Active NPI
Alix Vath
- Family Nurse Practitioner
- Jackson, WY
National Provider Identifier
1780535237
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 56295
- Practice address
- 250 Scott LN Ste 105
Jackson, WY 83001-8060 - Phone
- (985) 630-9499
- NPI assigned
- Feb 9, 2026
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 56295 | WY | Primary |
Addresses
Primary practice location
250 Scott LN Ste 105
Jackson, WY 83001-8060
Mailing address
PO Box 11603
Jackson, WY 83002-1603
Phone (985) 630-9499
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 56295 | WY | MD | Family Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1770595200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1770595200000",
"number": "1780535237",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 11603",
"city": "JACKSON",
"state": "WY",
"postal_code": "830021603",
"telephone_number": "985-630-9499"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "250 SCOTT LN STE 105",
"city": "JACKSON",
"state": "WY",
"postal_code": "830018060",
"telephone_number": "985-630-9499"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VATH",
"first_name": "ALIX",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2026-02-09",
"last_updated": "2026-02-09",
"certification_date": "2026-02-09",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "WY",
"license": "56295",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jackson, WY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.