NPIMap

Organization Active NPI

Campbell County Hospital District,

Doing business as Campbell County Medical Group - Post Discharge Clinic

  • General Practice Physician
  • Gillette, WY
National Provider Identifier
1922784891
Registry record updated Jun 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
Legal business name
CAMPBELL COUNTY HOSPITAL DISTRICT,
Doing business as
Campbell County Medical Group - Post Discharge Clinic
Practice address
501 S Burma Ave
Gillette, WY 82716
Phone
(307) 688-3636
NPI assigned
Jun 26, 2023
Last updated
Jun 26, 2023By the provider in NPPES
Organization subpart
Yes
Parent organization
CAMPBELL COUNTY HOSPITAL DISTRICTAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 26, 2023

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

Authorized official

Name
Gerard Dennis Klein
Title
Coo
Phone
(307) 688-1520

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X Primary

Addresses

Primary practice location

501 S Burma Ave
Gillette, WY 82716

Mailing address

500 Ross Street 154-0455 / PO Box 392967
Pittsburgh, PA 15251-9967

Other names 1

  • Campbell County Medical Group - Post Discharge Clinic 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
Tax ID family
Laura Anders MD35 organizations share this tax ID, including this one
Part of
Laura Anders MD

Other organizations with this tax ID 34

Organizations that report the same tax identification number in the National Provider Directory.

View all 34

Practitioners & affiliated clinicians

Practitioners 24

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.

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1687737600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1687737600000",
    "number": "1922784891",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 ROSS STREET 154-0455 / PO BOX 392967",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152519967"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 S BURMA AVE",
            "city": "GILLETTE",
            "state": "WY",
            "postal_code": "82716",
            "telephone_number": "307-688-3636"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAMPBELL COUNTY HOSPITAL DISTRICT,",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CAMPBELL COUNTY HOSPITAL DISTRICT",
        "enumeration_date": "2023-06-26",
        "last_updated": "2023-06-26",
        "certification_date": "2023-06-26",
        "status": "A",
        "authorized_official_last_name": "KLEIN",
        "authorized_official_first_name": "GERARD",
        "authorized_official_middle_name": "DENNIS",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "307-688-1520"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Campbell County Medical Group - Post Discharge Clinic",
            "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 Jun 26, 2023; 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.