Prater Mountain Health Clinic

Organization Active NPI Multi-Specialty Clinic/Center · Thayne, WY

NPI 1982420311 · NPPES record last updated Feb 12, 2025

Key facts

NPI
1982420311
Entity type
Organization (NPI type 2)
Primary specialty
Multi-Specialty Clinic/Center 261QM1300X
Legal business name
PRATER MOUNTAIN HEALTH CLINIC
Practice address
118 S Main St
Suite 400
Thayne, WY 83127
Phone
(307) 883-7246
Fax
(307) 883-7247
NPI assigned
Dec 2, 2024
Organization subpart
No

Authorized official

Name
Dr. Darnell Simpson, DC
Title
President
Phone
(307) 883-7246

Practitioners 3

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

Medicare participation

Medicare fee-for-service enrollment
Enrolled in WY

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20250204001523 WY Part B Supplier - Clinic/Group Practice 0648700807 Receives reassigned benefits from 3 practitioners
Practice locations: Thayne, WY

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician
Group: 193200000X MULTI-SPECIALTY GROUP
207Q00000X
General Practice Physician
Group: 193200000X MULTI-SPECIALTY GROUP
208D00000X
Multi-Specialty Clinic/Center 261QM1300X Yes

Addresses

Primary practice location

118 S Main St
Suite 400
Thayne, WY 83127

Mailing address

PO Box 1179
Thayne, WY 83127-1179
Phone (307) 883-7246

Other names

  • Prater Mountain Health Clinic Doing business as

Other providers in Thayne, WY

All providers in Thayne, WY · Multi-Specialty Clinic/Center in Wyoming

Sources for this page

Verify at the official NPI Registry.