Evanston Clinic Corp

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

EVANSTON CLINIC CORP

Doing business as

Bridger Valley Family Practice

Practice address

107 N Main St
Lyman, WY 82937

Phone

(307) 787-3313

NPI assigned

Oct 15, 2007

Last updated

Oct 15, 2007By the provider in NPPES

Organization subpart

Yes

Parent organization

EVANSTON CLINIC CORPAs reported in NPPES

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

Authorized official

Name

Debbie T Brewer, MBA

Title

Director of Provider Enrollment

Phone

(615) 465-7626

Specialties & licenses 1

Addresses

Other names 1

• Bridger Valley Family Practice Doing business as

Part of

Evanston Clinic Corp

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.

• Evanston Clinic Corp

  • Family Medicine Physician
  • Evanston, WY
  • NPI 1013916519
  NPPES parent name

Practitioners 1

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.

• Cheri Lyn Willard, RN

  • Registered Nurse
  • Evanston, WY
  • NPI 1922277862
  NPD

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

{
    "created_epoch": "1192406400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1192406400000",
    "number": "1801084926",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7100 COMMERCE WAY",
            "address_2": "SUITE 180",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370272829",
            "telephone_number": "615-465-7626"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 N MAIN ST",
            "city": "LYMAN",
            "state": "WY",
            "postal_code": "82937",
            "telephone_number": "307-787-3313"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVANSTON CLINIC CORP",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "EVANSTON CLINIC CORP",
        "enumeration_date": "2007-10-15",
        "last_updated": "2007-10-15",
        "status": "A",
        "authorized_official_last_name": "BREWER",
        "authorized_official_first_name": "DEBBIE",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "DIRECTOR OF PROVIDER ENROLLMENT",
        "authorized_official_telephone_number": "615-465-7626",
        "authorized_official_credential": "MBA"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WY",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bridger Valley Family Practice",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Randall Carter Christopherson, PT
• Clifford Olguin Dental Care
• Zanna L Clifford Olguin, DDS
• Lynn J Clifford, DDS
• Cowboy Cares, Inc. (Cowboy Cares Home Health)
• Evanston Hospital Corporation (Bridger Valley Medical Group)
• Evanston Hospital Corporation
• David Christopher Fields
• Felicia Renee Galvin, FNP-BC
• Jessica Groll

• Family Medicine Physician in Lyman, WY
• Providers in Lyman, WY by specialty
• Family Medicine Physician in Wyoming

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2007; 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.