Lander Valley Medical Center LLC

Primary specialty

Rural Acute Care HospitalTaxonomy code 282NR1301X

License

06149 Issued in WY

Legal business name

LANDER VALLEY MEDICAL CENTER LLC

Doing business as

Lander Regional Hospital

Practice address

1320 Bishop Randall Dr
Lander, WY 82520-3939

Phone

(307) 332-4420

Fax

(307) 332-3548

NPI assigned

Sep 20, 2006

Organization subpart

No

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

Authorized official

Name

Donald J. Bivacca

Title

President

Phone

(615) 920-7000

Specialties & licenses 1

Addresses

Other identifiers 6

Other names 1

• Lander Regional Hospital Doing business as

Member of 1

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

• Community Hospital of Andalusia LLC

  dba Florala Health Clinic

  • Family Medicine Physician
  • Florala, AL
  • NPI 1437684305

  Member Of

  NPD member

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1398988800000",
    "number": "1396842308",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330 SEVEN SPRINGS WAY",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370274536",
            "telephone_number": "615-920-7000",
            "fax_number": "615-920-8913"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1320 BISHOP RANDALL DR",
            "city": "LANDER",
            "state": "WY",
            "postal_code": "825203939",
            "telephone_number": "307-332-4420",
            "fax_number": "307-332-3548"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LANDER VALLEY MEDICAL CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-20",
        "last_updated": "2014-05-02",
        "status": "A",
        "authorized_official_last_name": "BIVACCA",
        "authorized_official_first_name": "DONALD",
        "authorized_official_middle_name": "J.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "615-920-7000"
    },
    "taxonomies": [
        {
            "code": "282NR1301X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Rural",
            "state": "WY",
            "license": "06149",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PROFESSIONAL FEES",
            "identifier": "00371001",
            "state": "WY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "041434",
            "state": "WY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "115864303",
            "state": "WY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "115864300",
            "state": "WY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "115864305",
            "state": "WY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "115864304",
            "state": "WY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lander Regional Hospital",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Lander Medical Clinic, PC
• Lander Regional Hospital
• Lander Valley Ambulatory Surgery Center LLC (Lander Outpatient Surgical Center)
• Lander Valley Family Practice PC
• Lander Valley Medical Center LLC (Lander Valley Medical Center Hospitalists)
• Lander Valley Medical Center LLC
• Lander Valley Medical Center LLC (Lander Regional Hospital)
• Lander Valley Medical Center LLC (Lander Regional Hospital)
• Lander Valley Medical Center LLC (Lander Regional Hospital)
• Lander Valley Physician Practices, LLC

• Rural Acute Care Hospital in Lander, WY
• Providers in Lander, WY by specialty
• Rural Acute Care Hospital in Wyoming

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.