NPIMap

Organization Active NPI

Westside Medical, LLC

  • Family Nurse Practitioner
  • Wilson, WY
National Provider Identifier
1750536587
Registry record updated Nov 20, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
169260139 Issued in WY
Legal business name
WESTSIDE MEDICAL, LLC
Practice address
5235 HHR Ranch Rd
Wilson, WY 83014
Phone
(307) 733-5676
Fax
(307) 739-1048
NPI assigned
Nov 20, 2008
Last updated
Nov 20, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 20, 2008

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

Authorized official

Name
Sally L.H. Luke, FNPNPI 1740312172
Title
Owner
Phone
(307) 733-5676

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 169260139 WY Primary

Addresses

Primary practice location

5235 HHR Ranch Rd
Wilson, WY 83014

Mailing address

PO Box 1582
Wilson, WY 83014-1582
Phone (307) 733-5676

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1227139200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1227139200000",
    "number": "1750536587",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1582",
            "city": "WILSON",
            "state": "WY",
            "postal_code": "830141582",
            "telephone_number": "307-733-5676",
            "fax_number": "307-739-1048"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5235 HHR RANCH RD",
            "city": "WILSON",
            "state": "WY",
            "postal_code": "83014",
            "telephone_number": "307-733-5676",
            "fax_number": "307-739-1048"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WESTSIDE MEDICAL, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-11-20",
        "last_updated": "2008-11-20",
        "status": "A",
        "authorized_official_last_name": "LUKE",
        "authorized_official_first_name": "SALLY",
        "authorized_official_middle_name": "L.H.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "307-733-5676",
        "authorized_official_credential": "FNP"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WY",
            "license": "169260139",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilson, WY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2008; 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.