NPIMap

Organization Active NPI

Campbell County Hospital District

  • Obstetrics & Gynecology Physician
  • Gillette, WY
National Provider Identifier
1740463520
Registry record updated Mar 31, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
Legal business name
CAMPBELL COUNTY HOSPITAL DISTRICT
Practice address
1414 W 4TH St
Gillette, WY 82716-3328
Phone
(307) 686-3855
Fax
(307) 686-8190
NPI assigned
Dec 14, 2007
Organization subpart
Yes
Parent organization
CAMPBELL COUNTY MEMORIAL HOSPITALAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 31, 2008

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

Authorized official

Name
Mrs. Karen Louise Marshall
Title
Office Manager
Phone
(307) 686-3855

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207V00000X Primary

Addresses

Primary practice location

1414 W 4TH St
Gillette, WY 82716-3328

Mailing address

1414 W 4TH St
Gillette, WY 82716-3328
Phone (307) 686-3855

Other identifiers 1

IdentifierTypeStateIssuer
06213001OtherWYBCBS OF WY

Other names 1

  • CCMH OBGYN Specialists Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040206000510 WY Part B Supplier - Clinic/Group Practice 2860392529 Receives reassigned benefits from 299 practitioners
27 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Wright, WY; Gillette, WY; Sheridan, WY; Hulett, WY

Other NPIs on the same Medicare enrollment 27

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 27

National Provider Directory

National Provider Directory
Tax ID family
Community Mental Health Services35 organizations share this tax ID, including this one
Part of
Community Mental Health Services

Other organizations with this tax ID 34

Organizations that report the same tax identification number in the National Provider Directory.

View all 34

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1197590400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1206921600000",
    "number": "1740463520",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1414 W 4TH ST",
            "city": "GILLETTE",
            "state": "WY",
            "postal_code": "827163328",
            "telephone_number": "307-686-3855",
            "fax_number": "307-686-8190"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1414 W 4TH ST",
            "city": "GILLETTE",
            "state": "WY",
            "postal_code": "827163328",
            "telephone_number": "307-686-3855",
            "fax_number": "307-686-8190"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAMPBELL COUNTY HOSPITAL DISTRICT",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CAMPBELL COUNTY MEMORIAL HOSPITAL",
        "enumeration_date": "2007-12-14",
        "last_updated": "2008-03-31",
        "status": "A",
        "authorized_official_last_name": "MARSHALL",
        "authorized_official_first_name": "KAREN",
        "authorized_official_middle_name": "LOUISE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "307-686-3855",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF WY",
            "identifier": "06213001",
            "state": "WY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CCMH OBGYN Specialists",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Gillette, WY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2008; 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.

Verify at the official NPI Registry.