Wind River Pediatrics, LLC

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

7224A Issued in WY

Legal business name

WIND RIVER PEDIATRICS, LLC

Practice address

1005 College View Dr
Riverton, WY 82501-2266

Phone

(307) 857-5247

Fax

(307) 857-5215

NPI assigned

Jun 5, 2006

Organization subpart

No

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

Authorized official

Name

Michael R Fisher, MD

Title

Ceo

Phone

(307) 857-5247

Specialties & licenses 1

Addresses

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

CLIA laboratory certificates

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

{
    "created_epoch": "1149465600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1215976253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1005 COLLEGE VIEW DR",
            "city": "RIVERTON",
            "state": "WY",
            "postal_code": "825012266",
            "telephone_number": "307-857-5247",
            "fax_number": "307-857-5215"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1005 COLLEGE VIEW DR",
            "city": "RIVERTON",
            "state": "WY",
            "postal_code": "825012266",
            "telephone_number": "307-857-5247",
            "fax_number": "307-857-5215"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WIND RIVER PEDIATRICS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-05",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "FISHER",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "307-857-5247",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": "WY",
            "license": "7224A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Pediatrics Physician in Riverton, WY
• Providers in Riverton, WY by specialty
• Pediatrics Physician in Wyoming

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• 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.