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WILLOW CREEK FAMILY MEDICINE, P.C.
NPI 1184800674
Nurse Practitioner - Family in Cheyenne, WY

Active since January 14, 2008CLIA 53D1080142 · Waiver
4003 RAWLINS ST., CHEYENNE, WY 82001(307) 638-8975(307) 634-9267 Get Directions Write a Review

NPPES record last updated: March 14, 2012. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Willow Creek Family Medicine, P.c. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

WILLOW CREEK FAMILY MEDICINE, P.C. (NPI 1184800674) is a healthcare organization registered as a family in Cheyenne, Wyoming and active in the NPI registry since January 2008. The organization holds a CLIA Waiver certificate valid through February 13, 2028 and lists Diane E Hattel, Owner, as its authorized official.

NPPES Registry Identity

NPI1184800674
Entity TypeOrganization
Primary Taxonomy363LF0000X
Legal Business NameWILLOW CREEK FAMILY MEDICINE, P.C.
Location Address4003 RAWLINS ST.Cheyenne, WY 82001-1800
Mailing Address4003 Rawlins StCheyenne, WY 82001-1800 · (307) 638-8975 · Fax (307) 634-9267
Phone(307) 638-8975
Fax(307) 634-9267
Organization SubpartNo
Authorized OfficialDiane E HattelOwner · (307) 638-8975
Enumeration DateJanuary 14, 2008
Last NPPES UpdateMarch 14, 2012
✔ NPI 1184800674 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
License✔ Licensed in WY · 16129.0890
4003 RAWLINS ST., Cheyenne, WY 82001
Open in Google Maps ↗

Other Identifiers 3

Medicare PIN21772
Medicaid125575400WY
OtherDN1175Railroad Medicare - Palmetto Gba

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross Blue Shield of Wyoming.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 53D1080142

Willow Creek Family Medicine · Cheyenne, WY
Active · expires Feb 13, 2028
CLIA Number53D1080142
Laboratory TypePhysician Office
Certificate Effective DateFebruary 14, 2026
Certificate Expiration DateFebruary 13, 2028
Laboratory DirectorDiane E. Hattel
Laboratory Phone(307) 638-8975
Laboratory LocationWillow Creek Family Medicine2232 Dell Range Blvd Suite 100, Cheyenne, WY 82009
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

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 Willow Creek Family Medicine, P.C.'s NPI number?

The NPI number for Willow Creek Family Medicine, P.C. is 1184800674. It was assigned to this organization in the NPPES registry on January 14, 2008.

Where is Willow Creek Family Medicine, P.C. located?

Willow Creek Family Medicine, P.C. is located at 4003 Rawlins St., Cheyenne, WY 82001. The listed phone number is (307) 638-8975.

What is Willow Creek Family Medicine, P.C.'s specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Does Willow Creek Family Medicine, P.C. hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 53D1080142) is associated with this NPI, valid through February 13, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Willow Creek Family Medicine, P.C. accept?

Health plans from Blue Cross Blue Shield of Wyoming list Willow Creek Family Medicine, 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 Willow Creek Family Medicine, P.C. was last updated on March 14, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 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.