County of Campbell

Primary specialty

Public Health or Welfare AgencyTaxonomy code 251K00000X

License

08-079 Issued in WY

Legal business name

COUNTY OF CAMPBELL

Practice address

2301 South 4J Rd
Gillette, WY 82718

Phone

(307) 682-7275

Fax

(307) 682-0374

NPI assigned

Sep 24, 2007

Last updated

Dec 29, 2014By 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

Della G. Amend, RN-BC

Title

Director of Nursing

Phone

(307) 682-7274

Specialties & licenses 1

Addresses

Other names 1

• Campbell County Puiblic Health Former legal business name

Medicare fee-for-service enrollment

Enrolled in WY

Enrollment records 1

Locations

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

{
    "created_epoch": "1190592000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1419811200000",
    "number": "1225224231",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3420",
            "city": "GILLETTE",
            "state": "WY",
            "postal_code": "827173420",
            "telephone_number": "307-682-7275",
            "fax_number": "307-682-0374"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2301 SOUTH 4J RD",
            "city": "GILLETTE",
            "state": "WY",
            "postal_code": "82718",
            "telephone_number": "307-682-7275",
            "fax_number": "307-682-0374"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COUNTY OF CAMPBELL",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-24",
        "last_updated": "2014-12-29",
        "status": "A",
        "authorized_official_last_name": "AMEND",
        "authorized_official_first_name": "DELLA",
        "authorized_official_middle_name": "G.",
        "authorized_official_title_or_position": "DIRECTOR OF NURSING",
        "authorized_official_telephone_number": "307-682-7274",
        "authorized_official_credential": "RN-BC"
    },
    "taxonomies": [
        {
            "code": "251K00000X",
            "taxonomy_group": "",
            "desc": "Public Health or Welfare",
            "state": "WY",
            "license": "08-079",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Campbell County Puiblic Health",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.