FSC LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

License

10312 Issued in WY

Legal business name

FSC LLC

Practice address

1503 Cressett St
Gillette, WY 82716-3339

Phone

(307) 670-3500

NPI assigned

May 4, 2011

Organization subpart

No

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

Authorized official

Name

Mark Lloyd Wisniewski, MD

Title

Co-Owner

Phone

(307) 670-3500

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1304467200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1304467200000",
    "number": "1811289218",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 962",
            "city": "GILLETTE",
            "state": "WY",
            "postal_code": "827170962",
            "telephone_number": "307-670-3500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1503 CRESSETT ST",
            "city": "GILLETTE",
            "state": "WY",
            "postal_code": "827163339",
            "telephone_number": "307-670-3500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FSC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-05-04",
        "last_updated": "2011-05-04",
        "status": "A",
        "authorized_official_last_name": "WISNIEWSKI",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "LLOYD",
        "authorized_official_title_or_position": "CO-OWNER",
        "authorized_official_telephone_number": "307-670-3500",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "WY",
            "license": "10312",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amber Friedlan, M.A PPC
• Derek Friedlan, BS
• Frontier Family Medicine, LLC
• Kristina Marie Fry
• Jason Allen Frye
• Matthew Jay Fuhr, PT, DPT
• Christian Ignacio Galindo
• John Anthony Gall, M.D.
• Thomas Patrick Galvin
• Andrea Garlick, LPC

• Ambulatory Surgical Clinic/Center in Gillette, WY
• Providers in Gillette, WY by specialty
• Ambulatory Surgical Clinic/Center in Wyoming

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2011; 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.