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GRAND AVE FAMILY MEDICINE
NPI 1437842390
Family Medicine in Laramie, WY

Active since May 29, 2023CLIA 53D2325098 · Waiver
3236 E GRAND AVE STE D, LARAMIE, WY 82070(970) 231-3498 Get Directions Write a Review

NPPES record last updated: May 29, 2023. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Grand Ave Family Medicine NPPES

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

GRAND AVE FAMILY MEDICINE (NPI 1437842390) is a healthcare organization registered as a family medicine in Laramie, Wyoming and active in the NPI registry since May 2023. The organization holds a CLIA Waiver certificate valid through June 5, 2027 and lists John Jacobs, Owner, as its authorized official.

NPPES Registry Identity

NPI1437842390
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameGRAND AVE FAMILY MEDICINE
Location Address3236 E GRAND AVE STE DLaramie, WY 82070-5100
Mailing Address3236 E Grand Ave Ste DLaramie, WY 82070-5100 · (970) 231-3498
Phone(970) 231-3498
Organization SubpartNo
Authorized OfficialJohn JacobsOwner · (970) 231-3498
Enumeration DateMay 29, 2023
NPPES CertifiedMay 27, 2023
✔ NPI 1437842390 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
3236 E GRAND AVE STE D, Laramie, WY 82070
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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 MULTIPLE 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 53D2325098

Grand Ave Family Medicine, LLC · Laramie, WY
Active · expires Jun 5, 2027
CLIA Number53D2325098
Laboratory TypePhysician Office
Certificate Effective DateJune 6, 2025
Certificate Expiration DateJune 5, 2027
Laboratory DirectorJohn Jacobs
Laboratory Phone(307) 760-8602
Laboratory LocationGrand Ave Family Medicine, LLC3236 East Grand Ave, Suite I, Laramie, WY 82070
CLIA data matches this NPI record on: Name
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 5

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

GRAND AVENUE URGENT CARE, LLC
Clinic/Center (Urgent Care)
3236 E GRAND AVE STE D
LARAMIE, WY 82070
Albany County (307) 760-8602
HANNAH FAITH WEBER PA
Physician Assistant
3236 E GRAND AVE STE D
LARAMIE, WY 82070
Albany County (307) 760-8602
PHILIP LERORY SANDERS III FNP-C
Nurse Practitioner (Family)
3236 E GRAND AVE STE D
LARAMIE, WY 82070
Albany County (307) 760-8602
JOHN JACOBS III NP-C
Nurse Practitioner (Acute Care)
3236 E GRAND AVE STE D
LARAMIE, WY 82070
Albany County (307) 760-8602
CHRIS OTTO PA
Physician Assistant (Medical)
3236 E GRAND AVE STE D
LARAMIE, WY 82070
Albany County (307) 760-8602

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 Grand Ave Family Medicine's NPI number?

The NPI number for Grand Ave Family Medicine is 1437842390. It was assigned to this organization in the NPPES registry on May 29, 2023.

Where is Grand Ave Family Medicine located?

Grand Ave Family Medicine is located at 3236 E Grand Ave Ste D, Laramie, WY 82070. The listed phone number is (970) 231-3498.

What is Grand Ave Family Medicine's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Does Grand Ave Family Medicine hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 53D2325098) is associated with this NPI, valid through June 5, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Grand Ave Family Medicine accept?

Health plans from Blue Cross Blue Shield of Wyoming list Grand Ave Family Medicine 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 Grand Ave Family Medicine was last updated on May 29, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.