NPIMap

Organization Active NPI

Sterling Provider Group

  • Primary Care Clinic/Center
  • Afton, WY
National Provider Identifier
1962047431
Registry record updated Jun 17, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
STERLING PROVIDER GROUP
Practice address
47 Doc Perkes Rd
Afton, WY 83110-7703
Phone
(307) 885-3637
Fax
(307) 885-3638
NPI assigned
Nov 8, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2026

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

Authorized official

Name
Corbin Bunnage, PA-C
Title
Provider/Owner
Phone
(208) 542-9111

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X
Primary Care Clinic/Center 261QP2300X Primary
Urgent Care Clinic/Center 261QU0200X
Occupational Medicine Clinic/Center 261QX0100X

Addresses

Primary practice location

47 Doc Perkes Rd
Afton, WY 83110-7703

Mailing address

740 S Woodruff Ave
Idaho Falls, ID 83401-5285
Phone (208) 542-9111

Other identifiers 1

IdentifierTypeStateIssuer
53D2147193OtherWYCLIA

National Provider Directory

National Provider Directory
Tax ID family
Sterling Provider Group19 organizations share this tax ID, including this one

Other organizations with this tax ID 18

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

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1573171200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1781654400000",
    "number": "1962047431",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "740 S WOODRUFF AVE",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834015285",
            "telephone_number": "208-542-9111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "47 DOC PERKES RD",
            "city": "AFTON",
            "state": "WY",
            "postal_code": "831107703",
            "telephone_number": "307-885-3637",
            "fax_number": "307-885-3638"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STERLING PROVIDER GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-11-08",
        "last_updated": "2026-06-17",
        "certification_date": "2026-06-17",
        "status": "A",
        "authorized_official_last_name": "BUNNAGE",
        "authorized_official_first_name": "CORBIN",
        "authorized_official_title_or_position": "PROVIDER/OWNER",
        "authorized_official_telephone_number": "208-542-9111",
        "authorized_official_credential": "PA-C"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QX0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Occupational Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA",
            "identifier": "53D2147193",
            "state": "WY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Afton, WY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2026; 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.