Alta Vista Center for Integrative Medicine, LLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

7766A Issued in WY

Legal business name

ALTA VISTA CENTER FOR INTEGRATIVE MEDICINE, LLC

Practice address

313 S 2ND St
Suite B
Laramie, WY 82070-3611

Phone

(307) 399-3119

Fax

(866) 827-3930

NPI assigned

Jul 30, 2012

Last updated

Jul 30, 2012By 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

Dr. William S. Fitterman, D.O.

Title

Ceo/Medical Director

Phone

(307) 399-3119

Specialties & licenses 2

Addresses

Locations

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

{
    "created_epoch": "1343606400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1343606400000",
    "number": "1598011306",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "313 S 2ND ST",
            "address_2": "SUITE B",
            "city": "LARAMIE",
            "state": "WY",
            "postal_code": "820703611",
            "telephone_number": "307-399-3119",
            "fax_number": "866-827-3930"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "313 S 2ND ST",
            "address_2": "SUITE B",
            "city": "LARAMIE",
            "state": "WY",
            "postal_code": "820703611",
            "telephone_number": "307-399-3119",
            "fax_number": "866-827-3930"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALTA VISTA CENTER FOR INTEGRATIVE MEDICINE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-07-30",
        "last_updated": "2012-07-30",
        "status": "A",
        "authorized_official_last_name": "FITTERMAN",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "S.",
        "authorized_official_title_or_position": "CEO/MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "307-399-3119",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "WY",
            "license": "7766A",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": "WY",
            "license": "7766A",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Internal Medicine Physician in Laramie, WY
• Providers in Laramie, WY by specialty
• Internal Medicine Physician in Wyoming

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2012; 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.