| Wyoming State Hospital | |
|
251 Yellowstone River Dr Evanston WY 82930-5340 | |
| (307) 444-0839 | |
| (307) 789-7373 |
| Full Name | Wyoming State Hospital |
|---|---|
| Speciality | Psychiatric Hospital |
| Location | 251 Yellowstone River Dr, Evanston, Wyoming |
| Authorized Official Name and Position | Kristi Barker (BUSINESS MANAGER) |
| Authorized Official Contact | 3074440721 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Wyoming State Hospital Po Box 177 Evanston WY 82931-0177 Ph: (307) 444-0839 | Wyoming State Hospital 251 Yellowstone River Dr Evanston WY 82930-5340 Ph: (307) 444-0839 |
| NPI Number | 1316011562 |
|---|---|
| Provider Enumeration Date | 11/20/2006 |
| Last Update Date | 01/25/2024 |
| Medicare PECOS PAC ID | 4587552583 |
|---|---|
| Medicare Enrollment ID | O20040728001439 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316011562 | NPI | - | NPPES |
| 1316011562 | Other | WY | NATIONAL PROVIDER IDENTIFIER |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | 15163 (Wyoming) | Secondary |
| 283Q00000X | Psychiatric Hospital | 15163 (Wyoming) | Primary |
| Provider Name | Pamela R Fuller |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1053469452 PECOS PAC ID: 0244323566 Enrollment ID: I20070831000642 |
| Provider Name | Cora J Klotzbach |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1356495808 PECOS PAC ID: 3870686199 Enrollment ID: I20070831000644 |
| Provider Name | James K Robinett |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1578529491 PECOS PAC ID: 1658444856 Enrollment ID: I20080722000164 |
| Provider Name | Mary Phillips |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639263650 PECOS PAC ID: 7810922093 Enrollment ID: I20081201000347 |
| Provider Name | Martha M Mueller |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760559876 PECOS PAC ID: 9436207727 Enrollment ID: I20090424000079 |
| Provider Name | James Fleenor |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023394590 PECOS PAC ID: 6103091525 Enrollment ID: I20111214000437 |
| Provider Name | Eric G Roman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700157948 PECOS PAC ID: 4385804863 Enrollment ID: I20120320000659 |
| Provider Name | David W Carrington |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1942323654 PECOS PAC ID: 4385778497 Enrollment ID: I20130213000611 |
| Provider Name | Peter P Heinbecker |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1417992934 PECOS PAC ID: 3072671312 Enrollment ID: I20130819000558 |
| Provider Name | Lauri S Morgan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1568804664 PECOS PAC ID: 9234355207 Enrollment ID: I20140728002103 |
| Provider Name | Howard Leftin |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1295748184 PECOS PAC ID: 0941397194 Enrollment ID: I20150511002353 |
| Provider Name | Mary E Coffeen Carley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598868689 PECOS PAC ID: 3870491020 Enrollment ID: I20150713002592 |
| Provider Name | Thomas A Wilkinson |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1891890117 PECOS PAC ID: 6002086717 Enrollment ID: I20151104000057 |
| Provider Name | Carl Taswell |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1679799266 PECOS PAC ID: 5890769509 Enrollment ID: I20151217002302 |
| Provider Name | Alan L Barnes |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1184712242 PECOS PAC ID: 9133181415 Enrollment ID: I20160526001188 |
| Provider Name | Patricia Lowrimore |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1831194455 PECOS PAC ID: 4688762685 Enrollment ID: I20161011001837 |
| Provider Name | Ryan Paul Hunsaker |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1558809905 PECOS PAC ID: 6406130681 Enrollment ID: I20170307002368 |
| Provider Name | Marie D. Raine |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1245219054 PECOS PAC ID: 8628163540 Enrollment ID: I20170330000722 |
| Provider Name | Priyantha S Wijayagunaratne |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1710012851 PECOS PAC ID: 3577651330 Enrollment ID: I20170621002189 |
| Provider Name | Carolyn J Ewell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760513667 PECOS PAC ID: 4880640515 Enrollment ID: I20180308001546 |
| Provider Name | Jerry K Kubena |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1104023563 PECOS PAC ID: 8022269356 Enrollment ID: I20180405001896 |
| Provider Name | Helen Rosella Chrena |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740406230 PECOS PAC ID: 1355437310 Enrollment ID: I20180420000983 |
| Provider Name | Julie K Krause |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679777148 PECOS PAC ID: 4981733144 Enrollment ID: I20180618000839 |
| Provider Name | Brenda Alexander O Neil |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467905778 PECOS PAC ID: 1658651260 Enrollment ID: I20180711000905 |
| Provider Name | William H Campbell |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1194837369 PECOS PAC ID: 7517871130 Enrollment ID: I20180921002794 |
| Provider Name | Melissa Louise Scott |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205187051 PECOS PAC ID: 9234471616 Enrollment ID: I20190506000765 |
| Provider Name | Bryan D Peltier |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1811346943 PECOS PAC ID: 4183958614 Enrollment ID: I20190702003286 |
| Provider Name | Karen Checketts |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1114336617 PECOS PAC ID: 2668808866 Enrollment ID: I20200206002393 |
| Provider Name | Peter T Pinto |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1134363195 PECOS PAC ID: 2961637574 Enrollment ID: I20200303002414 |
| Provider Name | Elizabeth C Ricciardi |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1467681692 PECOS PAC ID: 1355666058 Enrollment ID: I20200420003167 |
| Provider Name | Kailey Dawn Tarufelli |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861036832 PECOS PAC ID: 6800213687 Enrollment ID: I20200915002252 |
| Provider Name | Mikale N Nowak |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366114472 PECOS PAC ID: 6204226483 Enrollment ID: I20211201003117 |
| Provider Name | Rhonda D Schlegel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760147011 PECOS PAC ID: 6002299401 Enrollment ID: I20230411001484 |
| Provider Name | Sara J Young |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871296137 PECOS PAC ID: 7517324692 Enrollment ID: I20230605002620 |
Evanston Clinic Corp Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 196 Arrowhead Dr Ste 8, Evanston, WY 82930 Phone: 307-783-8365 Fax: 307-783-8284 | |
Mountain Medicine Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 170 Arrowhead Dr, Evanston, WY 82930 Phone: 307-267-2116 | |
Sterling Provider Group Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1952 Harrison Dr Ste 1, Evanston, WY 82930 Phone: 208-542-9111 Fax: 208-542-9114 | |
High Country Behavioral Health Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 190 Overthrust Rd., Evanston, WY 82931 Phone: 307-789-4224 Fax: 307-789-4225 | |
Michael D. Adams, M.d., P.c. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 75 Yellow Creek Rd, Suite 102, Evanston, WY 82930 Phone: 307-789-8290 Fax: 307-789-8290 | |
Evanston Community Health Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 75 Yellow Creek Rd, Suite 102, Evanston, WY 82930 Phone: 307-789-8290 Fax: 307-789-8975 | |
Arrowhead Family Medicine Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 195 Feather Way Ste 100, Evanston, WY 82930 Phone: 307-200-9200 Fax: 307-200-4808 |