NPIMap

Organization Active NPI

Popo Agie Women'S Clinic, Inc

  • Adult Health Nurse Practitioner
  • Lander, WY
National Provider Identifier
1871623124
Registry record updated Mar 5, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
9192.0137 Issued in WY
Legal business name
POPO AGIE WOMEN'S CLINIC, INC
Practice address
1460 Main St
Lander, WY 82520-2657
Phone
(307) 332-2223
NPI assigned
Mar 6, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 5, 2009

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

Authorized official

Name
Mrs. Ruth C Zebroski, WHNP-C
Title
President
Phone
(307) 332-2223

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LA2200X 9192.0137 WY Primary
Family Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LF0000X 9192.0137 WY
Women's Health Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LW0102X 9192.0137 WY

Addresses

Primary practice location

1460 Main St
Lander, WY 82520-2657

Mailing address

1460 Main St
Lander, WY 82520-2657
Phone (307) 332-2223

Other identifiers 1

IdentifierTypeStateIssuer
116652200MedicaidWY

Other names 1

  • Popo Agie Women's Clinic Former legal business name

National Provider Directory

National Provider Directory

Locations

1460 Main St
Lander, WY 82520
Phone (307) 332-2223

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1173139200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1236211200000",
    "number": "1871623124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1460 MAIN ST",
            "city": "LANDER",
            "state": "WY",
            "postal_code": "825202657",
            "telephone_number": "307-332-2223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1460 MAIN ST",
            "city": "LANDER",
            "state": "WY",
            "postal_code": "825202657",
            "telephone_number": "307-332-2223"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "POPO AGIE WOMEN'S CLINIC, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-06",
        "last_updated": "2009-03-05",
        "status": "A",
        "authorized_official_last_name": "ZEBROSKI",
        "authorized_official_first_name": "RUTH",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "307-332-2223",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "WHNP-C"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "WY",
            "license": "9192.0137",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "WY",
            "license": "9192.0137",
            "primary": false
        },
        {
            "code": "363LW0102X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "WY",
            "license": "9192.0137",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "116652200",
            "state": "WY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Popo Agie Women's Clinic",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Lander, WY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2009; 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.