PG Direct Care LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

PG DIRECT CARE LLC

Practice address

1100 Pine Ave
Ste 3B
Kemmerer, WY 83101

Phone

(307) 381-8446

Fax

(307) 209-5774

NPI assigned

Jul 9, 2026

Last updated

Jul 9, 2026By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Nicholas J Green, NP

Title

Owner

Phone

(307) 381-8446

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1783555200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1783555200000",
    "number": "1972421576",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 N GOULD ST STE N",
            "city": "SHERIDAN",
            "state": "WY",
            "postal_code": "828016317",
            "telephone_number": "307-381-8446",
            "fax_number": "307-209-5774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 PINE AVE",
            "address_2": "STE 3B",
            "city": "KEMMERER",
            "state": "WY",
            "postal_code": "83101",
            "telephone_number": "307-381-8446",
            "fax_number": "307-209-5774"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PG DIRECT CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-07-09",
        "last_updated": "2026-07-09",
        "certification_date": "2026-06-04",
        "status": "A",
        "authorized_official_last_name": "GREEN",
        "authorized_official_first_name": "NICHOLAS",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "307-381-8446",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• George Christopher Krell, MD
• Tammy Krell, RN, MSN
• Madonna Elizabeth Marie Long
• Ania Mathews, PHARMD
• Novus Wyoming a Professional Corporation
• Ridley's Family Markets Inc (Ridley's pharmacy#1163)
• Robert P. Tyrrell, D.D.S.
• Karl D Robinson, DDS
• Phillip Robert Rutledge, PA
• Carrie Renee Rydstrom

• Family Medicine Physician in Kemmerer, WY
• Providers in Kemmerer, WY by specialty
• Family Medicine Physician in Wyoming

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 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.