| Summit Memorial Medical Group LLC | |
|
6500 E 2nd St Casper WY 82609-4338 | |
| (307) 577-1000 | |
| Not Available |
| Full Name | Summit Memorial Medical Group LLC |
|---|---|
| Speciality | General Practice |
| Location | 6500 E 2nd St, Casper, Wyoming |
| Authorized Official Name and Position | James Cussins (CFO) |
| Authorized Official Contact | 3072866738 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Summit Memorial Medical Group LLC 222 S 5th St Douglas WY 82633-2534 Ph: (307) 358-1459 | Summit Memorial Medical Group LLC 6500 E 2nd St Casper WY 82609-4338 Ph: (307) 577-1000 |
| NPI Number | 1598469462 |
|---|---|
| Provider Enumeration Date | 03/27/2023 |
| Last Update Date | 10/16/2024 |
| Certification Date | 10/16/2024 |
| Medicare PECOS PAC ID | 1254876683 |
|---|---|
| Medicare Enrollment ID | O20240710002657 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1598469462 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | () | Primary |
| Provider Name | Jonathan P Binder |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1841214954 PECOS PAC ID: 0941291405 Enrollment ID: I20040521001379 |
| Provider Name | Carissa Dawn Briddle |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1376635581 PECOS PAC ID: 3971594482 Enrollment ID: I20040522000353 |
| Provider Name | Joseph K Schoeber |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1740233071 PECOS PAC ID: 6709775075 Enrollment ID: I20040623000332 |
| Provider Name | Todd a Hammond |
|---|---|
| Provider Type | Practitioner - Pain Management |
| Provider Identifiers | NPI Number: 1659359610 PECOS PAC ID: 4183683410 Enrollment ID: I20041004000516 |
| Provider Name | Angelo Mario Santiago |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1598792483 PECOS PAC ID: 0749249860 Enrollment ID: I20041006000204 |
| Provider Name | Amy Maxson |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1245332337 PECOS PAC ID: 9537158936 Enrollment ID: I20041214001159 |
| Provider Name | Joseph Mickelson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1467448043 PECOS PAC ID: 2668365008 Enrollment ID: I20050822000307 |
| Provider Name | Sherrill a Fox |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1124034566 PECOS PAC ID: 0345244851 Enrollment ID: I20060913000619 |
| Provider Name | Matthew Mitchell |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1386695310 PECOS PAC ID: 5496856528 Enrollment ID: I20070719000477 |
| Provider Name | Geoffrey Sherman |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1275787087 PECOS PAC ID: 3971665001 Enrollment ID: I20081223000464 |
| Provider Name | Brehan Newell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922335579 PECOS PAC ID: 0840332110 Enrollment ID: I20100126000750 |
| Provider Name | David Barahal |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1093803918 PECOS PAC ID: 7012049224 Enrollment ID: I20100722000759 |
| Provider Name | Eric Schubert |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1275594467 PECOS PAC ID: 6901808054 Enrollment ID: I20111116000964 |
| Provider Name | Kerry K Fischer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437522125 PECOS PAC ID: 7012217557 Enrollment ID: I20151204001554 |
| Provider Name | Gordon T Erickson |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1194033530 PECOS PAC ID: 7416256045 Enrollment ID: I20160503000230 |
| Provider Name | Jamie C Kidder |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114402849 PECOS PAC ID: 1254677487 Enrollment ID: I20190109002197 |
| Provider Name | Jennifer Ella Wagy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861042392 PECOS PAC ID: 2567896061 Enrollment ID: I20191216001545 |
| Provider Name | Sara M Thronburg |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225662216 PECOS PAC ID: 0840620951 Enrollment ID: I20200413003035 |
| Provider Name | Kourtney E White |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1184212441 PECOS PAC ID: 3971918913 Enrollment ID: I20210224002287 |
| Provider Name | Cristian Adrian Balcescu |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1306231832 PECOS PAC ID: 8426489022 Enrollment ID: I20210721003224 |
| Provider Name | Brittany Myers |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1396237889 PECOS PAC ID: 5799012183 Enrollment ID: I20220815001699 |
| Provider Name | Keith L Murdock |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1326305509 PECOS PAC ID: 6901112614 Enrollment ID: I20220818002955 |
| Provider Name | Joseph Gutman |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1780633875 PECOS PAC ID: 9234298027 Enrollment ID: I20221026001414 |
| Provider Name | Jacob a Ehlert |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1073397113 PECOS PAC ID: 4284087974 Enrollment ID: I20240130000540 |
| Provider Name | Danielle N Clarke |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861180473 PECOS PAC ID: 5597109454 Enrollment ID: I20240219002626 |
| Provider Name | Bengt Grua |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1275093650 PECOS PAC ID: 6305171554 Enrollment ID: I20240815000207 |
| Provider Name | Phillip Kravetz |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1881660264 PECOS PAC ID: 9830151703 Enrollment ID: I20240820001784 |
| Provider Name | Robert Shawhan |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1841581287 PECOS PAC ID: 8921315581 Enrollment ID: I20240906001023 |
| Provider Name | Elias Hsu |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1902077332 PECOS PAC ID: 3577638188 Enrollment ID: I20241105004130 |
| Provider Name | Rebecca Yuko Mabie |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1184206898 PECOS PAC ID: 3678974383 Enrollment ID: I20250103003142 |
| Provider Name | Mrinal MD Dhar |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1417275256 PECOS PAC ID: 8325234271 Enrollment ID: I20250108002439 |
| Provider Name | Mona Nesrallah |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1073769535 PECOS PAC ID: 9638329873 Enrollment ID: I20250120000520 |
| Provider Name | Kenneth S Yun |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1780916833 PECOS PAC ID: 3971797978 Enrollment ID: I20250403003064 |
| Provider Name | John Peck |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1891895538 PECOS PAC ID: 4183523194 Enrollment ID: I20250414002090 |
| Provider Name | Joseph P Coppola |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1013969583 PECOS PAC ID: 6002702321 Enrollment ID: I20250730002979 |
| Provider Name | Justin Graff |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1699304345 PECOS PAC ID: 1456859750 Enrollment ID: I20250806004350 |
| Provider Name | Kody James Wheeler |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881573467 PECOS PAC ID: 3274026877 Enrollment ID: I20251202003753 |
| Provider Name | Savannah Marie Cardenas |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033094941 PECOS PAC ID: 4880188721 Enrollment ID: I20251209002483 |
| Provider Name | Branden Lassen |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1932631157 PECOS PAC ID: 8022386994 Enrollment ID: I20251217001143 |
| Provider Name | Marc Dicklin |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1205837408 PECOS PAC ID: 7719876655 Enrollment ID: I20260212002436 |
| Provider Name | Jackson Wagoner |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1689137408 PECOS PAC ID: 6305269382 Enrollment ID: I20260219002020 |
| Provider Name | Jeffrey Lyons |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1851386908 PECOS PAC ID: 7911924501 Enrollment ID: I20260520004164 |
Wyocity Medical Group LLC Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 940 E 3rd St Ste 205, Casper, WY 82601 Phone: 307-394-1341 |
Gunflint Eye Care, LLC Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 10577 Bishop Rd, Casper, WY 82604 Phone: 307-439-0100 |
Banner Health Physicians West LLC Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1020 E 2nd St Ste 201, Casper, WY 82601 Phone: 307-233-0250 |
Western Medical Associates, LLC Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2546 E 2nd St, Suite 600, Casper, WY 82609 Phone: 307-265-3737 Fax: 307-265-3700 |
Rocky Mountain Family Medicine LLC Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 5840 E 2nd St. Suite 200, Casper, WY 82601 Phone: 307-315-6133 Fax: 307-315-6134 |
Imed Hrs Casper Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1233 E 2nd St, Casper, WY 82601 Phone: 801-507-3500 |