Individual provider Active NPI

Nikole Marie Lawrence, APRN

  • Primary Care Nurse Practitioner
  • Gillette, WY
National Provider Identifier
1417569732
Registry record updated Sep 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
46184 Issued in WY
Practice address
430 S Medical Arts CT
Gillette, WY 82716-3364
Phone
(307) 685-6500
Fax
(307) 685-3081
NPI assigned
Aug 18, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 14, 2023

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 46184 WY
Primary Care Nurse Practitioner 363LP2300X 46184 WY Primary

Addresses

Primary practice location

430 S Medical Arts CT
Gillette, WY 82716-3364

Mailing address

1204 Pintail Dr
Gillette, WY 82718-8006
Phone (307) 670-2496

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address cchwyo@cchwyo.sdhealthlink.net Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WY
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 1

Enrollment IDStateProvider typePAC IDDetails
I20200929003179 WY Practitioner - Nurse Practitioner 0941629612 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
46184WYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Campbell County Hospital District, CurrentSince Sep 16, 2020 Accepting new patients
Campbell County Hospital District CurrentSince Sep 16, 2020 Accepting new patients
Campbell County Hospital District Current Accepting new patients
Campbell County Hospital District Current Accepting new patients

Locations

430 S Medical Arts Ct
Gillette, WY 82716
Phone (307) 685-6500

501 S Burma Ave
Fl 3
Gillette, WY 82716
Phone (307) 688-3636

501 S Burma Ave
Gillette, WY 82716
Phone (307) 682-8811

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1597708800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694649600000",
    "number": "1417569732",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1204 PINTAIL DR",
            "city": "GILLETTE",
            "state": "WY",
            "postal_code": "827188006",
            "telephone_number": "307-670-2496"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "430 S MEDICAL ARTS CT",
            "city": "GILLETTE",
            "state": "WY",
            "postal_code": "827163364",
            "telephone_number": "307-685-6500",
            "fax_number": "307-685-3081"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAWRENCE",
        "first_name": "NIKOLE",
        "middle_name": "MARIE",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-18",
        "last_updated": "2023-09-14",
        "certification_date": "2023-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WY",
            "license": "46184",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "WY",
            "license": "46184",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cchwyo@cchwyo.sdhealthlink.net",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "501 S Burma Ave",
            "city": "Gillette",
            "state": "WY",
            "country_code": "US",
            "postal_code": "827163426",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Gillette, WY

Sources for this page

Verify at the official NPI Registry.