Active NPI
Billy Burke Stange, MLT
- Clinical Medical Laboratory
- Lander, WY
National Provider Identifier
1902137862
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Medical Laboratory
- License
- 93339
- Practice address
- 125 Dillon Dr Apt 104
Lander, WY 82520-2938 - Phone
- (575) 937-5752
- NPI assigned
- Jan 15, 2010
- Last updated
- Jan 15, 2010
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Medical Laboratory | 291U00000X | 93339 | NM | Primary |
Addresses
Primary practice location
125 Dillon Dr Apt 104
Lander, WY 82520-2938
Mailing address
125 Dillon Dr Apt 104
Lander, WY 82520-2938
Phone (575) 937-5752
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 93339 | NM | MD | Clinical Medical Laboratory |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1263513600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1263513600000",
"number": "1902137862",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "125 DILLON DR APT 104",
"city": "LANDER",
"state": "WY",
"postal_code": "825202938",
"telephone_number": "575-937-5752"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "125 DILLON DR APT 104",
"city": "LANDER",
"state": "WY",
"postal_code": "825202938",
"telephone_number": "575-937-5752"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STANGE",
"first_name": "BILLY",
"middle_name": "BURKE",
"name_prefix": "Mr.",
"credential": "MLT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2010-01-15",
"last_updated": "2010-01-15",
"status": "A"
},
"taxonomies": [
{
"code": "291U00000X",
"taxonomy_group": "",
"desc": "Clinical Medical Laboratory",
"state": "NM",
"license": "93339",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lander, WY
- Jennifer Janet Spain
- Elisabeth Sparks
- Kayse Sparks
- Darwin St. Clair Jr., BA
- Thomas Sanders Stamps, MD
- State of Wyoming (Wyoming State Training School)
- State of Wyoming (Mountain View Skilled Nursing Community at Wyoming Life Resource Cente)
- State of Wyoming (Wyoming Life Resource Center)
- Heidi Stearns, CNM
- Stephen a. Hickner, M.D., LLC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.