Big Horn Pediatrics

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

Legal business name

BIG HORN PEDIATRICS

Practice address

1308 W 4TH St
Gillette, WY 82716-3330

Phone

(307) 687-1300

Fax

(307) 682-1309

NPI assigned

Aug 24, 2006

Last updated

Jul 27, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ann L Edwards

Title

Office Manager

Phone

(307) 687-1300

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in WY

Enrollment records 1

Locations

Practitioners 7

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.

• Aubrey Dozier Tabb, MD

  • Family Medicine Physician
  • Buffalo, WY
  • NPI 1316925456
  Medicare reassignment Care Compare group NPD
• Stefanie Ray Hepp Garcia, PA-C

  • Family Medicine Physician
  • Gillette, WY
  • NPI 1528210523
  Medicare reassignment Care Compare group
• Mindy Keil, PA-C

  • Medical Physician Assistant
  • Gillette, WY
  • NPI 1356592976
  Medicare reassignment Care Compare group
• Lynn P Perlenfein, PA-C

  • Physician Assistant
  • Gillette, WY
  • NPI 1881641553
  Medicare reassignment
• David Robert Fall, M.D.

  • Pediatric Adolescent Medicine Physician
  • Gillette, WY
  • NPI 1578676490
  NPD (past)
• Julie Shibata Fall, M.D.

  • Pediatric Adolescent Medicine Physician
  • Gillette, WY
  • NPI 1306959267
  NPD (past)
• Rachel Anne Helms, APRN

  • Pediatric Nurse Practitioner
  • Gillette, WY
  • NPI 1942546015
  NPD (past)

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

{
    "created_epoch": "1156377600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1595808000000",
    "number": "1477660447",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1308 W 4TH ST",
            "city": "GILLETTE",
            "state": "WY",
            "postal_code": "827163330",
            "telephone_number": "307-687-1300",
            "fax_number": "307-682-1309"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1308 W 4TH ST",
            "city": "GILLETTE",
            "state": "WY",
            "postal_code": "827163330",
            "telephone_number": "307-687-1300",
            "fax_number": "307-682-1309"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "106 West Angus",
            "address_purpose": "LOCATION",
            "city": "Buffalo",
            "state": "WY",
            "postal_code": "82834",
            "country_code": "US",
            "telephone_number": "307-620-8845",
            "fax_number": "307-682-1309",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "BIG HORN PEDIATRICS",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-24",
        "last_updated": "2020-07-27",
        "certification_date": "2020-07-27",
        "status": "A",
        "authorized_official_last_name": "EDWARDS",
        "authorized_official_first_name": "ANN",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "307-687-1300"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX I.D.#",
            "identifier": "830306207",
            "state": "WY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Braden Benson, DPT
• Stephanie Berens
• Edward Patrick Bergin, MD, MS
• Amanda Louise Bialas
• Kim Biegler, MS, NCC, LPC
• Angela E Biggs, MD
• Rodney C. Biggs, M.D.
• Bighorn Dental Clinic PC
• Bighorn Valley Health Center Incorporated (One Health - Gillette)
• Billings Orthodontics, PLLC (Bennion Lambourne Orthodontics)

• Pediatrics Physician in Gillette, WY
• Providers in Gillette, WY by specialty
• Pediatrics Physician in Wyoming

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2020; 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.