NPIMap

Organization Active NPI

Campbell County Hospital District

Doing business as Campbell County Clinics - Neurology & Pain

  • Neurology Physician
  • Gillette, WY
National Provider Identifier
1811264732
Registry record updated Nov 21, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
8793A Issued in WY
Legal business name
CAMPBELL COUNTY HOSPITAL DISTRICT
Doing business as
Campbell County Clinics - Neurology & Pain
Practice address
501 S Burma Ave 3N-Neuro
Gillette, WY 82716-3426
Phone
(307) 688-3500
Fax
(307) 688-3510
NPI assigned
Nov 21, 2011
Last updated
Nov 21, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 21, 2011

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

Authorized official

Name
William A Fitzgerald
Title
Executive Vice President
Phone
(307) 688-1520

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084N0400X 8793A WY Primary

Addresses

Primary practice location

501 S Burma Ave 3N-Neuro
Gillette, WY 82716-3426

Mailing address

PO Box 3011
Gillette, WY 82717-3011
Phone (307) 688-3500

Other names 1

  • Campbell County Clinics - Neurology & Pain 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

Practitioners & affiliated clinicians

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.

  • Leslie J McLean, MD
    • Hospice and Palliative Medicine (Family Medicine) Physician
    • Gillette, WY
    • NPI 1396753943
    NPD

NPI Registry JSON

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

{
    "created_epoch": "1321833600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1321833600000",
    "number": "1811264732",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3011",
            "city": "GILLETTE",
            "state": "WY",
            "postal_code": "827173011",
            "telephone_number": "307-688-3500",
            "fax_number": "307-688-3510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 S BURMA AVE 3N-NEURO",
            "city": "GILLETTE",
            "state": "WY",
            "postal_code": "827163426",
            "telephone_number": "307-688-3500",
            "fax_number": "307-688-3510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAMPBELL COUNTY HOSPITAL DISTRICT",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-11-21",
        "last_updated": "2011-11-21",
        "status": "A",
        "authorized_official_last_name": "FITZGERALD",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "EXECUTIVE VICE PRESIDENT",
        "authorized_official_telephone_number": "307-688-1520"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "WY",
            "license": "8793A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Campbell County Clinics - Neurology & Pain",
            "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 Nov 21, 2011; 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.