NPI Code Detail JSON Logo

1982420311 NPI number — PRATER MOUNTAIN HEALTH CLINIC

NPI Number: 1982420311
Health Care Provider/Practitioner: PRATER MOUNTAIN HEALTH CLINIC

Information about “1982420311” NPI (PRATER MOUNTAIN HEALTH CLINIC) exists in 1982420311 in HTML format HTML  |  1982420311 in plain Text format TXT  |  1982420311 in PDF (Portable Document Format) PDF  |  1982420311 in an XML format XML  formats.

NPI Number : 1982420311 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1982420311",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "PRATER MOUNTAIN HEALTH CLINIC",
    "LastName": null,
    "FirstName": null,
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": null,
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": "6",
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "PO BOX 1179",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "THAYNE",
    "MailingAddressStateName": "WY",
    "MailingAddressPostalCode": "83127-1179",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "307-883-7246",
    "MailingAddressFaxNumber": "307-883-7247",
    "FirstLinePracticeLocationAddress": "118 S MAIN ST",
    "SecondLinePracticeLocationAddress": "SUITE 400",
    "PracticeLocationAddressCityName": "THAYNE",
    "PracticeLocationAddressStateName": "WY",
    "PracticeLocationAddressPostalCode": "83127",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "307-883-7246",
    "PracticeLocationAddressFaxNumber": "307-883-7247",
    "EnumerationDate": "12/02/2024",
    "LastUpdateDate": "02/12/2025",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "SIMPSON",
    "AuthorizedOfficialFirstName": "DARNELL",
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": "PRESIDENT",
    "AuthorizedOfficialNamePrefix": "DR.",
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": "DC",
    "AuthorizedOfficialTelephoneNumber": "307-883-7246",
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "207Q00000X",
          "TaxonomyName": "Family Medicine Physician",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "208D00000X",
          "TaxonomyName": "General Practice Physician",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "261QM1300X",
          "TaxonomyName": "Multi-Specialty Clinic/Center",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": {
      "HealthcareProviderTaxonomyGroup": [
        {
          "HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
          "HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
        },
        {
          "HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
          "HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
        }
      ]
    }
  }
}
                
            

Copyright © 2007-2026 Data Labs Health. All rights reserved.