GOOSE CREEK FAMILY PRACTICE, P.C.
NPI 1134407356
Clinic/Center in Sheridan, WY
About Goose Creek Family Practice, P.c. NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
GOOSE CREEK FAMILY PRACTICE, P.C. (NPI 1134407356) is a healthcare organization registered as a clinic/center in Sheridan, Wyoming and active in the NPI registry since July 2011. The organization holds a CLIA Waiver certificate valid through January 29, 2027 and lists Debra Ann Kawulok, President, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Identifiers 2
Accepted Insurance
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 53D2027136
Goose Creek Family Practice, PC · Sheridan, WYOther Providers at the Same Location NPPES
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
Frequently 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 Goose Creek Family Practice, P.C.'s NPI number?
The NPI number for Goose Creek Family Practice, P.C. is 1134407356. It was assigned to this organization in the NPPES registry on July 22, 2011.
Where is Goose Creek Family Practice, P.C. located?
Goose Creek Family Practice, P.C. is located at 304 Coffeen Ave Suite A, Sheridan, WY 82801. The listed phone number is (307) 674-1744.
What is Goose Creek Family Practice, P.C.'s specialty?
The primary specialty registered for this NPI is Clinic/Center with taxonomy code 261Q00000X.
Does Goose Creek Family Practice, P.C. hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 53D2027136) is associated with this NPI, valid through January 29, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
What insurance does Goose Creek Family Practice, P.C. accept?
Health plans from Blue Cross Blue Shield of Wyoming list Goose Creek Family Practice, P.C. 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 Goose Creek Family Practice, P.C. was last updated on November 9, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 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.
# Goose Creek Family Practice, P.c. · NPI 1134407356
Clinic/Center organization in Sheridan, Wyoming. Organization record, active in the CMS NPPES registry since July 22, 2011.
## Identity
- **NPI:** 1134407356 (Entity type: Organization)
- **Enumerated:** July 22, 2011
- **Primary specialty:** Clinic/Center · taxonomy 261Q00000X
- **Organization subpart:** No
- **Authorized official:** Debra Kawulok, PRESIDENT
## Practice location
- **Address:** 304 COFFEEN AVE, SUITE A, Sheridan, WY 82801-4803
- **Phone:** (307) 674-1744 · **Fax:** (307) 674-1752
## Record status
- **NPPES last updated:** November 9, 2012
- **Other identifiers:** Medicare PIN W23011 (WY); Other 1013242502
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1134407356) · Data from the CMS NPPES public registry.