Active NPI
Monument Health Network, Inc.
- Family Medicine Physician
- Upton, WY
National Provider Identifier
1629457643
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- Legal business name
- MONUMENT HEALTH NETWORK, INC.
- Practice address
- 717 Pine Street
Upton, WY 82730-9901 - Phone
- (307) 468-2302
- Fax
- (605) 718-7082
- NPI assigned
- May 22, 2015
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Thomas Worsley
- Title
- President Spearfish Hospital
- Phone
- (605) 644-4091
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | Primary |
Addresses
Primary practice location
717 Pine Street
Upton, WY 82730-9901
Mailing address
PO Box 860013
Minneapolis, MN 55486-0013
Phone (307) 468-2302
Other names 1
- Monument Health Upton Clinic
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WY
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20150611001949 | WY | Part B Supplier - Clinic/Group Practice | 5991616427 |
Receives reassigned benefits from 10 practitioners 6 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Gillette, WY |
Other NPIs on the same Medicare enrollment 6
NPIs listed together on one Medicare enrollment, typically parts of the same organization.
-
- Rural Health Clinic/Center
- Newcastle, WY
- NPI 1659750578
O20150611001949
-
- Orthopaedic Surgery Physician
- Spearfish, SD
- NPI 1104205020
O20150611001949
-
- Multi-Specialty Clinic/Center
- Spearfish, SD
- NPI 1578942496
O20150611001949
-
- Multi-Specialty Clinic/Center
- Spearfish, SD
- NPI 1902285828
O20150611001949
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 2
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Dermatology Physician
- Spearfish, SD
- NPI 1972790160
-
- Family Nurse Practitioner
- Spearfish, SD
- NPI 1033638291
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1432252800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1586131200000",
"number": "1629457643",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 860013",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554860013",
"telephone_number": "307-468-2302",
"fax_number": "605-755-7884"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "717 PINE STREET",
"city": "UPTON",
"state": "WY",
"postal_code": "827309901",
"telephone_number": "307-468-2302",
"fax_number": "605-718-7082"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MONUMENT HEALTH NETWORK, INC.",
"organizational_subpart": "NO",
"enumeration_date": "2015-05-22",
"last_updated": "2020-04-06",
"certification_date": "2020-04-06",
"status": "A",
"authorized_official_last_name": "WORSLEY",
"authorized_official_first_name": "THOMAS",
"authorized_official_title_or_position": "PRESIDENT SPEARFISH HOSPITAL",
"authorized_official_telephone_number": "605-644-4091"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Family Medicine",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Monument Health Upton Clinic",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "Monument Health Upton Clinic",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Upton, WY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.