University of Wyoming

Primary specialty

Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X

Legal business name

UNIVERSITY OF WYOMING

Practice address

117 E 4TH St
Pine Bluffs, WY 82082

Phone

(307) 245-3666

NPI assigned

Oct 2, 2014

Last updated

Apr 13, 2016By the provider in NPPES

Organization subpart

Yes

Parent organization

UNIVERSITY OF WYOMINGAs reported in NPPES

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

Authorized official

Name

Ronald Malm, MDNPI 1457459125

Title

Program Director

Phone

(307) 632-2434

Specialties & licenses 2

Addresses

Other names 1

• Pine Bluffs Clinic Other name

Medicare fee-for-service enrollment

Enrolled in WY

Enrollment records 1

Other NPIs on the same Medicare enrollment 4

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• University of Wyoming

  • Federally Qualified Health Center (FQHC)
  • Casper, WY
  • NPI 1558657650

  O20040610001637

  Same enrollment
• University of Wyoming

  dba Albany Community Health Clinic

  • Federally Qualified Health Center (FQHC)
  • Laramie, WY
  • NPI 1639617061

  O20040610001637

  Same enrollment
• University of Wyoming

  dba University of Wyoming Family Medicine

  • Federally Qualified Health Center (FQHC)
  • Cheyenne, WY
  • NPI 1770681439

  O20040610001637

  Same enrollment
• University of Wyoming Speech and Hearing Clinic

  • Audiologist
  • Laramie, WY
  • NPI 1184760993

  O20040610001637

  Same enrollment

Part of

U W Family Prac at Casp

Practitioners 1

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.

• Ronald Lee Malm, DO

  • Family Medicine Physician
  • Cheyenne, WY
  • NPI 1457459125
  Authorized official Same address or phone

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

{
    "created_epoch": "1412208000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1460505600000",
    "number": "1316340417",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "820 E 17TH ST",
            "city": "CHEYENNE",
            "state": "WY",
            "postal_code": "820014714",
            "telephone_number": "307-245-3666"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "117 E 4TH ST",
            "city": "PINE BLUFFS",
            "state": "WY",
            "postal_code": "82082",
            "telephone_number": "307-245-3666"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNIVERSITY OF WYOMING",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "UNIVERSITY OF WYOMING",
        "enumeration_date": "2014-10-02",
        "last_updated": "2016-04-13",
        "status": "A",
        "authorized_official_last_name": "MALM",
        "authorized_official_first_name": "RONALD",
        "authorized_official_title_or_position": "PROGRAM DIRECTOR",
        "authorized_official_telephone_number": "307-632-2434",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pine Bluffs Clinic",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Nicole Christine Rasmussen, APRN
• Wendy Saggus
• Laura A Shepard, CAP
• Meribeth W Smith, LCSW
• Christine A Sujka
• Elly J White
• Wyoming Physical Therapy PC (Brookside Physical Therapy)
• Victor Yeley

• Federally Qualified Health Center (FQHC) in Pine Bluffs, WY
• Providers in Pine Bluffs, WY by specialty
• Federally Qualified Health Center (FQHC) in Wyoming

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2016; 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.