Davis Outpatient Therapy LLC

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

DAVIS OUTPATIENT THERAPY LLC

Practice address

902 E 3Rd St
Gillette, WY 82716-4023

Phone

(307) 756-9200

Fax

(888) 715-6736

NPI assigned

Nov 1, 2021

Organization subpart

No

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

Authorized official

Name

Mrs. Lacy Larae Davis, RN

Title

RN Administrator

Phone

(307) 756-9200

Specialties & licenses 5

Addresses

Other names 1

• Healing Hearts Home Health Outpatient Therapy Doing business as

Electronic endpoints 2

Medicare fee-for-service enrollment

Enrolled in WY

Enrollment records 1

Locations

Practitioners 8

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

• Emily Paige Caro, OTR/L

  • Occupational Therapist
  • Moorcroft, WY
  • NPI 1457004848
  Medicare reassignment Care Compare group NPD
• Sydney Lynne Hoflund, PT, DPT

  • Physical Therapist
  • Gillette, WY
  • NPI 1497342265
  Medicare reassignment Care Compare group NPD
• Kristi Kay Wilde, PT

  • Physical Therapist
  • Moorcroft, WY
  • NPI 1366923104
  Medicare reassignment Care Compare group NPD
• Cathryn Guzman, SPEECH THERAPIST

  • Speech-Language Pathologist
  • Gillette, WY
  • NPI 1316697188
  Medicare reassignment NPD
• Tenny Hanson, FNP

  • Family Nurse Practitioner
  • Rock Springs, WY
  • NPI 1790278141
  Medicare reassignment NPD
• Ryan Schrock, DPT

  • Neurology Physical Therapist
  • Gillette, WY
  • NPI 1639618671
  Medicare reassignment NPD
• Hannah Lynn Christine Proefrock, PT, DPT

  • Physical Therapist
  • Gillette, WY
  • NPI 1285396382
  NPD
• Sara R Thompson, P T

  • Physical Therapist
  • Green River, WY
  • NPI 1821393158
  NPD (past)

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

{
    "created_epoch": "1635724800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658707200000",
    "number": "1972268431",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 338",
            "city": "MOORCROFT",
            "state": "WY",
            "postal_code": "827210338",
            "telephone_number": "307-756-9200",
            "fax_number": "888-715-6736"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "902 E 3RD ST",
            "city": "GILLETTE",
            "state": "WY",
            "postal_code": "827164023",
            "telephone_number": "307-756-9200",
            "fax_number": "888-715-6736"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "101 West Crook Street",
            "address_purpose": "LOCATION",
            "city": "Moorcroft",
            "state": "WY",
            "postal_code": "827210338",
            "country_code": "US",
            "telephone_number": "307-756-9200",
            "fax_number": "888-715-6736",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "DAVIS OUTPATIENT THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-11-01",
        "last_updated": "2022-07-25",
        "certification_date": "2022-07-25",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "LACY",
        "authorized_official_middle_name": "LARAE",
        "authorized_official_title_or_position": "RN ADMINISTRATOR",
        "authorized_official_telephone_number": "307-756-9200",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "225200000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapy Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lacy@healingheartshomehealth.org",
            "affiliation": "Y",
            "affiliationName": "Davis Home Health LLC",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "101 West Crook Street",
            "city": "Moorcroft",
            "state": "WY",
            "country_code": "US",
            "postal_code": "827210338",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lacy@healingheartshomehealth.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "902 E 3rd St",
            "city": "Gillette",
            "state": "WY",
            "country_code": "US",
            "postal_code": "827164023",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Healing Hearts Home Health Outpatient Therapy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Healing Hearts Home Health Outpatient Therapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Daniel Davidovich Young, M.D.
• Davis ENT Specialists, PC
• Davis ENT Specialists, PC
• Davis Home Health LLC
• Davis Hospice, LLC
• Bethany Davis
• Cameron Wayne Davis, DO
• Thomas Clifford Davis, M.D.
• Nancy Day, LPC NCSC
• Jean-Raphael De Raoulx, LPC #2556

• Physical Therapist in Gillette, WY
• Providers in Gillette, WY by specialty
• Physical Therapist in Wyoming

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2022; 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.