PPM Wyoming LLC

Primary specialty

Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X

Legal business name

PPM WYOMING LLC

Practice address

770 S Washington St Ste B
Afton, WY 83110-5135

Phone

(888) 253-6598

NPI assigned

Jul 9, 2024

Organization subpart

No

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

Authorized official

Name

Amber Tueller

Title

Corporate Secretary

Phone

(208) 401-1400

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WY

Enrollment records 1

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Finding Home Healthcare, Inc.

  dba Finding Home Medical Services

  • Multi-Specialty Clinic/Center
  • Eagle, ID
  • NPI 1609327022

  Member Of

  NPD member

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Mandy Jarvis, APRN

  • Family Nurse Practitioner
  • Rock Springs, WY
  • NPI 1366903445
  Medicare reassignment NPD
• Tim Robert Schuijt

  • Family Nurse Practitioner
  • Idaho Falls, ID
  • NPI 1801550553
  NPD

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

{
    "created_epoch": "1720483200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1720483200000",
    "number": "1366289290",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1916 N 700 W STE 110",
            "city": "LAYTON",
            "state": "UT",
            "postal_code": "840415754",
            "telephone_number": "385-427-1570"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "770 S WASHINGTON ST STE B",
            "city": "AFTON",
            "state": "WY",
            "postal_code": "831105135",
            "telephone_number": "888-253-6598"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PPM WYOMING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-07-09",
        "last_updated": "2024-07-09",
        "certification_date": "2024-07-09",
        "status": "A",
        "authorized_official_last_name": "TUELLER",
        "authorized_official_first_name": "AMBER",
        "authorized_official_title_or_position": "CORPORATE SECRETARY",
        "authorized_official_telephone_number": "208-401-1400"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Luke L Owens, DMD
• Andrew Parker, LPC
• Sara Pettinelli, MD
• Michael Ross Pieper, D.O.
• Susan Potter, PPC-913
• Quality Case Management
• Quality Case Management Inc
• Dee J Rammell
• Tamara Rammell
• Red Tail Therapy LLC (Red Tail Therapy)

• Multi-Specialty Clinic/Center in Afton, WY
• Providers in Afton, WY by specialty
• Multi-Specialty Clinic/Center in Wyoming

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2024; 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.