EVANSTON CLINIC CORP
NPI 1013916519
Family Medicine in Evanston, WY
About Evanston Clinic Corp NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
EVANSTON CLINIC CORP (NPI 1013916519) is a healthcare organization registered as a family medicine in Evanston, Wyoming and active in the NPI registry since July 2005. The organization holds a CLIA Waiver certificate valid through July 15, 2027 and lists Laura J Fey, Director Revenue Cycle, as its authorized official.
NPPES Registry Identity
Specialties & Licenses 9
Other Identifiers 2
Group Practice 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, revalidation and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Evanston Clinic Corp is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Revalidation Due Date
Revalidation due by December 31, 2026
Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.
Clinicians Billing Medicare Through This Organization
33Medicare enrollment records show 33 clinicians reassign Medicare billing to Evanston Clinic Corp, which bills Medicare for the services they deliver. Of these, 3 practice at this address and 9 within 10 miles. Listed here are the 20 practicing nearest to this location.
Clinicians by Medicare Specialty 14
Nearest to this location (20)
See all 33Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
CLIA Laboratory Certificates CMS CLIA
Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.
Certificate of Waiver 53D0951953
Evanston Clinic Corp Dba/ Uinta Family Practice · Evanston, WYFrequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Evanston Clinic Corp's NPI number?
The NPI number for Evanston Clinic Corp is 1013916519. It was assigned to this organization in the NPPES registry on July 18, 2005.
Where is Evanston Clinic Corp located?
Evanston Clinic Corp is located at 196 Arrowhead Dr Ste 8, Evanston, WY 82930. The listed phone number is (307) 783-8365.
What is Evanston Clinic Corp's specialty?
The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.
Is Evanston Clinic Corp enrolled in Medicare?
Yes. Evanston Clinic Corp is registered in the Medicare PECOS enrollment system.
When is Evanston Clinic Corp's Medicare revalidation due?
According to the CMS Revalidation Due Date List (October 2026 release), the Medicare Non-DME Part B enrollment for this organization (Wyoming, Clinic/Group Practice) is due for revalidation by December 31, 2026. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.
How many clinicians bill Medicare through Evanston Clinic Corp?
According to the CMS Revalidation Reassignment List (October 2026 release), 33 clinicians in 14 Medicare specialties reassign their Medicare billing to Evanston Clinic Corp. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Nurse Practitioner (7), Family Practice (5) and Obstetrics/Gynecology (4). Of these, 3 practice at this address and 9 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does Evanston Clinic Corp hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 53D0951953) is associated with this NPI, valid through July 15, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
What insurance does Evanston Clinic Corp accept?
Health plans from Blue Cross Blue Shield of Wyoming and University of Utah Health Plans list Evanston Clinic Corp as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for Evanston Clinic Corp was last updated on March 4, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Evanston Clinic Corp · NPI 1013916519
Family Medicine organization in Evanston, Wyoming. Organization record, active in the CMS NPPES registry since July 18, 2005.
## Identity
- **NPI:** 1013916519 (Entity type: Organization)
- **Enumerated:** July 18, 2005
- **Primary specialty:** Family Medicine · taxonomy 207Q00000X
- **Organization subpart:** No
- **Authorized official:** Laura Fey, DIRECTOR REVENUE CYCLE
## Practice location
- **Address:** 196 ARROWHEAD DR STE 8, Evanston, WY 82930-8752
- **Phone:** (307) 783-8365 · **Fax:** (307) 783-8284
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Medicare revalidation due:** December 31, 2026 (Non-DME Part B, Wyoming, Clinic/Group Practice) · CMS Revalidation Due Date List, October 2026 release
- **Clinicians billing through this organization:** 33 clinicians in 14 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Nurse Practitioner (7), Family Practice (5), Obstetrics/Gynecology (4); 3 practice at this address and 9 within 10 miles; [full list](https://npiprofile.com/npi/1013916519/clinicians) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** March 4, 2019
- **Other identifiers:** Other 06159001 (WY); Medicaid 1013916519 (WY)
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1013916519) · Data from the CMS NPPES public registry.