Susan Gail Wolff, PMH-NP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

67729 Issued in ID

Practice address

745 Buena Vista Dr
Lander, WY 82520-3431

Phone

(307) 332-2941

NPI assigned

Sep 23, 2019

Last updated

Jun 29, 2023By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in WY, ID2 enrollments

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 2

Specialty

Nurse Practitioner

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Hospital & facility affiliations

• St Johns Medical Center Hospital, Jackson, WY, CCN 530015

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Lupine Mental Health and Integrative Psychiatry LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Jackson, WY
  • NPI 1871103127

  ID

  Medicare reassignment NPD Authorized official
• TBT, LLC

  dba Teton Behavior Therapy

  • Community/Behavioral Health Agency
  • Jackson, WY
  • NPI 1407230766
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Teton County Hospital District

  dba St John's Medical Center/ or St John's Health

  • General Acute Care Hospital
  • Jackson, WY
  • NPI 1801835475
  Care Compare affiliation

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

{
    "created_epoch": "1569196800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687996800000",
    "number": "1558912477",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4150 GLORY VISTA TER",
            "city": "JACKSON",
            "state": "WY",
            "postal_code": "830018997",
            "telephone_number": "307-690-4368"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "745 BUENA VISTA DR",
            "city": "LANDER",
            "state": "WY",
            "postal_code": "825203431",
            "telephone_number": "307-332-2941"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "125 E Pearl Ave Ste 207",
            "address_purpose": "LOCATION",
            "city": "Jackson",
            "state": "WY",
            "postal_code": "830018599",
            "country_code": "US",
            "telephone_number": "303-203-2656",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1960 Diamond T Trl",
            "address_purpose": "LOCATION",
            "city": "Victor",
            "state": "ID",
            "postal_code": "834554833",
            "country_code": "US",
            "telephone_number": "307-200-4948",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WOLFF",
        "first_name": "SUSAN",
        "middle_name": "GAIL",
        "credential": "PMH-NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-09-23",
        "last_updated": "2023-06-29",
        "certification_date": "2023-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "WY",
            "license": "44657",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "ID",
            "license": "67729",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Wyoming Dental Imaging, LLC
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• Psychiatric/Mental Health Nurse Practitioner in Lander, WY
• Providers in Lander, WY by specialty
• Psychiatric/Mental Health Nurse Practitioner in Wyoming

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.