South Lincoln Hospital District
Organization Active NPI Clinic/Center · Rock Springs, WY
NPI 1649803271 · NPPES record last updated Jul 13, 2020
Key facts
- NPI
- 1649803271
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Clinic/Center 261Q00000X
- Legal business name
- SOUTH LINCOLN HOSPITAL DISTRICT
- Practice address
- 2624 Commercial Way
Rock Springs, WY 82901-4769 - Phone
- (307) 522-5500
- Fax
- (307) 522-5559
- NPI assigned
- Feb 21, 2020
- Organization subpart
- Yes
- Parent organization (as reported)
- SOUTH LINCOLN HOSPITAL DISTRICT
Authorized official
- Name
- Karl E Sundberg
- Title
- Ceo
- Phone
- (307) 877-4401
Other NPIs on the same Medicare enrollment 4
Corporate family (same tax ID) 9
Practitioners 8
-
Fred A Baldwin, P.A.
-
Gregory J Allred, DO
-
Aaron Matthew Bronson, CRNA
-
Rock E. Harper, CRNA
-
David Allan Reese, M.D.
-
Trevor J Steiner, PA-C
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WY
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040604000832 | WY | Part B Supplier - Clinic/Group Practice | 2961490057 |
Receives reassigned benefits from 22 practitioners 4 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Kemmerer, WY; Rock Springs, WY; Evanston, WY |
National Provider Directory
- Tax ID family
- South Lincoln Hosp District
- Part of
- South Lincoln Hosp District
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinic/Center | 261Q00000X | Yes |
Addresses
Primary practice location
2624 Commercial Way
Rock Springs, WY 82901-4769
Mailing address
711 Onyx St
Kemmerer, WY 83101-3214
Phone (307) 877-4401
Other names
- SOUTH LINCOLN MEDICAL CLINIC ROCK SPRINGS
Other providers in Rock Springs, WY
- Leslie Washburn Smith
- Michelle Marie Smith
- Smiths Food & Drug Centers Inc
- Jasmine Soller
- Souly Unique LLC
- Southwest Counseling
- Southwest Counseling Service
- Southwest Counseling Service
- Southwest Counseling Service
- Southwest Counseling Service
All providers in Rock Springs, WY · Clinic/Center in Wyoming
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 13, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.