Organization Active NPI

Kris Canfield, MD, PC

  • Substance Use Disorder Rehabilitation Hospital Unit
  • Gillette, WY
National Provider Identifier
1992011407
Registry record updated Aug 20, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Use Disorder Rehabilitation Hospital UnitTaxonomy code 276400000X
License
K00-29-6430 Issued in KS
Legal business name
KRIS CANFIELD, MD, PC
Practice address
1001 S Douglas Hwy
Buite B5
Gillette, WY 82716-4924
Phone
(307) 682-7500
Fax
(307) 682-7585
NPI assigned
Aug 20, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2010

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

Authorized official

Name
Dr. Kris Allen Canfield, M.D.NPI 1366441131
Title
General Surgeon
Phone
(307) 682-7500

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Use Disorder Rehabilitation Hospital Unit 276400000X K00-29-6430 KS Primary

Addresses

Primary practice location

1001 S Douglas Hwy
Buite B5
Gillette, WY 82716-4924

Mailing address

PO Box 967
Gillette, WY 82717-0967
Phone (307) 682-7500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20101012000334 WY Part B Supplier - Clinic/Group Practice 9830381680 Receives reassigned benefits from 1 practitioner
Practice locations: Gillette, WY

National Provider Directory

National Provider Directory

Locations

407 S Medical Arts Ct
Ste B
Gillette, WY 82716
Phone (307) 682-7500

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/ABIJAA

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1282262400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1282262400000",
    "number": "1992011407",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 967",
            "city": "GILLETTE",
            "state": "WY",
            "postal_code": "827170967",
            "telephone_number": "307-682-7500",
            "fax_number": "307-682-7585"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 S DOUGLAS HWY",
            "address_2": "BUITE B5",
            "city": "GILLETTE",
            "state": "WY",
            "postal_code": "827164924",
            "telephone_number": "307-682-7500",
            "fax_number": "307-682-7585"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KRIS CANFIELD, MD, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-08-20",
        "last_updated": "2010-08-20",
        "status": "A",
        "authorized_official_last_name": "CANFIELD",
        "authorized_official_first_name": "KRIS",
        "authorized_official_middle_name": "ALLEN",
        "authorized_official_title_or_position": "GENERAL SURGEON",
        "authorized_official_telephone_number": "307-682-7500",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "276400000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation, Substance Use Disorder Unit",
            "state": "KS",
            "license": "K00-29-6430",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Aug 20, 2010; 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.