SUMMIT OB GYN PC NPI 1942664107

NPI Information

  • NPI: 1942664107
  • Provider Name: SUMMIT OB GYN PC
  • Classification: Specialist - 174400000X
  • Entity Type: Organization
  • CLIA Number: 53D2115216
  • Address: 1414 W 4TH ST
    GILLETTE, WY
    ZIP 82716
  • Phone: (307) 299-4496

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NPI Details

SUMMIT OB GYN PC is a specialist in Gillette, WY. The provider is an individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. SUMMIT OB GYN PC NPI is 1942664107. The provider is registered as an organization entity type and is a multiple single specialty group.

The provider's business location address is:

1414 W 4TH ST
GILLETTE, WY
ZIP 82716-328
Phone: (307) 299-4496

The provider's authorized official is Anna Wilson .
The authorized official title is Practice Manager and has the following contact phone number (307) 682-6263.

The CLIA number assigned to this NPI record is 53D2115216 - physician office with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 4/13/2016 and was last updated on 3/15/2024.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1174400000XSpecialist7203AWYOMINGYes
2174400000XSpecialist8045AWYOMINGNo
3207V00000XObstetrics & Gynecology8335AWYOMINGNo

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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