| Star Valley Medical Center | |
|
901 Adams Afton WY 83110-9621 | |
| (307) 885-5800 | |
| (307) 885-5865 |
| Full Name | Star Valley Medical Center |
|---|---|
| Speciality | Family Medicine |
| Location | 901 Adams, Afton, Wyoming |
| Authorized Official Name and Position | Denise Wheeler (REV CYCLE DIRECTOR) |
| Authorized Official Contact | 3078855877 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Star Valley Medical Center 901 Adams Afton WY 83110-9621 Ph: (307) 885-5800 | Star Valley Medical Center 901 Adams Afton WY 83110-9621 Ph: (307) 885-5800 |
| NPI Number | 1730132523 |
|---|---|
| Provider Enumeration Date | 05/19/2006 |
| Last Update Date | 12/02/2014 |
| Medicare PECOS PAC ID | 4789580218 |
|---|---|
| Medicare Enrollment ID | O20031208000415 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730132523 | NPI | - | NPPES |
| 114481204 | Medicaid | WY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (Wyoming) | Primary |
| 275N00000X | Medicare Defined Swing Bed Unit | 10309 (Wyoming) | Secondary |
| 341600000X | Ambulance | 09184 (Wyoming) | Secondary |
| Provider Name | Donald J Kirk |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1861447971 PECOS PAC ID: 2567451164 Enrollment ID: I20040510000331 |
| Provider Name | Ryan T Clifford |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1295773505 PECOS PAC ID: 7113810557 Enrollment ID: I20040614001462 |
| Provider Name | Edward J Frink |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1154402451 PECOS PAC ID: 7810960416 Enrollment ID: I20040817000784 |
| Provider Name | Tamara O Cottam |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1164488185 PECOS PAC ID: 2062481732 Enrollment ID: I20040930000324 |
| Provider Name | Curt R Stock |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1275681686 PECOS PAC ID: 5496653990 Enrollment ID: I20050513000226 |
| Provider Name | Edward A Henry |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437104536 PECOS PAC ID: 3274545538 Enrollment ID: I20060705000072 |
| Provider Name | David M Johnson |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1851314785 PECOS PAC ID: 1254330558 Enrollment ID: I20061214000448 |
| Provider Name | Shannan Raquel Wright |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1427004910 PECOS PAC ID: 7719977602 Enrollment ID: I20071119000371 |
| Provider Name | Martha S Hageman |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1033395561 PECOS PAC ID: 9537242466 Enrollment ID: I20080214000471 |
| Provider Name | Christian M Morgan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1457358962 PECOS PAC ID: 1153391636 Enrollment ID: I20091106000349 |
| Provider Name | Michael H Beus |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1982926390 PECOS PAC ID: 3072648666 Enrollment ID: I20100322000497 |
| Provider Name | Mark E Wilson |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1881608800 PECOS PAC ID: 4789589920 Enrollment ID: I20100702000267 |
| Provider Name | Michael R Pieper |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1174717128 PECOS PAC ID: 2163568247 Enrollment ID: I20100726000786 |
| Provider Name | Niki M Milleson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1225155997 PECOS PAC ID: 9537214309 Enrollment ID: I20101004001427 |
| Provider Name | Noel B Stibor |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1750327979 PECOS PAC ID: 4082898788 Enrollment ID: I20110404000808 |
| Provider Name | William H Kennington |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1174818769 PECOS PAC ID: 3476723503 Enrollment ID: I20110829000687 |
| Provider Name | Dirk E Bigler |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1457304776 PECOS PAC ID: 7618900374 Enrollment ID: I20111209000397 |
| Provider Name | Brent V Bowles |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1245564434 PECOS PAC ID: 5698810935 Enrollment ID: I20121119000218 |
| Provider Name | Bradley Dee Mangum |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235465147 PECOS PAC ID: 5092845883 Enrollment ID: I20130214000449 |
| Provider Name | Samuel W Linford |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1306091046 PECOS PAC ID: 6608025986 Enrollment ID: I20130919000722 |
| Provider Name | Aaron R Brown |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1154653178 PECOS PAC ID: 3476682402 Enrollment ID: I20131211002072 |
| Provider Name | Jessica Draney |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1295162105 PECOS PAC ID: 3678797917 Enrollment ID: I20140606001414 |
| Provider Name | Chad A Bagley |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1346483666 PECOS PAC ID: 7214086925 Enrollment ID: I20140813000896 |
| Provider Name | Jonah J Green |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1013079524 PECOS PAC ID: 8123029378 Enrollment ID: I20140814002261 |
| Provider Name | Korry Wheeler |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1013307768 PECOS PAC ID: 3577881317 Enrollment ID: I20150408000006 |
| Provider Name | Sean Elliott Knighton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043549157 PECOS PAC ID: 6507997293 Enrollment ID: I20150529002515 |
| Provider Name | Brian S Mcclure |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1184918781 PECOS PAC ID: 9739488982 Enrollment ID: I20160629003185 |
| Provider Name | Andrew J Hoene |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1821230384 PECOS PAC ID: 9739347113 Enrollment ID: I20160721001655 |
| Provider Name | Kevin L Stucki |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1306975701 PECOS PAC ID: 0345332698 Enrollment ID: I20160909001282 |
| Provider Name | Hans Ayres |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528511375 PECOS PAC ID: 7517254873 Enrollment ID: I20160929002669 |
| Provider Name | John F Murray |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1568403830 PECOS PAC ID: 4082512819 Enrollment ID: I20161121001020 |
| Provider Name | Brad David Oliverson |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1366705444 PECOS PAC ID: 1052622404 Enrollment ID: I20170123002855 |
| Provider Name | Brett Scott Talbot |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1356630420 PECOS PAC ID: 9335434091 Enrollment ID: I20170606000883 |
| Provider Name | Erich M Hunsaker |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1356643589 PECOS PAC ID: 2860630829 Enrollment ID: I20170724003886 |
| Provider Name | Clayton J Brown |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1033557657 PECOS PAC ID: 2062711211 Enrollment ID: I20170728003205 |
| Provider Name | Clint Allred |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1609190172 PECOS PAC ID: 6103067467 Enrollment ID: I20171205003462 |
| Provider Name | Richard Brad Washburn |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1497998900 PECOS PAC ID: 9032435003 Enrollment ID: I20171221001358 |
| Provider Name | Erik C Mcclure |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1033471602 PECOS PAC ID: 0345497418 Enrollment ID: I20180419001197 |
| Provider Name | Mark Wayne Larsen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689166266 PECOS PAC ID: 8325395296 Enrollment ID: I20180724000964 |
| Provider Name | Zackary M Hale |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1861599912 PECOS PAC ID: 8426010182 Enrollment ID: I20181023000458 |
| Provider Name | Jason E. Sharp |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1366470510 PECOS PAC ID: 7012920440 Enrollment ID: I20181213001448 |
| Provider Name | Todd M Haderlie |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1326059155 PECOS PAC ID: 0446273098 Enrollment ID: I20190403000504 |
| Provider Name | Landon B Bluemel |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1023402955 PECOS PAC ID: 4587945076 Enrollment ID: I20190715001699 |
| Provider Name | Mark J Cowan |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1740626183 PECOS PAC ID: 9537428792 Enrollment ID: I20190819002628 |
| Provider Name | Daphne A Kontos |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1437579240 PECOS PAC ID: 4789922410 Enrollment ID: I20191029002776 |
| Provider Name | Laurie L Hanson |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1770880965 PECOS PAC ID: 8527485739 Enrollment ID: I20200902002901 |
| Provider Name | Jacqueline E Clark |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1215452958 PECOS PAC ID: 8628497369 Enrollment ID: I20200930001976 |
| Provider Name | Joel Gardner |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1942329883 PECOS PAC ID: 6507902731 Enrollment ID: I20201119001473 |
| Provider Name | Ryker M Kiel |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1528450327 PECOS PAC ID: 9830434133 Enrollment ID: I20210506001684 |
| Provider Name | Sara C Burnside |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1023468634 PECOS PAC ID: 5597165779 Enrollment ID: I20210609001502 |
| Provider Name | Kristle J Westover |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1780097709 PECOS PAC ID: 7517367774 Enrollment ID: I20210610000964 |
| Provider Name | Tracy D Osborne |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306187158 PECOS PAC ID: 6709013790 Enrollment ID: I20210628003040 |
| Provider Name | David Draney |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144471061 PECOS PAC ID: 1153482013 Enrollment ID: I20211025001521 |
| Provider Name | Wade K Jensen |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1730139890 PECOS PAC ID: 4486752706 Enrollment ID: I20220222002696 |
| Provider Name | David Gonzalez |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1043208218 PECOS PAC ID: 0648276204 Enrollment ID: I20220420002425 |
| Provider Name | Donna Givens |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1811063407 PECOS PAC ID: 9537257092 Enrollment ID: I20220426002405 |
| Provider Name | Dustin Tew |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1568821163 PECOS PAC ID: 7315225752 Enrollment ID: I20220513000905 |
| Provider Name | Donald Howser |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1750389425 PECOS PAC ID: 9234212432 Enrollment ID: I20221129002344 |
| Provider Name | Brian Affleck |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1386633824 PECOS PAC ID: 4183715436 Enrollment ID: I20221215002555 |
| Provider Name | Katarzyna Lameka |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1164711487 PECOS PAC ID: 9234394073 Enrollment ID: I20221230001038 |
| Provider Name | Kyle Paul Arslanian |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1144752882 PECOS PAC ID: 5597147819 Enrollment ID: I20230301002230 |
| Provider Name | Stephen G Chang |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1568451284 PECOS PAC ID: 9234110008 Enrollment ID: I20230330000347 |
| Provider Name | Kaitlin Mikel Bird |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639822240 PECOS PAC ID: 0749645182 Enrollment ID: I20230508001674 |
| Provider Name | Mark W. Slepian |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1558350314 PECOS PAC ID: 3779488960 Enrollment ID: I20230921000696 |
| Provider Name | William Theodorou |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1063686624 PECOS PAC ID: 9436399722 Enrollment ID: I20231013001041 |
| Provider Name | Craig Edward Hancock |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1982693693 PECOS PAC ID: 7517871940 Enrollment ID: I20231013001119 |
| Provider Name | Mark E. Dearing |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1386669372 PECOS PAC ID: 9436165321 Enrollment ID: I20231023003006 |
| Provider Name | Eric Schackmuth |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1205817186 PECOS PAC ID: 7416853718 Enrollment ID: I20231024002434 |
| Provider Name | Randall Haschke |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1114018256 PECOS PAC ID: 2668661307 Enrollment ID: I20231106003392 |
| Provider Name | Julia Peters |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1154613255 PECOS PAC ID: 8426360710 Enrollment ID: I20231120000740 |
| Provider Name | Joshua Christiansen |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1184067373 PECOS PAC ID: 2961623038 Enrollment ID: I20240110003286 |
| Provider Name | Jared Tyler |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1609198142 PECOS PAC ID: 8022234186 Enrollment ID: I20240123003595 |
| Provider Name | Nicholas Karr |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1568608644 PECOS PAC ID: 0749451540 Enrollment ID: I20240314004281 |
| Provider Name | Scott Douglas Unice |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1508952367 PECOS PAC ID: 3971795642 Enrollment ID: I20240605004025 |
Ppm Wyoming Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 770 S Washington St Ste B, Afton, WY 83110 Phone: 888-253-6598 | |
High Country Behavioral Health Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 389 Adams St., Afton, WY 83110 Phone: 307-885-9883 Fax: 307-885-5206 | |
High Country Behavioral Health Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 389 Adams Street, Afton, WY 83110 Phone: 307-885-9883 Fax: 307-885-5206 | |
Imed Utah Heart - Afton Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 110 Hospital Ln, Afton, WY 83110 Phone: 801-507-3500 | |
Sterling Provider Group Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 47 Doc Perkes Rd, Afton, WY 83110 Phone: 307-885-3637 Fax: 307-885-3638 |