Powder River Physical Medicine & Rehabilitation, LLC

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

License

10678A Issued in WY

Legal business name

POWDER RIVER PHYSICAL MEDICINE & REHABILITATION, LLC

Practice address

3100 W Lakeway Rd
Suite 3
Gillette, WY 82718-6372

Phone

(307) 206-4990

Fax

(307) 363-4033

NPI assigned

Jan 9, 2017

Last updated

Jan 9, 2017By 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

Linda Lee Walby, MD

Title

Manager

Phone

(307) 206-4990

Specialties & licenses 1

Addresses

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/14644/brand/1/csg/1/fhir/r4

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

{
    "created_epoch": "1483920000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1483920000000",
    "number": "1619413044",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3100 W LAKEWAY RD",
            "address_2": "SUITE 3",
            "city": "GILLETTE",
            "state": "WY",
            "postal_code": "827186372",
            "telephone_number": "307-206-4990",
            "fax_number": "307-363-4033"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3100 W LAKEWAY RD",
            "address_2": "SUITE 3",
            "city": "GILLETTE",
            "state": "WY",
            "postal_code": "827186372",
            "telephone_number": "307-206-4990",
            "fax_number": "307-363-4033"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "POWDER RIVER PHYSICAL MEDICINE & REHABILITATION, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-01-09",
        "last_updated": "2017-01-09",
        "status": "A",
        "authorized_official_last_name": "WALBY",
        "authorized_official_first_name": "LINDA",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "307-206-4990",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "WY",
            "license": "10678A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Nancy Preuit, MA,LPC,NCC,DC

• Physical Medicine & Rehabilitation Physician in Gillette, WY
• Providers in Gillette, WY by specialty
• Physical Medicine & Rehabilitation Physician in Wyoming

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 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.