Organization Active NPI

Womens Healthcare PC

  • Obstetrics & Gynecology Physician
  • Gillette, WY
National Provider Identifier
1306854302
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
Legal business name
WOMENS HEALTHCARE PC
Practice address
1402 West 4TH Street
Gillette, WY 82716-3328
Phone
(307) 682-2233
Fax
(307) 682-2233
NPI assigned
Aug 4, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Toby R Marshall, MD
Title
Officer
Phone
(307) 682-2233

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X Primary

Addresses

Primary practice location

1402 West 4TH Street
Gillette, WY 82716-3328

Mailing address

1402 West 4TH Street
Gillette, WY 82716-3328
Phone (307) 682-2233

Other identifiers 1

IdentifierTypeStateIssuer
01241001OtherWYBLUE CROSS BLUE SHIELD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040408001018 WY Part B Supplier - Clinic/Group Practice 6800880329 Receives reassigned benefits from 3 practitioners
Practice locations: Gillette, WY

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
53D0903719Womens Healthcare PC1402 West Fourth Street, Gillette, WY 82716Provider-performed microscopyJul 26, 2027

National Provider Directory

National Provider Directory

Locations

1402 W 4th St
Gillette, WY 82716
Phone (307) 682-2233

Practitioners & affiliated clinicians

Practitioners 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1154649600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1306854302",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1402 WEST 4TH STREET",
            "city": "GILLETTE",
            "state": "WY",
            "postal_code": "827163328",
            "telephone_number": "307-682-2233",
            "fax_number": "307-682-2165"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1402 WEST 4TH STREET",
            "city": "GILLETTE",
            "state": "WY",
            "postal_code": "827163328",
            "telephone_number": "307-682-2233",
            "fax_number": "307-682-2233"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WOMENS HEALTHCARE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-04",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MARSHALL",
        "authorized_official_first_name": "TOBY",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OFFICER",
        "authorized_official_telephone_number": "307-682-2233",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "01241001",
            "state": "WY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gillette, WY

Sources for this page

  • 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 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.