GOOSE CREEK FAMILY PRACTICE, P.C.
NPI 1134407356
Clinic/Center in Sheridan, WY
NPI Status: Active since July 22, 2011
Contact Information
304 COFFEEN AVE
SUITE A
SHERIDAN, WY
ZIP 82801
Phone: (307) 674-1744
Fax: (307) 674-1752
- Organization
- Clinic/Center
- Accepts Insurance
- CLIA Number: 53D2027136
- CLIA Cert. Type: Practitioner Other
- CLIA Exp. Date: 01-29-2027
About GOOSE CREEK FAMILY PRACTICE, P.C.
This page provides the complete NPI Profile along with additional information for Goose Creek Family Practice, P.c., a provider established in Sheridan, Wyoming operating as a Clinic/center. The healthcare provider is registered in the NPI registry with number 1134407356 assigned on July 2011. The practitioner's primary taxonomy code is 261Q00000X with license number 11988.1019 (WY). The provider is registered as an organization and their NPI record was last updated 14 years ago. The authorized official of this NPI record is Ms. Debra Ann Kawulok Fnp-c (President)
- NPI
- 1134407356
- Provider Name
- GOOSE CREEK FAMILY PRACTICE, P.C.
- Entity Type
- Organization
- Location Address
- 304 COFFEEN AVE SUITE A SHERIDAN, WY 82801
- Location Phone
- (307) 674-1744
- Location Fax
- (307) 674-1752
- Mailing Address
- 304 COFFEEN AVE SUITE A SHERIDAN, WY 82801
- Mailing Phone
- (307) 674-1744
- Mailing Fax
- (307) 674-1752
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 07-22-2011
- Last Update Date
- 11-09-2012
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Clinic/Center
- Taxonomy Code
- 261Q00000X
- Type
- Ambulatory Health Care Facilities
- License No.
- 11988.1019
- License State
- WY
- Taxonomy Description
- A facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- BlueSelect Bronze Basic - PPO
- BlueSelect Bronze Core - PPO
- BlueSelect Expanded Bronze Standard without Kid's Dental - PPO
- BlueSelect Gold Core - PPO
- BlueSelect Gold HealthPlus - PPO
- BlueSelect Gold Standard without Kid's Dental - PPO
- BlueSelect Silver Classic - PPO
- BlueSelect Silver Classic without Kid's Dental - PPO
- BlueSelect Silver HealthPlus - PPO
- BlueSelect Silver HealthPlus without Kid's Dental - PPO
- BlueSelect Silver Standard without Kid's Dental - PPO
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| W23011 | MEDICARE PIN (08) | WY | |
| 1013242502 | OTHER (01) | NPI # |
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 53D2027136
- Facility Type
- Practitioner Other
- Certificate Effective Date
- January 30, 2025
- Certificate Expiration Date
- January 29, 2027
- Laboratory Director
- DEBRA KAWULOK
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Goose Creek Family Practice, P.c. to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1134407356, we treat the final digit (6) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 54. The final step is to find the difference between that total and the next multiple of ten (60 - 54 = 6).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 54 is 60. The difference is the calculated check digit.
Other Providers at the Same Location
The following 1 provider is registered at the same or a nearby location.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1134407356, enumerated as an "organization" on July 22, 2011.
The provider is located at 304 COFFEEN AVE SUITE A SHERIDAN, WY 82801 and the phone number is (307) 674-1744.
Clinic/Center with taxonomy code 261Q00000X.
The provider might be accepting Accepts: Blue Cross Blue Shield of Wyoming, Medicare and. Please consult your insurance carrier or call the provider to verify.
