Active NPI
Little Snake River Clinic LLC
- Primary Care Clinic/Center
- Baggs, WY
National Provider Identifier
1336950591
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Primary Care Clinic/Center
- Legal business name
- LITTLE SNAKE RIVER CLINIC LLC
- Practice address
- 210 Penland St
Baggs, WY 82321-5051 - Phone
- (307) 361-8104
- NPI assigned
- Jan 16, 2025
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- James Richard Zimmerman, PA-C
- Title
- President
- Phone
- (307) 361-8104
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Primary Care Clinic/Center | 261QP2300X | Primary |
Addresses
Primary practice location
210 Penland St
Baggs, WY 82321-5051
Mailing address
PO Box 37
Baggs, WY 82321-0037
Phone (307) 361-8104
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WY
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20250814002108 | WY | Part B Supplier - Clinic/Group Practice | 5799284162 |
Receives reassigned benefits from 1 practitioner Practice locations: Baggs, WY |
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1736985600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1747872000000",
"number": "1336950591",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 37",
"city": "BAGGS",
"state": "WY",
"postal_code": "823210037",
"telephone_number": "307-361-8104"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "210 PENLAND ST",
"city": "BAGGS",
"state": "WY",
"postal_code": "823215051",
"telephone_number": "307-361-8104"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "LITTLE SNAKE RIVER CLINIC LLC",
"organizational_subpart": "NO",
"enumeration_date": "2025-01-16",
"last_updated": "2025-05-22",
"certification_date": "2025-05-22",
"status": "A",
"authorized_official_last_name": "ZIMMERMAN",
"authorized_official_first_name": "JAMES",
"authorized_official_middle_name": "RICHARD",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "307-361-8104",
"authorized_official_credential": "PA-C"
},
"taxonomies": [
{
"code": "261QP2300X",
"taxonomy_group": "",
"desc": "Clinic/Center, Primary Care",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Baggs, WY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2025; 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.