GRAND TETON MEDICAL CLINIC
NPI 1891997151
Clinic/Center - Urgent Care in Moran, WY
NPI Status: Active since May 31, 2007
Contact Information
INNER LOOP ROAD
JACKSON LAKE LODGE
MORAN, WY
ZIP 83013
Phone: (307) 543-2514
Fax: (307) 543-2514
- Organization
- Clinic/Center
- Urgent Care
- CLIA Number: 53D2262925
- CLIA Cert. Type: Rural Health Clinic
- CLIA Exp. Date: 06-20-2026
About GRAND TETON MEDICAL CLINIC
This page provides the complete NPI Profile along with additional information for Grand Teton Medical Clinic, a provider established in Moran, Wyoming operating as a Clinic/center, focusing in urgent care . The healthcare provider is registered in the NPI registry with number 1891997151 assigned on May 2007. The practitioner's primary taxonomy code is 261QU0200X. The provider is registered as an organization and their NPI record was last updated 19 years ago. The authorized official of this NPI record is Dr. Brent Blue M.d. (Clinic Owner)
- NPI
- 1891997151
- Provider Name
- GRAND TETON MEDICAL CLINIC
- Entity Type
- Organization
- Location Address
- INNER LOOP ROAD JACKSON LAKE LODGE MORAN, WY 83013
- Location Phone
- (307) 543-2514
- Location Fax
- (307) 543-2514
- Mailing Address
- PO BOX 15240 JACKSON, WY 83002
- Mailing Phone
- (307) 733-8002
- Mailing Fax
- (307) 543-2514
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 05-31-2007
- Last Update Date
- 08-02-2007
- 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 Urgent Care
- Taxonomy Code
- 261QU0200X
- Type
- Ambulatory Health Care Facilities
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
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 |
|---|---|---|---|
| 1096516-00 | MEDICAID (05) | WY | |
| 4371429 | MEDICARE PIN (08) | WY |
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
- 53D2262925
- Facility Type
- Rural Health Clinic
- Certificate Effective Date
- June 21, 2024
- Certificate Expiration Date
- June 20, 2026
- Laboratory Director
- DAVID KAPPENMAN
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Grand Teton Medical Clinic 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 1891997151, we treat the final digit (1) 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 69. The final step is to find the difference between that total and the next multiple of ten (70 - 69 = 1).
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 69 is 70. The difference is the calculated check digit.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1891997151, enumerated as an "organization" on May 31, 2007.
The provider is located at INNER LOOP ROAD JACKSON LAKE LODGE MORAN, WY 83013 and the phone number is (307) 543-2514.
Clinic/Center with taxonomy code 261QU0200X and a focus in Urgent Care.
The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.
