| Sublette County Hospital District Dba Pinedale Medical Clinic | |
|
625 E Hennick St Pinedale WY 82941-5228 | |
| (307) 367-4133 | |
| (307) 459-8576 |
| Full Name | Sublette County Hospital District Dba Pinedale Medical Clinic |
|---|---|
| Speciality | Family Medicine |
| Location | 625 E Hennick St, Pinedale, Wyoming |
| Authorized Official Name and Position | Rex Walk (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Contact | 3073670150 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Sublette County Hospital District Dba Pinedale Medical Clinic Po Box 627 Pinedale WY 82941-0627 Ph: (307) 367-4133 | Sublette County Hospital District Dba Pinedale Medical Clinic 625 E Hennick St Pinedale WY 82941-5228 Ph: (307) 367-4133 |
| NPI Number | 1104410596 |
|---|---|
| Provider Enumeration Date | 02/25/2021 |
| Last Update Date | 06/23/2026 |
| Medicare PECOS PAC ID | 5496163461 |
|---|---|
| Medicare Enrollment ID | O20210518002474 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104410596 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| 261QU0200X | Clinic/center - Urgent Care | (* (Not Available)) | Secondary |
| Provider Name | Ragnvaldr B Bjornsson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1851379119 PECOS PAC ID: 7810895877 Enrollment ID: I20050330000894 |
| Provider Name | William David Burnett |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1760579023 PECOS PAC ID: 6103808795 Enrollment ID: I20050708000732 |
| Provider Name | Rex Emerson Wortham |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1679580492 PECOS PAC ID: 0749278760 Enrollment ID: I20070104000514 |
| Provider Name | James P Demetriou |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1447298583 PECOS PAC ID: 3779550280 Enrollment ID: I20080415000568 |
| Provider Name | Keri L Hull |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225409477 PECOS PAC ID: 6800199431 Enrollment ID: I20160114001870 |
| Provider Name | Renae Dorrity |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1629293055 PECOS PAC ID: 3971657768 Enrollment ID: I20171129003221 |
| Provider Name | Rafael Hastey |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1871989665 PECOS PAC ID: 6305153362 Enrollment ID: I20220706000192 |
| Provider Name | Andras T. Eder |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1851603146 PECOS PAC ID: 7719359637 Enrollment ID: I20230727002443 |
High Country Behavioral Health Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 24 Country Club Lane, Pinedale, WY 82941 Phone: 307-367-2111 Fax: 307-367-2166 | |
Apogee Medical Group Wyoming Pc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 625 E Hennick St, Pinedale, WY 82941 Phone: 214-592-1329 | |
High Country Behavioral Health Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 24 Country Club Lane, Pinedale, WY 82941 Phone: 307-367-2111 Fax: 307-367-2166 |