Powell Valley Health Care Inc – Home Health Agency

Key facts

NPI: 1851452965
Entity type: Organization (NPI type 2)
Primary specialty: Home Health Agency 251E00000X
License: 07098 (WY)
Legal business name: POWELL VALLEY HEALTH CARE INC
Practice address: 777 Avenue H
Powell, WY 82435-2260
Phone: (307) 754-1101
Fax: (307) 754-3176
NPI assigned: Dec 12, 2006
Organization subpart: No

Authorized official

Name: Rod Barton
Title: Ceo
Phone: (307) 754-1101

National Provider Directory

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Home Health Agency	251E00000X	07098	WY	Yes

Addresses

Primary practice location

777 Avenue H
Powell, WY 82435-2260

Mailing address

777 Avenue H
Powell, WY 82435-2260
Phone (307) 754-1101

Other identifiers

Identifier	Type	State	Issuer
007203	Other	WY	BCBS PROVIDER #
107049500	Medicaid	WY

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Mar 24, 2009.

{
    "created_epoch": "1165881600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1237852800000",
    "number": "1851452965",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "777 AVENUE H",
            "city": "POWELL",
            "state": "WY",
            "postal_code": "824352260",
            "telephone_number": "307-754-1101",
            "fax_number": "307-754-3176"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "777 AVENUE H",
            "city": "POWELL",
            "state": "WY",
            "postal_code": "824352260",
            "telephone_number": "307-754-1101",
            "fax_number": "307-754-3176"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "POWELL VALLEY HEALTH CARE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-12",
        "last_updated": "2009-03-24",
        "status": "A",
        "authorized_official_last_name": "BARTON",
        "authorized_official_first_name": "ROD",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "307-754-1101"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "WY",
            "license": "07098",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PROVIDER #",
            "identifier": "007203",
            "state": "WY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "107049500",
            "state": "WY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Powell, WY

All providers in Powell, WY · Home Health Agency in Wyoming

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 24, 2009. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.