Individual provider Active NPI

Paul D Dearing, MD

  • Surgery Physician
  • Gillette, WY
National Provider Identifier
1497789093
Registry record updated Oct 10, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
6966A Issued in WY
Practice address
501 S Burma Ave
2ND Floor
Gillette, WY 82716-3426
Phone
(307) 687-0030
Fax
(307) 687-0044
NPI assigned
Jul 10, 2006
Last updated
Oct 10, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 10, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 6966A WY Primary

Addresses

Primary practice location

501 S Burma Ave
2ND Floor
Gillette, WY 82716-3426

Mailing address

PO Box 3799
Gillette, WY 82717-3799
Phone (307) 687-0030

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ND
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221104000746 ND Practitioner - General Surgery 7012968571 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
McKenzie County Healthcare Systems Inc Surgery CurrentSince Jul 2, 2022 Accepting new patients
McKenzie County Healthcare Systems Inc CurrentSince Jul 2, 2022 Accepting new patients
Pediatric Hematology Clinic LTD Past Accepting new patients
McKenzie County Healthcare Systems Inc Past Accepting new patients
McKenzie County Healthcare Systems Inc Past Accepting new patients
McKenzie County Healthcare Systems Inc Past Accepting new patients
McKenzie County Healthcare Systems Inc Past Accepting new patients
McKenzie County Healthcare Systems Inc Past Accepting new patients
Pediatric Hematology Oncology Pharmacy LTC Past Accepting new patients

Locations

709 4th Ave NE
Watford City, ND 58854
Phone (701) 444-2331

Organizations & group practices 9

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1152489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1191974400000",
    "number": "1497789093",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3799",
            "city": "GILLETTE",
            "state": "WY",
            "postal_code": "827173799",
            "telephone_number": "307-687-0030",
            "fax_number": "307-687-0044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 S BURMA AVE",
            "address_2": "2ND FLOOR",
            "city": "GILLETTE",
            "state": "WY",
            "postal_code": "827163426",
            "telephone_number": "307-687-0030",
            "fax_number": "307-687-0044"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEARING",
        "first_name": "PAUL",
        "middle_name": "D",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-10",
        "last_updated": "2007-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "WY",
            "license": "6966A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gillette, WY

Sources for this page

Verify at the official NPI Registry.