Organization Active NPI

Prosperity Practice LLC

  • Family Nurse Practitioner
  • Lyman, WY
National Provider Identifier
1396570875
Registry record updated May 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
Legal business name
PROSPERITY PRACTICE LLC
Practice address
107 E Owen Ave
Lyman, WY 82937-5119
Phone
(307) 679-1403
Fax
(307) 242-5077
NPI assigned
Sep 4, 2024
Last updated
May 9, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 9, 2025

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

Authorized official

Name
Cathy Jones
Title
Administrator
Phone
(307) 679-1403

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X
Family Nurse Practitioner 363LF0000X Primary

Addresses

Primary practice location

107 E Owen Ave
Lyman, WY 82937-5119

Mailing address

PO Box 1322
Lyman, WY 82937-1322
Phone (307) 679-1403

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20241010000793 WY Part B Supplier - Clinic/Group Practice 9133651557 Receives reassigned benefits from 1 practitioner
Practice locations: Lyman, WY

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1725408000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1746748800000",
    "number": "1396570875",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1322",
            "city": "LYMAN",
            "state": "WY",
            "postal_code": "829371322",
            "telephone_number": "307-679-1403",
            "fax_number": "307-242-5077"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 E OWEN AVE",
            "city": "LYMAN",
            "state": "WY",
            "postal_code": "829375119",
            "telephone_number": "307-679-1403",
            "fax_number": "307-242-5077"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROSPERITY PRACTICE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-09-04",
        "last_updated": "2025-05-09",
        "certification_date": "2025-05-09",
        "status": "A",
        "authorized_official_last_name": "JONES",
        "authorized_official_first_name": "CATHY",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "307-679-1403"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lyman, WY

Sources for this page

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

Verify at the official NPI Registry.