Empres at Riverton, LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

15199 Issued in WY

Legal business name

EMPRES AT RIVERTON, LLC

Doing business as

Wind River Rehabilitation and Wellness

Practice address

1002 Forest Dr
Riverton, WY 82501-2918

Phone

(307) 856-9471

Fax

(307) 856-1749

NPI assigned

Jul 27, 2015

Last updated

Jan 30, 2017By the provider in NPPES

Organization subpart

Yes

Parent organization

EMPRES WYOMING HEALTHCARE, LLCAs reported in NPPES

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

Authorized official

Name

Brent Weil

Title

Ceo and Manager

Phone

(360) 892-6628

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Wind River Rehabilitation and Wellness Doing business as

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

{
    "created_epoch": "1437955200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1485734400000",
    "number": "1508241977",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4601 NE 77TH AVE",
            "address_2": "SUITE 300",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986626729",
            "telephone_number": "360-892-6628",
            "fax_number": "360-882-5793"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1002 FOREST DR",
            "city": "RIVERTON",
            "state": "WY",
            "postal_code": "825012918",
            "telephone_number": "307-856-9471",
            "fax_number": "307-856-1749"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EMPRES AT RIVERTON, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "EMPRES WYOMING HEALTHCARE, LLC",
        "enumeration_date": "2015-07-27",
        "last_updated": "2017-01-30",
        "status": "A",
        "authorized_official_last_name": "WEIL",
        "authorized_official_first_name": "BRENT",
        "authorized_official_title_or_position": "CEO AND MANAGER",
        "authorized_official_telephone_number": "360-892-6628"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "WY",
            "license": "15199",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "141198500",
            "state": "WY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Wind River Rehabilitation and Wellness",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Aaron Deane Donaldson, DPM
• Austin Alan Dopp
• Dr. Josh Fowler, DMD, PC
• Dawn Marie Dubeau, PMHNP-BC
• Elevation Wellness Center LLC (Elevation Wellness)
• Erin Kathaleen Engavo-Munnell, PCSW
• Hilary Engum, RN
• Brian Enos
• Tinsley M Erickson, NTP
• Eyes on Fremont LLC (Shelly Cadman)

• Skilled Nursing Facility in Riverton, WY
• Providers in Riverton, WY by specialty
• Skilled Nursing Facility in Wyoming

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2017; 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.