NPIMap

Individual provider Active NPI

Clinton McMahill, M.D.

  • Internal Medicine Physician
  • Lander, WY
National Provider Identifier
1245556190
Registry record updated Jul 25, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
TL2257 Issued in WY
Practice address
745 Buena Vista Dr
Lander, WY 82520-3431
Phone
(307) 332-2941
NPI assigned
Apr 18, 2010
Last updated
Jul 25, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Internal Medicine Physician 207R00000X TL2257 WY Primary

Addresses

Primary practice location

745 Buena Vista Dr
Lander, WY 82520-3431

Mailing address

745 Buena Vista Dr
Lander, WY 82520-3431
Phone (307) 332-2941

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20131001000210 WY Practitioner - Internal Medicine 7810121019 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Washington School of Medicine, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Lander Medical Clinic PCGroup PAC ID 1355323940, 18 clinicians

Practice addresses (Care Compare)

745 Buena Vista Dr
Lander, WY 82520-3431
Phone (307) 332-2941

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10
Removal of skin lesions18
Removal of nail tissue1-10
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
TL2257WYMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Riverton Physician Practices, LLC CurrentSince Oct 1, 2013 Accepting new patients
Lander Valley Physician Practices, LLC Internal Medicine CurrentSince Oct 1, 2013 Accepting new patients
Riverton Physician Practices LLC CurrentSince Oct 1, 2013 Accepting new patients
Lander Medical Clinic, PC CurrentSince Oct 1, 2013 Accepting new patients
State of Wyoming Past Accepting new patients
Westward Heights Corp Past Accepting new patients

Locations

1320 Bishop Randall Dr
Lander, WY 82520
Phone (307) 332-4420

745 Buena Vista Dr
Lander, WY 82520
Phone (307) 332-2941

1005 College View Dr
Riverton, WY 82501
Phone (307) 857-3486

609 E Madison Ave
Riverton, WY 82501
Phone (307) 330-8183

Interoperability endpoints

  • Direct secure messaging: clinton.mcmahill.1@2483.direct.athenahealth.com
  • FHIR API: https://api.platform.athenahealth.com/2483/brand/1/csg/1/fhir/r4

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1271548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1374710400000",
    "number": "1245556190",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "745 BUENA VISTA DR",
            "city": "LANDER",
            "state": "WY",
            "postal_code": "825203431",
            "telephone_number": "307-332-2941"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "745 BUENA VISTA DR",
            "city": "LANDER",
            "state": "WY",
            "postal_code": "825203431",
            "telephone_number": "307-332-2941"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCMAHILL",
        "first_name": "CLINTON",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-04-18",
        "last_updated": "2013-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WY",
            "license": "TL2257",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lander, WY

Sources for this page

Verify at the official NPI Registry.