Healthy Lifestyle Medicine - Medicare Primary Care in Cheyenne, WY

Healthy Lifestyle Medicine is a medicare enrolled primary clinic (Family Medicine - Adult Medicine) in Cheyenne, Wyoming. The current practice location for Healthy Lifestyle Medicine is 6015 Sycamore Rd, Cheyenne, Wyoming. For appointments, you can reach them via phone at (307) 823-2968. The mailing address for Healthy Lifestyle Medicine is 6015 Sycamore Rd, Cheyenne, Wyoming and phone number is (307) 823-2968.

Healthy Lifestyle Medicine is licensed to practice in * (Not Available) (license number ). The clinic also participates in the medicare program and its NPI number is 1912478819. This medical practice accepts medicare insurance (which means this clinic accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance). However, please confirm if they accept your insurance at (307) 823-2968.

Contact Information

Healthy Lifestyle Medicine
6015 Sycamore Rd
Cheyenne
WY 82009-4347
(307) 823-2968
Not Available

Primary Care Clinic Profile

Full NameHealthy Lifestyle Medicine
SpecialityFamily Medicine
Location6015 Sycamore Rd, Cheyenne, Wyoming
Authorized Official Name and PositionKristine Van Kirk (OWNER/PROVIDER)
Authorized Official Contact3078232968
Accepts Medicare InsuranceYes. This clinic participates in medicare program and accept medicare insurance.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Healthy Lifestyle Medicine
6015 Sycamore Rd
Cheyenne
WY 82009-4347

Ph: (307) 823-2968
Healthy Lifestyle Medicine
6015 Sycamore Rd
Cheyenne
WY 82009-4347

Ph: (307) 823-2968

NPI Details:

NPI Number1912478819
Provider Enumeration Date12/17/2018
Last Update Date12/20/2018

Medicare PECOS Information:

Medicare PECOS PAC ID3577802941
Medicare Enrollment IDO20190301000090

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Medical Identifiers

Medical identifiers for Healthy Lifestyle Medicine such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1912478819NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
207QA0505XFamily Medicine - Adult Medicine (* (Not Available))Primary
2083B0002XPreventive Medicine - Obesity Medicine (* (Not Available))Secondary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Healthy Lifestyle Medicine acts as a billing entity for following providers:
Provider NameKelly Gebauer
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1356964464
PECOS PAC ID: 0840692596
Enrollment ID: I20210716002411

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