Individual provider Active NPI

Karen Zoller, CNP

  • Family Nurse Practitioner
  • Fort Washakie, WY
National Provider Identifier
1730357377
Registry record updated Jun 26, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
30534.1168 Issued in WY
Practice address
28 Black Coal Dr.
Fort Washakie, WY 82514
Phone
(307) 322-7300
Fax
(307) 322-1503
NPI assigned
Feb 18, 2008
Last updated
Jun 26, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 30534.1168 WY Primary

Addresses

Primary practice location

28 Black Coal Dr.
Fort Washakie, WY 82514

Mailing address

PO Box 128
Fort Washakie, WY 82514-0128
Phone (307) 322-7300

Other identifiers 1

IdentifierTypeStateIssuer
72583380MedicaidNM

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WY, TX2 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

Enrollment IDStateProvider typePAC IDDetails
I20120709000326 WY Practitioner - Nurse Practitioner 8022195361 Reassigns benefits to 1 organization
I20130712000607 TX Practitioner - Nurse Practitioner 8022195361 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2008
Medicare assignment
May accept Medicare assignment
Group practices
Wind River Family and Community Healthc CareGroup PAC ID 1850683780, 42 clinicians

Practice addresses (Care Compare)

14 Great Plains Rd
Arapahoe, WY 82510-9144
Phone 3078569281119

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Practitioner, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
30534.1168WYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
US Health Dept of Health & Human Services CurrentSince May 25, 2013 Accepting new patients
University of Wyoming Speech and Hearing Clinic CurrentSince Jul 5, 2022 Accepting new patients
University of Wyoming CurrentSince Jul 5, 2022 Accepting new patients
U S Health Dept of Health & Human Services CurrentSince May 25, 2013 Accepting new patients
University of Wyoming Current Accepting new patients
US Health Dept of Health & Human Services Current Accepting new patients
US Health Dept of Health & Human Services Past Accepting new patients
New Mexico Oncology Hematology Consultants, LTD. Past Accepting new patients

Locations

669 Agency Main St
Harlem, MT 59526
Phone (406) 353-3100

14 Great Plains Rd
Arapahoe, WY 82510

1174 N 22nd St
Laramie, WY 82072
Phone (307) 745-3704

2710 Harney St
Ste 202204
Laramie, WY 82072
Phone (307) 431-5055

Interoperability endpoints

  • Direct secure messaging: karen.zoller@direct.wyomingmedicalcenter.org

Organizations & group practices 9

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.

NPI Registry JSON

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

{
    "created_epoch": "1203292800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1372204800000",
    "number": "1730357377",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 128",
            "city": "FORT WASHAKIE",
            "state": "WY",
            "postal_code": "825140128",
            "telephone_number": "307-322-7300",
            "fax_number": "307-322-1503"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28 BLACK COAL DR.",
            "city": "FORT WASHAKIE",
            "state": "WY",
            "postal_code": "82514",
            "telephone_number": "307-322-7300",
            "fax_number": "307-322-1503"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZOLLER",
        "first_name": "KAREN",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-02-18",
        "last_updated": "2013-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WY",
            "license": "30534.1168",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "72583380",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Washakie, WY

Sources for this page

Verify at the official NPI Registry.