463 17TH AVE",
            "city": "MITCHELL",
            "state": "NE",
            "postal_code": "693571429",
            "telephone_number": "308-623-1313",
            "fax_number": "308-623-1313"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WESTERN TRAILS FAMILY MEDICINE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-04-22",
        "last_updated": "2015-04-22",
        "status": "A",
        "authorized_official_last_name": "BOWLIN",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "WESLY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "308-623-1313",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PT, DPT"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lori Renae Snyder, PTA
• Jennifer Splichal, MS, CCC-SLP
• Gabriella Lyn Stevenson
• Susan B Weitzel
• Western Trails Chiropractic LLC
• Western Trails Physical Therapy, LLC

• Family Medicine Physician in Mitchell, NE
• Providers in Mitchell, NE by specialty
• Family Medicine Physician in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2015; 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.