Active NPI
Hannah Lynn Christine Proefrock, PT, DPT
- Physical Therapist
- Gillette, WY
National Provider Identifier
1285396382
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 2114
- Practice address
- 902 E 3Rd St
Gillette, WY 82716-4023 - Phone
- (307) 756-9200
- Fax
- (307) 756-9203
- NPI assigned
- Oct 6, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 2114 | WY | Primary |
Addresses
Primary practice location
902 E 3Rd St
Gillette, WY 82716-4023
Mailing address
1103 E Boxelder Rd Ste U
Gillette, WY 82718-5582
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2114 | WY | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Davis Outpatient Therapy LLC | Physical Therapist | Current | Accepting new patients |
| Professional Rehabilitation Center Inc | Physical Therapist | Current | Accepting new patients |
| Power Basin Therapy LLC | Physical Therapist | Past | Accepting new patients |
| Davis Home Health LLC | Past | Accepting new patients |
Locations
4450 31st Ave S
Ste 104
Fargo, ND 58104
Phone (701) 451-9417
1200 Harwood Dr S
Fargo, ND 58104
Phone (701) 451-4811
902 E 3rd St
Gillette, WY 82716
Phone (307) 756-9200
Organizations & group practices 4
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Physical Therapist
- Gillette, WY
- NPI 1972268431
-
- Physical Therapist
- Fargo, ND
- NPI 1215014105
-
- Home Health Agency
- Gillette, WY
- NPI 1336661933
-
- Physical Therapist
- Eagle, ID
- NPI 1982580452
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1633478400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1702512000000",
"number": "1285396382",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1103 E BOXELDER RD STE U",
"city": "GILLETTE",
"state": "WY",
"postal_code": "827185582"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "902 E 3RD ST",
"city": "GILLETTE",
"state": "WY",
"postal_code": "827164023",
"telephone_number": "307-756-9200",
"fax_number": "307-756-9203"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PROEFROCK",
"first_name": "HANNAH",
"middle_name": "LYNN CHRISTINE",
"credential": "PT, DPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-10-06",
"last_updated": "2023-12-14",
"certification_date": "2023-12-14",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "WY",
"license": "2114",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Gillette, WY
- Premise Health of Wyoming Medical PC
- Preuit & Daigle Professional Counseling P.C.
- Nancy Preuit, MA,LPC,NCC,DC
- Cynthia Ellen Prince, MSN, RN, WCC
- Aaron Charles Proefrock, PT, DPT
- Professional Hearing Group
- Pronghorn Family Dentistry LLC
- Bradley John Pyne, DC
- Margaret Quiriarte
- R & R Chiropractic, LLC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.