Yellowstone Chiropractic, PC
Organization Active NPI Chiropractor · Lovell, WY
NPI 1497767115 · NPPES record last updated Oct 4, 2007
Key facts
- NPI
- 1497767115
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Chiropractor 111N00000X
- License
- 615 (WY)
- Legal business name
- YELLOWSTONE CHIROPRACTIC, PC
- Practice address
- 223 E Main St
Lovell, WY 82431-2101 - Phone
- (307) 548-9338
- Fax
- (307) 548-9335
- NPI assigned
- Aug 12, 2006
- Organization subpart
- No
Authorized official
- Name
- Dr. Ross B Fuller, DC
- Title
- President
- Phone
- (307) 548-9338
Practitioners 2
-
Ross B Fuller, DC
-
Melissa Kramer, DC
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WY
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20050421000829 | WY | Part B Supplier - Clinic/Group Practice | 2668410424 |
Receives reassigned benefits from 2 practitioners Practice locations: Lovell, WY |
National Provider Directory
Locations
223 E Main St
Lovell, WY 82431
Phone (307) 548-9338
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor |
111N00000X | 615 | WY | Yes |
Addresses
Primary practice location
223 E Main St
Lovell, WY 82431-2101
Mailing address
223 E Main St
Lovell, WY 82431-2101
Phone (307) 548-9338
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 313386 | Other | WY | BLUE CROSS BLUE SHIELD |
Other providers in Lovell, WY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 4, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.