| Sheridan Memorial Clinics | |
|
1333 W 5th St Sheridan WY 82801-2752 | |
| (307) 675-2650 | |
| (307) 675-2651 |
| Full Name | Sheridan Memorial Clinics |
|---|---|
| Speciality | Internal Medicine |
| Location | 1333 W 5th St, Sheridan, Wyoming |
| Authorized Official Name and Position | Nathan Stutte (CFO) |
| Authorized Official Contact | 3076721000 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Sheridan Memorial Clinics 1333 W 5th St Ste 110 Sheridan WY 82801-2752 Ph: (307) 675-2649 | Sheridan Memorial Clinics 1333 W 5th St Sheridan WY 82801-2752 Ph: (307) 675-2650 |
| NPI Number | 1861722688 |
|---|---|
| Provider Enumeration Date | 12/29/2009 |
| Last Update Date | 12/15/2025 |
| Certification Date | 12/15/2025 |
| Medicare PECOS PAC ID | 1254476484 |
|---|---|
| Medicare Enrollment ID | O20100226000582 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1861722688 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | () | Primary |
| Provider Name | Michael W Brennan |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1619903705 PECOS PAC ID: 3971405929 Enrollment ID: I20040413000636 |
| Provider Name | Tanja L Sloan |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1225046139 PECOS PAC ID: 1658273602 Enrollment ID: I20050922000855 |
| Provider Name | Anthony B Quinn |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1083637920 PECOS PAC ID: 8820022239 Enrollment ID: I20050926000163 |
| Provider Name | Brenton F Milner |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1780644393 PECOS PAC ID: 0446284855 Enrollment ID: I20050926000186 |
| Provider Name | Corey J Jost |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1700914306 PECOS PAC ID: 3476582321 Enrollment ID: I20060126000839 |
| Provider Name | Derek H Gilbert |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1477665925 PECOS PAC ID: 6305815317 Enrollment ID: I20060302000595 |
| Provider Name | Laura M Ferries |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1700827557 PECOS PAC ID: 9335151174 Enrollment ID: I20060619000244 |
| Provider Name | Tracy L Jons |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1588614895 PECOS PAC ID: 9537255062 Enrollment ID: I20071015000481 |
| Provider Name | Barry E Mangus |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1063627115 PECOS PAC ID: 1557449089 Enrollment ID: I20080423000490 |
| Provider Name | Erin S Strahan |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1396995890 PECOS PAC ID: 8729140132 Enrollment ID: I20081218000634 |
| Provider Name | James a Ulibarri |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1578586269 PECOS PAC ID: 4789680539 Enrollment ID: I20090511000435 |
| Provider Name | Jeremy P Zebroski |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1497840318 PECOS PAC ID: 3375697428 Enrollment ID: I20090824000721 |
| Provider Name | Brian D Laman |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1396794152 PECOS PAC ID: 0143375246 Enrollment ID: I20090825000555 |
| Provider Name | Shaun J Gonda |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1881810596 PECOS PAC ID: 3476608910 Enrollment ID: I20090904000059 |
| Provider Name | Jason L Otto |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1558697177 PECOS PAC ID: 1355483108 Enrollment ID: I20100118000084 |
| Provider Name | Sara C Smith Maguire |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1245280148 PECOS PAC ID: 7810992179 Enrollment ID: I20100224000836 |
| Provider Name | Jennifer a Graslie |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1699959593 PECOS PAC ID: 7517049810 Enrollment ID: I20110216000262 |
| Provider Name | Autumn a Barrett |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1174893614 PECOS PAC ID: 9234390808 Enrollment ID: I20120409000648 |
| Provider Name | Cheryl L Varner |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1568443398 PECOS PAC ID: 2567447329 Enrollment ID: I20120522001323 |
| Provider Name | Joseph R Garcia |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1376686329 PECOS PAC ID: 4789646761 Enrollment ID: I20120920000788 |
| Provider Name | Kimberlee D Williams |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356696371 PECOS PAC ID: 1456501287 Enrollment ID: I20121101000091 |
| Provider Name | Angela L Knutson |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1417915950 PECOS PAC ID: 3678596905 Enrollment ID: I20121205000317 |
| Provider Name | Mary E Widener |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1508164856 PECOS PAC ID: 2567603210 Enrollment ID: I20130723000954 |
| Provider Name | Kelly E Lieb |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1568615219 PECOS PAC ID: 1951462050 Enrollment ID: I20130807000298 |
| Provider Name | Luke a Goddard |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1821300013 PECOS PAC ID: 5395988067 Enrollment ID: I20130828000167 |
| Provider Name | Juli a Ackerman |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1619292927 PECOS PAC ID: 3274777198 Enrollment ID: I20130916000531 |
| Provider Name | Jason D Ackerman |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1396060604 PECOS PAC ID: 3779727607 Enrollment ID: I20130916000596 |
| Provider Name | Becky L Olson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679772677 PECOS PAC ID: 9830333574 Enrollment ID: I20130918000603 |
| Provider Name | Rebecca R Franklund |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1881820256 PECOS PAC ID: 9537303979 Enrollment ID: I20130925000026 |
| Provider Name | David E Nickerson |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1982922001 PECOS PAC ID: 9436302445 Enrollment ID: I20131009000854 |
| Provider Name | David C Walker |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1639142508 PECOS PAC ID: 7719897636 Enrollment ID: I20131011000825 |
| Provider Name | Hannah M Hall |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1124343934 PECOS PAC ID: 7719111483 Enrollment ID: I20131011000924 |
| Provider Name | Sarah a Sommers |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1699100826 PECOS PAC ID: 0042445025 Enrollment ID: I20131029000486 |
| Provider Name | William B Taylor |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1447423322 PECOS PAC ID: 1456591015 Enrollment ID: I20140711001687 |
| Provider Name | Lisa M Mullen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1629364377 PECOS PAC ID: 9436396272 Enrollment ID: I20140925001204 |
| Provider Name | Amanda M Mcintire |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407265515 PECOS PAC ID: 1951523679 Enrollment ID: I20141113001550 |
| Provider Name | Tracy M Wickersham-frey |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1447653456 PECOS PAC ID: 0042539595 Enrollment ID: I20150505000395 |
| Provider Name | Kristopher C Schamber |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1942590054 PECOS PAC ID: 0840428116 Enrollment ID: I20150623003122 |
| Provider Name | Benjamin R Widener |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1487944484 PECOS PAC ID: 1052539111 Enrollment ID: I20150626000493 |
| Provider Name | Robin K Horsley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447671920 PECOS PAC ID: 4688982374 Enrollment ID: I20150929003229 |
| Provider Name | Jason E Grennan |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1457313314 PECOS PAC ID: 9830179092 Enrollment ID: I20160824001079 |
| Provider Name | Laci Dawn Little |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114396892 PECOS PAC ID: 5395053631 Enrollment ID: I20160908002154 |
| Provider Name | Erica D Rinker |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1679860597 PECOS PAC ID: 5597914846 Enrollment ID: I20160915002565 |
| Provider Name | Jonathan Jaksha |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1871555649 PECOS PAC ID: 3274632054 Enrollment ID: I20160921002082 |
| Provider Name | Mohammed Quraishi |
|---|---|
| Provider Type | Practitioner - Interventional Radiology |
| Provider Identifiers | NPI Number: 1871545269 PECOS PAC ID: 8123030814 Enrollment ID: I20160927000280 |
| Provider Name | Diana Rose Charlson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689129116 PECOS PAC ID: 0143518092 Enrollment ID: I20161010002129 |
| Provider Name | Rebekah J Montgomery |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215482195 PECOS PAC ID: 1951681345 Enrollment ID: I20161130001537 |
| Provider Name | Sean M Schoonover |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1366998437 PECOS PAC ID: 9931480076 Enrollment ID: I20170726002599 |
| Provider Name | Kenneth C Mckenzie |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1356744890 PECOS PAC ID: 2668795188 Enrollment ID: I20170830003121 |
| Provider Name | Sierra Dawn Gross |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1649698366 PECOS PAC ID: 1557588779 Enrollment ID: I20171016002766 |
| Provider Name | Jessica Neau |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1366890097 PECOS PAC ID: 5991063315 Enrollment ID: I20171227002679 |
| Provider Name | Lindsay Capron |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1447664412 PECOS PAC ID: 6608166806 Enrollment ID: I20180924000755 |
| Provider Name | Justin N Steinert |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1982965216 PECOS PAC ID: 8224273602 Enrollment ID: I20181105000813 |
| Provider Name | Christopher M Prior |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1487670717 PECOS PAC ID: 0042314569 Enrollment ID: I20190903002078 |
| Provider Name | David Henley |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1770518128 PECOS PAC ID: 2769374032 Enrollment ID: I20191118002842 |
| Provider Name | Jeffrey Anton Shideman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699316430 PECOS PAC ID: 7214361641 Enrollment ID: I20191218000724 |
| Provider Name | Elisabeth Marie Scalva |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1295173821 PECOS PAC ID: 3072802545 Enrollment ID: I20200702001974 |
| Provider Name | Elise Sylar |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1568994176 PECOS PAC ID: 3375968522 Enrollment ID: I20200804003742 |
| Provider Name | Pattie Visscher |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1912587882 PECOS PAC ID: 0840690285 Enrollment ID: I20210607002209 |
| Provider Name | Natalie R Mcclanahan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467033241 PECOS PAC ID: 0840691929 Enrollment ID: I20210628000197 |
| Provider Name | Tyler Slyngstad |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1134495104 PECOS PAC ID: 5597054494 Enrollment ID: I20210716000920 |
| Provider Name | Daniel D Holst |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1174974828 PECOS PAC ID: 8729485107 Enrollment ID: I20210928001565 |
| Provider Name | Rebecca Krzyminski |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1104185065 PECOS PAC ID: 8426378696 Enrollment ID: I20220711003266 |
| Provider Name | Derek Redinger |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1265963698 PECOS PAC ID: 9032548284 Enrollment ID: I20220713003217 |
| Provider Name | Joshua Scott |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1023240108 PECOS PAC ID: 4587848197 Enrollment ID: I20220815002019 |
| Provider Name | Jory N Wasserburger |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1548624901 PECOS PAC ID: 9830482769 Enrollment ID: I20220826002613 |
| Provider Name | Timothy Conner |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1750385357 PECOS PAC ID: 6709784119 Enrollment ID: I20221010001100 |
| Provider Name | Kathryn Cambron |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1396749867 PECOS PAC ID: 8224016530 Enrollment ID: I20221014000503 |
| Provider Name | Waheed Jalalzai |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1669444246 PECOS PAC ID: 6305816513 Enrollment ID: I20221014001430 |
| Provider Name | Shawn Timothy Stone |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1891040689 PECOS PAC ID: 6103103569 Enrollment ID: I20221014001557 |
| Provider Name | Jarret Kuo |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1720228778 PECOS PAC ID: 0446495626 Enrollment ID: I20221014001579 |
| Provider Name | Shannon L St Clair |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1881030997 PECOS PAC ID: 3678714268 Enrollment ID: I20221014001614 |
| Provider Name | Stanley Smith |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1003802968 PECOS PAC ID: 4082527205 Enrollment ID: I20221014001705 |
| Provider Name | Allison Summers |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1316926272 PECOS PAC ID: 1052366267 Enrollment ID: I20221017003075 |
| Provider Name | Veronica Y Ruvo |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1740252725 PECOS PAC ID: 4183523855 Enrollment ID: I20221019001840 |
| Provider Name | Scott White |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1144276338 PECOS PAC ID: 4385745215 Enrollment ID: I20221107003073 |
| Provider Name | David Lin |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1851326557 PECOS PAC ID: 7719984210 Enrollment ID: I20221108003643 |
| Provider Name | Brielle Pagett |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1649851080 PECOS PAC ID: 5395115448 Enrollment ID: I20230105002151 |
| Provider Name | Emily Denney |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1275832057 PECOS PAC ID: 2668775743 Enrollment ID: I20230112000553 |
| Provider Name | Colin Thompson |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1467615252 PECOS PAC ID: 5597982694 Enrollment ID: I20230315002202 |
| Provider Name | Jake Vrdoljak |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1619976230 PECOS PAC ID: 8527253400 Enrollment ID: I20230424000453 |
| Provider Name | Allison Dawson |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1114589256 PECOS PAC ID: 6800122813 Enrollment ID: I20230926003494 |
| Provider Name | Krista Frank |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346888161 PECOS PAC ID: 4082041777 Enrollment ID: I20230928001975 |
| Provider Name | Erin Henderson |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1063663102 PECOS PAC ID: 2163694803 Enrollment ID: I20231114001344 |
| Provider Name | Daniel L Peterson |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1437536786 PECOS PAC ID: 0648576447 Enrollment ID: I20231207002348 |
| Provider Name | Susan Kreager |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1881134500 PECOS PAC ID: 3678991353 Enrollment ID: I20240129000537 |
| Provider Name | Joseph Schmidt |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780100917 PECOS PAC ID: 5890068894 Enrollment ID: I20240226001490 |
| Provider Name | Claire Buckingham |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598230724 PECOS PAC ID: 1456697440 Enrollment ID: I20240418001462 |
| Provider Name | Robert C Anton |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1801816814 PECOS PAC ID: 3577461284 Enrollment ID: I20240715003638 |
| Provider Name | Sean Feinberg |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1104273549 PECOS PAC ID: 3476952557 Enrollment ID: I20240730001223 |
| Provider Name | Jesse Knight |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1770740854 PECOS PAC ID: 9133304058 Enrollment ID: I20240730001402 |
| Provider Name | Michael Wilson |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1568652147 PECOS PAC ID: 3577638204 Enrollment ID: I20240730002094 |
| Provider Name | Douglas Green |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1164635173 PECOS PAC ID: 0042489668 Enrollment ID: I20240730002556 |
| Provider Name | David Bodne |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1316944697 PECOS PAC ID: 6204936206 Enrollment ID: I20240730002877 |
| Provider Name | Peter Britt |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1023012010 PECOS PAC ID: 1850376096 Enrollment ID: I20240730004068 |
| Provider Name | Clinton Salyards |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1154065753 PECOS PAC ID: 7416494786 Enrollment ID: I20240805000887 |
| Provider Name | Abigail Turnbough |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1073073144 PECOS PAC ID: 3870960909 Enrollment ID: I20240816001972 |
| Provider Name | Poyan Rafiei |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1225290380 PECOS PAC ID: 1850517251 Enrollment ID: I20240820001844 |
| Provider Name | Jason Rogers |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1366885840 PECOS PAC ID: 4789927260 Enrollment ID: I20240820002247 |
| Provider Name | Kimia Khalatbari Kani |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1700028131 PECOS PAC ID: 5991856098 Enrollment ID: I20240924001894 |
| Provider Name | Kyle Seeley |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1326382490 PECOS PAC ID: 6103358379 Enrollment ID: I20241011003725 |
| Provider Name | Steven M Beverly |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1700878279 PECOS PAC ID: 8527115740 Enrollment ID: I20241029004223 |
| Provider Name | Michael Kinney |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1144857012 PECOS PAC ID: 1759747058 Enrollment ID: I20241205001036 |
| Provider Name | Marcella Wildeman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285185231 PECOS PAC ID: 3375823693 Enrollment ID: I20250107000293 |
| Provider Name | Matthew Bourne |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1619437779 PECOS PAC ID: 8325587264 Enrollment ID: I20250121003526 |
| Provider Name | Laura Fischer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487308904 PECOS PAC ID: 3779977640 Enrollment ID: I20250310001919 |
| Provider Name | Eric Munoz |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1952626079 PECOS PAC ID: 8820261365 Enrollment ID: I20250312003454 |
| Provider Name | Jeffrey Joseph Hebert |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1407824972 PECOS PAC ID: 7517947955 Enrollment ID: I20250408002021 |
| Provider Name | Muneer J Desai |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1376516021 PECOS PAC ID: 4688645591 Enrollment ID: I20250415001295 |
| Provider Name | Bryan Thomas Suchecki |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1184686933 PECOS PAC ID: 7416119540 Enrollment ID: I20250423002752 |
| Provider Name | Yuyang Zhang |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1538304035 PECOS PAC ID: 4880833615 Enrollment ID: I20250428000848 |
| Provider Name | Karen Phillips |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1801992813 PECOS PAC ID: 8729024161 Enrollment ID: I20250502002949 |
| Provider Name | Zi Rong Xu |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1114258191 PECOS PAC ID: 3173657624 Enrollment ID: I20250505002039 |
| Provider Name | Kyle David Hirschman |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1801175401 PECOS PAC ID: 2466686126 Enrollment ID: I20250625002142 |
| Provider Name | Travis Petree |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1487604625 PECOS PAC ID: 0648216291 Enrollment ID: I20250708002861 |
| Provider Name | Katie Mischke |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1457828238 PECOS PAC ID: 7810235504 Enrollment ID: I20250722002681 |
| Provider Name | Le Yu Chiu |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1457812042 PECOS PAC ID: 0941744692 Enrollment ID: I20250905001373 |
| Provider Name | Adham Shoujaa |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1407319064 PECOS PAC ID: 4688114952 Enrollment ID: I20251119002788 |
| Provider Name | Frank Welte |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1568676948 PECOS PAC ID: 6800933847 Enrollment ID: I20251119004322 |
| Provider Name | Lauren Q Gilkerson |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1679764195 PECOS PAC ID: 3173016490 Enrollment ID: I20251204004088 |
| Provider Name | Alexander Macrae Harvin |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1295097970 PECOS PAC ID: 5496044612 Enrollment ID: I20251209002540 |
| Provider Name | Trevor K Lewis |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1114307287 PECOS PAC ID: 7911217005 Enrollment ID: I20260123002012 |
| Provider Name | Sean Chia Chang |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1801108568 PECOS PAC ID: 8325216518 Enrollment ID: I20260211001655 |
| Provider Name | Andrew Ciccarelli |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1407893738 PECOS PAC ID: 9436162302 Enrollment ID: I20260211001765 |
| Provider Name | Oded Greenberg |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1003892928 PECOS PAC ID: 0840341533 Enrollment ID: I20260212002455 |
| Provider Name | Jonathan Reed |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1588653075 PECOS PAC ID: 3577669928 Enrollment ID: I20260212002589 |
| Provider Name | Ron Pearson |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1578901963 PECOS PAC ID: 3971747650 Enrollment ID: I20260212003012 |
| Provider Name | Randall Snyder |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1295729598 PECOS PAC ID: 3072544485 Enrollment ID: I20260219004338 |
| Provider Name | Dillenia Rosica |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1679893820 PECOS PAC ID: 4880914845 Enrollment ID: I20260302003689 |
| Provider Name | Alice Catherine Shaw |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063020279 PECOS PAC ID: 3274916994 Enrollment ID: I20260313003079 |
| Provider Name | Steven Black |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1609808369 PECOS PAC ID: 1951356583 Enrollment ID: I20260408002505 |
| Provider Name | Nicholas Levi Henson |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1255599825 PECOS PAC ID: 3375776461 Enrollment ID: I20260511003410 |
| Provider Name | Ian Landis |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1699394486 PECOS PAC ID: 3678092707 Enrollment ID: I20260622003305 |
Goose Creek Family Practice, P.C. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 304 Coffeen Ave, Suite A, Sheridan, WY 82801 Phone: 307-674-1744 Fax: 307-674-1752 |
Sheridan Family Practice, P.C. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1435 Burton St, Sheridan, WY 82801 Phone: 307-672-0763 Fax: 307-672-0766 |
Elite Medical and Vitality LLC Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1309 Coffeen Ave Ste 1200, Sheridan, WY 82801 Phone: 559-331-1649 |
Alvara Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 30 N Gould St Ste R, Sheridan, WY 82801 Phone: 307-434-9828 |
Child Development Center Region 2 Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 345 S Linden Ave, Sheridan, WY 82801 Phone: 307-672-6610 Fax: 307-674-5947 |
Goose Creek Dental Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 642 Val Vista St Ste B, Sheridan, WY 82801 Phone: 307-655-8661 Fax: 307-655-8662 |