Clear Image Laser Studio

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

License

9206-1081 Issued in WY

Legal business name

CLEAR IMAGE LASER STUDIO

Practice address

532 Val Vista St
Suite 104
Sheridan, WY 82801-3655

Phone

(307) 655-8289

Fax

(307) 655-8291

NPI assigned

Jun 4, 2013

Last updated

Jun 4, 2013By 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

Brenda Sue Mosher, FNP

Title

FNP

Phone

(307) 259-2434

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Linda Stone-Soukup, NP-C

  • Primary Care Nurse Practitioner
  • Gillette, WY
  • NPI 1225366081
  NPD (past)

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

{
    "created_epoch": "1370304000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1370304000000",
    "number": "1992143648",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "532 VAL VISTA ST",
            "address_2": "SUITE 104",
            "city": "SHERIDAN",
            "state": "WY",
            "postal_code": "828013655",
            "telephone_number": "307-655-8289",
            "fax_number": "307-655-8291"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "532 VAL VISTA ST",
            "address_2": "SUITE 104",
            "city": "SHERIDAN",
            "state": "WY",
            "postal_code": "828013655",
            "telephone_number": "307-655-8289",
            "fax_number": "307-655-8291"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLEAR IMAGE LASER STUDIO",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-06-04",
        "last_updated": "2013-06-04",
        "status": "A",
        "authorized_official_last_name": "MOSHER",
        "authorized_official_first_name": "BRENDA",
        "authorized_official_middle_name": "SUE",
        "authorized_official_title_or_position": "FNP",
        "authorized_official_telephone_number": "307-259-2434",
        "authorized_official_credential": "FNP"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "WY",
            "license": "9206-1081",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carol Clark, BA PSYCHOLOGY
• Jeffrey P. Clark, PSY.D.
• Mindy Clason
• Clay Smith MD PC
• Clear Eir Wellness, LLC
• Amy Marie Clearwater
• Alison L Clement, AA, CAP, CRPS, NCACI
• Diana Marie Cline, LCSW -706 LCSW
• Cloud Peak Endodontics, P.C.
• Cloud Peak Initiatives Inc.

• Primary Care Clinic/Center in Sheridan, WY
• Providers in Sheridan, WY by specialty
• Primary Care Clinic/Center in Wyoming

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2013; 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.