St John's Health - Medicare Primary Care in Jackson, WY

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St John's Health is a medicare enrolled primary clinic (General Practice) in Jackson, Wyoming. The current practice location for St John's Health is 625 E Broadway Ave, Jackson, Wyoming. For appointments, you can reach them via phone at (307) 733-3636. The mailing address for St John's Health is Po Box 428, Jackson, Wyoming and phone number is (307) 733-3636.

St John's Health is licensed to practice in Wyoming (license number 15109). The clinic also participates in the medicare program and its NPI number is 1487818605. This medical practice accepts medicare insurance (which means this clinic accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance). However, please confirm if they accept your insurance at (307) 733-3636.

Contact Information

St John's Health
625 E Broadway Ave
Jackson
WY 83001-8642
(307) 733-3636
(877) 205-2024

Map and Direction


Primary Care Clinic Profile

Full NameSt John's Health
SpecialityGeneral Practice
Location625 E Broadway Ave, Jackson, Wyoming
Authorized Official Name and PositionJohn Kren (COO/CFO)
Authorized Official Contact3077397526
Accepts Medicare InsuranceYes. This clinic participates in medicare program and accept medicare insurance.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
St John's Health
Po Box 428
Jackson
WY 83001-0428

Ph: (307) 733-3636		St John's Health
625 E Broadway Ave
Jackson
WY 83001-8642

Ph: (307) 733-3636

NPI Details:

NPI Number1487818605
Provider Enumeration Date07/16/2008
Last Update Date03/17/2022

Medicare PECOS Information:

Medicare PECOS PAC ID4880582295
Medicare Enrollment IDO20040308000954

Medical Identifiers

Medical identifiers for St John's Health such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1487818605NPI-NPPES
806430200MedicaidID
1062999-09MedicaidWY

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
208D00000XGeneral Practice 15109 (Wyoming)Primary
273Y00000XRehabilitation Unit (* (Not Available))Secondary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. St John's Health acts as a billing entity for following providers:
Provider NameLaura M Vignaroli
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1639249550
PECOS PAC ID: 6103810445
Enrollment ID: I20040412000246
Provider NameWilliam R Smith
Provider TypePractitioner - Emergency Medicine
Provider IdentifiersNPI Number: 1003922360
PECOS PAC ID: 5496727224
Enrollment ID: I20040811000697
Provider NameLisa J Finkelstein
Provider TypePractitioner - Urology
Provider IdentifiersNPI Number: 1689787566
PECOS PAC ID: 4385612738
Enrollment ID: I20040922001201
Provider NameMarc Domsky
Provider TypePractitioner - Anesthesiology
Provider IdentifiersNPI Number: 1821103268
PECOS PAC ID: 5991745101
Enrollment ID: I20050506000590
Provider NameAlbert Richard Wheeler
Provider TypePractitioner - Emergency Medicine
Provider IdentifiersNPI Number: 1780797050
PECOS PAC ID: 9739114711
Enrollment ID: I20050928000859
Provider NameKerry Brooke Carr
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1285716746
PECOS PAC ID: 8527049857
Enrollment ID: I20051105000328
Provider NameKaren E Worman
Provider TypePractitioner - Certified Registered Nurse Anesthetist (crna)
Provider IdentifiersNPI Number: 1871560102
PECOS PAC ID: 5991777278
Enrollment ID: I20061207000152
Provider NameDavid J Tomlinson
Provider TypePractitioner - Anesthesiology
Provider IdentifiersNPI Number: 1851350292
PECOS PAC ID: 7012945751
Enrollment ID: I20061218000163
Provider NameDavid P Kappenman
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1134149958
PECOS PAC ID: 9335174788
Enrollment ID: I20070213000569
Provider NameMichael J Menolascino
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1447364245
PECOS PAC ID: 3476641549
Enrollment ID: I20071127000195
Provider NameShawn B Wright
Provider TypePractitioner - Certified Registered Nurse Anesthetist (crna)
Provider IdentifiersNPI Number: 1003857624
PECOS PAC ID: 7012907058
Enrollment ID: I20080211000173
Provider NameRichard W Carver
Provider TypePractitioner - Certified Registered Nurse Anesthetist (crna)
Provider IdentifiersNPI Number: 1083785281
PECOS PAC ID: 8325127632
Enrollment ID: I20080512000113
Provider NameJames R Little
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1336169036
PECOS PAC ID: 2466477971
Enrollment ID: I20080807000452
Provider NameMartin S Trott
Provider TypePractitioner - Otolaryngology
Provider IdentifiersNPI Number: 1245339456
PECOS PAC ID: 7315923364
Enrollment ID: I20080915000053
Provider NameJenaneta S Hampton
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1396817516
PECOS PAC ID: 2769546472
Enrollment ID: I20090126000049
Provider NameMichael Rosenberg
Provider TypePractitioner - General Surgery
Provider IdentifiersNPI Number: 1659345221
PECOS PAC ID: 6305900028
Enrollment ID: I20090126000052
Provider NameJeffrey D Greenbaum
Provider TypePractitioner - Emergency Medicine
Provider IdentifiersNPI Number: 1649383001
PECOS PAC ID: 5092909622
Enrollment ID: I20101028000012
Provider NameSharon Eskam
Provider TypePractitioner - Obstetrics/gynecology
Provider IdentifiersNPI Number: 1629095310
PECOS PAC ID: 1153379367
Enrollment ID: I20101109000049
Provider NameJohn H Ward
Provider TypePractitioner - Hematology/oncology
Provider IdentifiersNPI Number: 1831289420
PECOS PAC ID: 2769451616
Enrollment ID: I20101117001484
Provider NameMark B Bromberg
Provider TypePractitioner - Neurology
Provider IdentifiersNPI Number: 1164517009
PECOS PAC ID: 5890757421
Enrollment ID: I20101119000920
Provider NameMartha G Stearn
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1285748343
PECOS PAC ID: 9537356290
Enrollment ID: I20101207000432
Provider NameRoseanne R Prince
Provider TypePractitioner - Qualified Audiologist
Provider IdentifiersNPI Number: 1093996449
PECOS PAC ID: 2567634728
Enrollment ID: I20111012000119
Provider NameChristine H Turner
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1194914747
PECOS PAC ID: 2567541550
Enrollment ID: I20111026000123
Provider NameDavid R Renner
Provider TypePractitioner - Neurology
Provider IdentifiersNPI Number: 1396835914
PECOS PAC ID: 6204897861
Enrollment ID: I20120216000248
Provider NameLayne E Lash
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1851661284
PECOS PAC ID: 7719145747
Enrollment ID: I20120222000870
Provider NameWeston Marshall Swindlehurst
Provider TypePractitioner - Certified Registered Nurse Anesthetist (crna)
Provider IdentifiersNPI Number: 1952628505
PECOS PAC ID: 0547449126
Enrollment ID: I20120615000327
Provider NameMarcia Lux
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1972531572
PECOS PAC ID: 5395714547
Enrollment ID: I20120803000646
Provider NameDaniel Anthony Nelson
Provider TypePractitioner - Emergency Medicine
Provider IdentifiersNPI Number: 1447488135
PECOS PAC ID: 2860637345
Enrollment ID: I20130404000319
Provider NameKathryn M Noyes
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1194969048
PECOS PAC ID: 8426294398
Enrollment ID: I20130419000126
Provider NameCecelia A. Tramburg
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1942648365
PECOS PAC ID: 8224270400
Enrollment ID: I20130821000239
Provider NameLeah N Gibson
Provider TypePractitioner - Certified Registered Nurse Anesthetist (crna)
Provider IdentifiersNPI Number: 1376964544
PECOS PAC ID: 0244453801
Enrollment ID: I20140529000479
Provider NameRandy J. Kjorstad
Provider TypePractitioner - General Surgery
Provider IdentifiersNPI Number: 1043283336
PECOS PAC ID: 6002003639
Enrollment ID: I20140702002454
Provider NameSarah K Mcdaniel
Provider TypePractitioner - Certified Registered Nurse Anesthetist (crna)
Provider IdentifiersNPI Number: 1184863664
PECOS PAC ID: 9931266087
Enrollment ID: I20150123000452
Provider NameJonathan P Boltax
Provider TypePractitioner - Pulmonary Disease
Provider IdentifiersNPI Number: 1629023692
PECOS PAC ID: 3577504695
Enrollment ID: I20150324002473
Provider NameChristian A Dean
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1437412806
PECOS PAC ID: 1153551080
Enrollment ID: I20150806012761
Provider NameRobert D Wood
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1619228186
PECOS PAC ID: 7416108329
Enrollment ID: I20150921001948
Provider NameBarron Justin Reyes
Provider TypePractitioner - Emergency Medicine
Provider IdentifiersNPI Number: 1891087300
PECOS PAC ID: 6608092549
Enrollment ID: I20151110002982
Provider NameAlicia Peterson
Provider TypePractitioner - Emergency Medicine
Provider IdentifiersNPI Number: 1215296561
PECOS PAC ID: 8426360447
Enrollment ID: I20151111000421
Provider NameSarah Peterson
Provider TypePractitioner - Registered Dietitian Or Nutrition Professional
Provider IdentifiersNPI Number: 1194196667
PECOS PAC ID: 4385944958
Enrollment ID: I20151203002262
Provider NameKeri L Hull
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1225409477
PECOS PAC ID: 6800199431
Enrollment ID: I20160114001870
Provider NameTiffany L Milner
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1639323116
PECOS PAC ID: 5496905812
Enrollment ID: I20160621001117
Provider NameHolbrook H Stoecklein
Provider TypePractitioner - Emergency Medicine
Provider IdentifiersNPI Number: 1780927541
PECOS PAC ID: 0547583007
Enrollment ID: I20160810002273
Provider NameEric Andrew Wieman
Provider TypePractitioner - General Surgery
Provider IdentifiersNPI Number: 1902021553
PECOS PAC ID: 8628216272
Enrollment ID: I20161222000655
Provider NameWilliam L Mullen
Provider TypePractitioner - Cardiovascular Disease (cardiology)
Provider IdentifiersNPI Number: 1457362329
PECOS PAC ID: 0345234290
Enrollment ID: I20170426002436
Provider NameKrishna M Sundar
Provider TypePractitioner - Sleep Medicine
Provider IdentifiersNPI Number: 1801802186
PECOS PAC ID: 6406757731
Enrollment ID: I20170524000847
Provider NameKelly J Biscombe
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1861922122
PECOS PAC ID: 8224309786
Enrollment ID: I20170802002552
Provider NameRebecca F Heisinger
Provider TypePractitioner - Certified Registered Nurse Anesthetist (crna)
Provider IdentifiersNPI Number: 1730624990
PECOS PAC ID: 3375829104
Enrollment ID: I20170914001416
Provider NameAnna Otis Felton
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1538688015
PECOS PAC ID: 3476828765
Enrollment ID: I20171012002788
Provider NameJoseph W Raboin
Provider TypePractitioner - Certified Registered Nurse Anesthetist (crna)
Provider IdentifiersNPI Number: 1235547803
PECOS PAC ID: 8224351564
Enrollment ID: I20180522000662
Provider NameLindsay Long
Provider TypePractitioner - Clinical Social Worker
Provider IdentifiersNPI Number: 1780011551
PECOS PAC ID: 4587929542
Enrollment ID: I20180523001351
Provider NameTed Olin Morgan
Provider TypePractitioner - Urology
Provider IdentifiersNPI Number: 1639160245
PECOS PAC ID: 6305894429
Enrollment ID: I20180618003089
Provider NameAnna Bramley Catino
Provider TypePractitioner - Cardiovascular Disease (cardiology)
Provider IdentifiersNPI Number: 1427282318
PECOS PAC ID: 2668691486
Enrollment ID: I20180725001185
Provider NameJohn Keith Hayes
Provider TypePractitioner - Radiation Oncology
Provider IdentifiersNPI Number: 1275672933
PECOS PAC ID: 3072402254
Enrollment ID: I20180810003083
Provider NameGlenn Edward Burnett
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1467400747
PECOS PAC ID: 1456381680
Enrollment ID: I20180816001505
Provider NameRoger S Hansen
Provider TypePractitioner - Radiation Oncology
Provider IdentifiersNPI Number: 1811036478
PECOS PAC ID: 9133106297
Enrollment ID: I20180824000696
Provider NameLauren H Theilen
Provider TypePractitioner - Obstetrics/gynecology
Provider IdentifiersNPI Number: 1174802250
PECOS PAC ID: 6507095270
Enrollment ID: I20180904001655
Provider NameBrandon J Fisher
Provider TypePractitioner - Radiation Oncology
Provider IdentifiersNPI Number: 1275789026
PECOS PAC ID: 3779731708
Enrollment ID: I20181022000111
Provider NameKevin Sanville
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1134307911
PECOS PAC ID: 4486602000
Enrollment ID: I20181026000322
Provider NameMichael Abram Tenofsky
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1194965608
PECOS PAC ID: 5890827596
Enrollment ID: I20190425000816
Provider NameBrittany Hayden Jones
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1164707907
PECOS PAC ID: 1557538519
Enrollment ID: I20190530000890
Provider NameTobin Dennis
Provider TypePractitioner - Emergency Medicine
Provider IdentifiersNPI Number: 1891141032
PECOS PAC ID: 9234424110
Enrollment ID: I20190731002205
Provider NameLauren E Furtney
Provider TypePractitioner - Clinical Social Worker
Provider IdentifiersNPI Number: 1093161572
PECOS PAC ID: 1759610157
Enrollment ID: I20190910003538
Provider NameKyle Mahoney
Provider TypePractitioner - Neurology
Provider IdentifiersNPI Number: 1568707586
PECOS PAC ID: 2466685987
Enrollment ID: I20191030001949
Provider NameStephanie Kay Ferris
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1770127136
PECOS PAC ID: 2961835772
Enrollment ID: I20191210000763
Provider NameDaniel H Miller
Provider TypePractitioner - Radiation Oncology
Provider IdentifiersNPI Number: 1447694922
PECOS PAC ID: 6406097799
Enrollment ID: I20191227000250
Provider NameElizabeth Smith Dannewald
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1669949590
PECOS PAC ID: 1850726498
Enrollment ID: I20200108002767
Provider NamePaolo Moretti
Provider TypePractitioner - Neurology
Provider IdentifiersNPI Number: 1093968265
PECOS PAC ID: 5395808000
Enrollment ID: I20200127001075
Provider NameNathan Blue
Provider TypePractitioner - Obstetrics/gynecology
Provider IdentifiersNPI Number: 1427300938
PECOS PAC ID: 0244547438
Enrollment ID: I20200131001073
Provider NameCarrie Ross Quinlan
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1942711254
PECOS PAC ID: 2163788910
Enrollment ID: I20200325000834
Provider NameMichelle Brittany Robertson
Provider TypePractitioner - Registered Dietitian Or Nutrition Professional
Provider IdentifiersNPI Number: 1154969251
PECOS PAC ID: 4486083516
Enrollment ID: I20200410001231
Provider NameSharon L Bailey
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1558454934
PECOS PAC ID: 0648394882
Enrollment ID: I20200529001916
Provider NameNils Charles Westfall
Provider TypePractitioner - Psychiatry
Provider IdentifiersNPI Number: 1992047682
PECOS PAC ID: 5193074888
Enrollment ID: I20200928003213
Provider NameChuanchau J Jou
Provider TypePractitioner - Cardiovascular Disease (cardiology)
Provider IdentifiersNPI Number: 1104011998
PECOS PAC ID: 7214120260
Enrollment ID: I20201109002734
Provider NameJason T Su
Provider TypePractitioner - Pediatric Medicine
Provider IdentifiersNPI Number: 1427137991
PECOS PAC ID: 0143291427
Enrollment ID: I20201116001557
Provider NameThomas Jared Bunch
Provider TypePractitioner - Cardiovascular Disease (cardiology)
Provider IdentifiersNPI Number: 1790757516
PECOS PAC ID: 3173601051
Enrollment ID: I20201207002587
Provider NameAllison Odato Armitage
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1760074322
PECOS PAC ID: 4082021720
Enrollment ID: I20210325001587
Provider NameRussell Charles Miller
Provider TypePractitioner - Certified Registered Nurse Anesthetist (crna)
Provider IdentifiersNPI Number: 1538408091
PECOS PAC ID: 7719127851
Enrollment ID: I20210611000575
Provider NameAlexandra E Flis
Provider TypePractitioner - Physical Medicine And Rehabilitation
Provider IdentifiersNPI Number: 1265723795
PECOS PAC ID: 9032339080
Enrollment ID: I20210712003606
Provider NameKelly K Baxter
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1407351224
PECOS PAC ID: 4183970650
Enrollment ID: I20210715002903
Provider NameDavid Paul Steinberg
Provider TypePractitioner - Physical Medicine And Rehabilitation
Provider IdentifiersNPI Number: 1093705170
PECOS PAC ID: 9032178546
Enrollment ID: I20210802003615
Provider NameBenjamin Todd Jensen
Provider TypePractitioner - Physical Medicine And Rehabilitation
Provider IdentifiersNPI Number: 1376885988
PECOS PAC ID: 5597986893
Enrollment ID: I20211028001161
Provider NameAmanda J Miller
Provider TypePractitioner - Certified Registered Nurse Anesthetist (crna)
Provider IdentifiersNPI Number: 1972842268
PECOS PAC ID: 0941441554
Enrollment ID: I20211110002284
Provider NameMichael M Green
Provider TypePractitioner - Physical Medicine And Rehabilitation
Provider IdentifiersNPI Number: 1063665719
PECOS PAC ID: 8022276500
Enrollment ID: I20211112001823
Provider NameAngela M Kent
Provider TypePractitioner - Certified Registered Nurse Anesthetist (crna)
Provider IdentifiersNPI Number: 1861735730
PECOS PAC ID: 3173761426
Enrollment ID: I20211115002440
Provider NameBeyron Alexis Zecher
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1255917803
PECOS PAC ID: 1153719877
Enrollment ID: I20211207001604
Provider NameKathleen A Vanier
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1790719011
PECOS PAC ID: 1850340092
Enrollment ID: I20220128000466
Provider NameDouglas E Holt
Provider TypePractitioner - Radiation Oncology
Provider IdentifiersNPI Number: 1417310046
PECOS PAC ID: 3072914084
Enrollment ID: I20220328000776
Provider NamePierre D Zabel
Provider TypePractitioner - Physical Medicine And Rehabilitation
Provider IdentifiersNPI Number: 1760717805
PECOS PAC ID: 6901045723
Enrollment ID: I20220401001045
Provider NamePaul Beisser
Provider TypePractitioner - Certified Registered Nurse Anesthetist (crna)
Provider IdentifiersNPI Number: 1053346593
PECOS PAC ID: 0840327896
Enrollment ID: I20220721001765
Provider NameCharles William Franker
Provider TypePractitioner - Certified Registered Nurse Anesthetist (crna)
Provider IdentifiersNPI Number: 1801327291
PECOS PAC ID: 0840563144
Enrollment ID: I20220808000722
Provider NameAhmad Bashirimoghaddam
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1487144457
PECOS PAC ID: 2466835079
Enrollment ID: I20220815002368
Provider NameMichael Hackett
Provider TypePractitioner - Certified Registered Nurse Anesthetist (crna)
Provider IdentifiersNPI Number: 1184688749
PECOS PAC ID: 8820980352
Enrollment ID: I20220817000930
Provider NameKathleen Kerrigan
Provider TypePractitioner - Medical Oncology
Provider IdentifiersNPI Number: 1457779035
PECOS PAC ID: 9133446891
Enrollment ID: I20220919002026
Provider NameLaura-lee A Berrett
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1033840905
PECOS PAC ID: 1658747811
Enrollment ID: I20221013001865
Provider NameGuillaume Lamotte
Provider TypePractitioner - Neurology
Provider IdentifiersNPI Number: 1114371416
PECOS PAC ID: 1557782687
Enrollment ID: I20221018000572
Provider NameJames Osmanski
Provider TypePractitioner - Sleep Medicine
Provider IdentifiersNPI Number: 1235275660
PECOS PAC ID: 3971519950
Enrollment ID: I20221104002126
Provider NameGeoffrey Kuzmich
Provider TypePractitioner - Certified Registered Nurse Anesthetist (crna)
Provider IdentifiersNPI Number: 1942257415
PECOS PAC ID: 9335108208
Enrollment ID: I20230123001878
Provider NameChristopher D Nevala-plagemann
Provider TypePractitioner - Medical Oncology
Provider IdentifiersNPI Number: 1659725851
PECOS PAC ID: 2567728108
Enrollment ID: I20230213000398
Provider NameOlga Baeva Johnson
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1942914395
PECOS PAC ID: 4486026879
Enrollment ID: I20230213000929
Provider NameRyley Greenbaum
Provider TypePractitioner - Obstetrics/gynecology
Provider IdentifiersNPI Number: 1053708669
PECOS PAC ID: 1557662491
Enrollment ID: I20230629000887
Provider NameMelissa J Cohen
Provider TypePractitioner - Medical Oncology
Provider IdentifiersNPI Number: 1174763262
PECOS PAC ID: 0547430613
Enrollment ID: I20230724002209
Provider NameHannah E Caulfield
Provider TypePractitioner - General Surgery
Provider IdentifiersNPI Number: 1093003808
PECOS PAC ID: 4284927534
Enrollment ID: I20230803000542
Provider NameAdeola Adelayo
Provider TypePractitioner - Psychiatry
Provider IdentifiersNPI Number: 1205996907
PECOS PAC ID: 1557322641
Enrollment ID: I20231009001636
Provider NameJennifer A Lanzillotta
Provider TypePractitioner - Certified Registered Nurse Anesthetist (crna)
Provider IdentifiersNPI Number: 1780824144
PECOS PAC ID: 5092867820
Enrollment ID: I20231011001706
Provider NameKevin Metz
Provider TypePractitioner - Certified Registered Nurse Anesthetist (crna)
Provider IdentifiersNPI Number: 1093128712
PECOS PAC ID: 9335528447
Enrollment ID: I20231030001170
Provider NameCrystal Blackburn
Provider TypePractitioner - Certified Registered Nurse Anesthetist (crna)
Provider IdentifiersNPI Number: 1851042857
PECOS PAC ID: 4981085388
Enrollment ID: I20231031002421
Provider NameRoger Blake
Provider TypePractitioner - General Surgery
Provider IdentifiersNPI Number: 1023049335
PECOS PAC ID: 8022049501
Enrollment ID: I20231114000855
Provider NameChristina L Gallop
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1992865273
PECOS PAC ID: 2466677109
Enrollment ID: I20231116003145
Provider NameCarl Allen Woods
Provider TypePractitioner - Gastroenterology
Provider IdentifiersNPI Number: 1174550727
PECOS PAC ID: 6103803903
Enrollment ID: I20231201002779
Provider NameAnn M Bruno
Provider TypePractitioner - Obstetrics/gynecology
Provider IdentifiersNPI Number: 1881075034
PECOS PAC ID: 3375856958
Enrollment ID: I20240103001612
Provider NameNancy Waldrop
Provider TypePractitioner - Mental Health Counselor
Provider IdentifiersNPI Number: 1699303826
PECOS PAC ID: 6507278637
Enrollment ID: I20240118002336
Provider NameMeredith T Ehn
Provider TypePractitioner - Physical Medicine And Rehabilitation
Provider IdentifiersNPI Number: 1447223656
PECOS PAC ID: 1052393923
Enrollment ID: I20240129000569
Provider NameEwa Korzeniowska
Provider TypePractitioner - Certified Registered Nurse Anesthetist (crna)
Provider IdentifiersNPI Number: 1336514728
PECOS PAC ID: 0648579474
Enrollment ID: I20240130001048
Provider NameEdward Snyder
Provider TypePractitioner - General Surgery
Provider IdentifiersNPI Number: 1083792873
PECOS PAC ID: 6204994296
Enrollment ID: I20240131002239
Provider NameKatelyn Ann Webb
Provider TypePractitioner - Mental Health Counselor
Provider IdentifiersNPI Number: 1821686528
PECOS PAC ID: 3971946971
Enrollment ID: I20240207000233
Provider NameJason D Provus
Provider TypePractitioner - Orthopedic Surgery
Provider IdentifiersNPI Number: 1972821320
PECOS PAC ID: 9537351960
Enrollment ID: I20240213001081
Provider NameNicholas E. Gavern
Provider TypePractitioner - Physical Medicine And Rehabilitation
Provider IdentifiersNPI Number: 1891255071
PECOS PAC ID: 7416375969
Enrollment ID: I20240301002184
Provider NameDebra G Angelo
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1174852362
PECOS PAC ID: 6204971393
Enrollment ID: I20240318001504
Provider NameLeah H Grange
Provider TypePractitioner - Certified Registered Nurse Anesthetist (crna)
Provider IdentifiersNPI Number: 1912283177
PECOS PAC ID: 3072780436
Enrollment ID: I20240417001053
Provider NameKathleen Elizabeth Kearns
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1790558963
PECOS PAC ID: 4082056783
Enrollment ID: I20240528000433

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Medicare: Not Enrolled in Medicare
Practice Location: 555 E Broadway Suite 108, Jackson, WY 83001
Phone: 307-734-1313    Fax: 307-734-0314
Womens Health & Family Care, Llc
Primary Care Clinic
Medicare: Medicare Enrolled
Practice Location: 555 E Broadway Ave Ste 108, Jackson, WY 83001
Phone: 307-734-1313    Fax: 307-734-5003
Imed Utah Heart - Jackson
Primary Care Clinic
Medicare: Not Enrolled in Medicare
Practice Location: 625 E Broadway, Jackson, WY 83001
Phone: 801-507-3500    
St Johns Medical Center Physician Services
Primary Care Clinic
Medicare: Not Enrolled in Medicare
Practice Location: Box 428 625 E Broadway Ave, Jackson, WY 83001
Phone: 307-733-3636    Fax: 307-734-9881

Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.