SOUTH LINCIOLN MEDICAL CLINIC – Rural Health Clinic/Center, NPI 1386716710

SOUTH LINCIOLN MEDICAL CLINIC is a healthcare provider. based in Kemmerer, Wyoming. specializing in Rural Health Clinic/Center. The organization holds a License No. 06-148 (WY). The NPI Number for SOUTH LINCIOLN MEDICAL CLINIC is 1386716710

Main info

Organization
Name
SOUTH LINCIOLN MEDICAL CLINIC
NPI
1386716710
Phone
(307) 877-4401
Address
711 ONYX ST
Authorized Official
DAVID RYERSE CEO
Enumeration Date
14 November 2006
Last Update Date
24 October 2025
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience67
Completeness90
Years active:19State licenses:1Digital endpoints

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Provider Addresses for SOUTH LINCIOLN MEDICAL CLINIC

  • South Lincoln Medical Center, 711, Onyx Street, Kemmerer, Lincoln County, Wyoming, 83101, United States

    KEMMERER, WY 83101

    Phone: (307) 877-4401

    Fax: (307) 877-3236

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2019-09-04

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Past revalidation due date

Earliest CMS due date was 2025-08-31 (285 days ago).

Enrollment records

1

Earliest due date

2025-08-31

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
O20190904002513ORural Health ClinicWY2025-08-31

What to do next

  • Verify current status on the CMS Revalidation Lookup Tool immediately.
  • Complete revalidation in PECOS or contact your Medicare Administrative Contractor (MAC).
  • Overdue revalidation can lead to deactivation of Medicare billing privileges.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 83101)

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Reviews

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Frequently asked questions

Is SOUTH LINCIOLN MEDICAL CLINIC listed with a National Provider Identifier?
Yes — SOUTH LINCIOLN MEDICAL CLINIC has NPI 1386716710 on file in the registry.
Would SOUTH LINCIOLN MEDICAL CLINIC appear as active to a payer?
You can treat SOUTH LINCIOLN MEDICAL CLINIC as active for directory purposes; confirm clinical privileges separately.
How would a patient describe SOUTH LINCIOLN MEDICAL CLINIC's focus?
For SOUTH LINCIOLN MEDICAL CLINIC, the primary taxonomy reads as Rural Health Clinic/Center. Clinical services aligned with this taxonomy classification.
Where in Wyoming is SOUTH LINCIOLN MEDICAL CLINIC registered?
Use Kemmerer, Wyoming as the headline location for SOUTH LINCIOLN MEDICAL CLINIC here.
When was this NPI issued?
Enumeration for SOUTH LINCIOLN MEDICAL CLINIC is noted as November 14, 2006 where the registry provides it.

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