Individual provider Active NPI

Mandy Jarvis, APRN

  • Family Nurse Practitioner
  • Rock Springs, WY
National Provider Identifier
1366903445
Registry record updated May 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
44162 Issued in WY
Practice address
120 Winston Dr Ste 101
Rock Springs, WY 82901-5833
Phone
(307) 352-9602
NPI assigned
Mar 29, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 7, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 5244410-4405 UT
Family Nurse Practitioner 363LF0000X 44162 WY Primary

Addresses

Primary practice location

120 Winston Dr Ste 101
Rock Springs, WY 82901-5833

Mailing address

120 Winston Dr Ste 101
Rock Springs, WY 82901-5833
Phone (307) 352-9602

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WY, UT2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20190924001829 WY Practitioner - Nurse Practitioner 9638409386 Reassigns benefits to 1 organization
I20260203002136 UT Practitioner - Nurse Practitioner 9638409386 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

770 S Washington St
Suite B
Afton, WY 83110-5135
Phone (888) 253-6598

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
86.39 of 100Reported as group
Quality
74.38
Promoting interoperability
99
Improvement activities
40
Cost
67.63

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
5244410-4405UTMDFamily Nurse Practitioner
44162WYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mavie LLC CurrentSince Nov 1, 2025 Accepting new patients
Loko LLC/ Dba Elements Integrative Wellness Center CurrentSince May 11, 2025 Accepting new patients
PPM Wyoming LLC CurrentSince Aug 24, 2025 Accepting new patients

Locations

943 W Overland Rd
Meridian, ID 83642
Phone (208) 519-9102

1916 N 700 W
Ste 110
Layton, UT 84041
Phone (801) 444-0221

180 N University Ave
Ste 270
Provo, UT 84601
Phone (385) 469-3731

770 S Washington St
#B
Afton, WY 83110
Phone (307) 885-7583

5830 E 2nd St
Casper, WY 82609
Phone (929) 282-4020

120 Winston Dr
Ste 101
Rock Springs, WY 82901
Phone (307) 352-9602

Organizations & group practices 3

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1553817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746576000000",
    "number": "1366903445",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 WINSTON DR STE 101",
            "city": "ROCK SPRINGS",
            "state": "WY",
            "postal_code": "829015833",
            "telephone_number": "307-352-9602",
            "fax_number": "866-422-2113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 WINSTON DR STE 101",
            "city": "ROCK SPRINGS",
            "state": "WY",
            "postal_code": "829015833",
            "telephone_number": "307-352-9602"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JARVIS",
        "first_name": "MANDY",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-03-29",
        "last_updated": "2025-05-07",
        "certification_date": "2025-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "UT",
            "license": "5244410-4405",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WY",
            "license": "44162",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rock Springs, WY

Sources for this page

Verify at the official NPI Registry.