Sterling Provider Group
Clinic/Center, Primary Care in Afton, WY. Organization (NPI-2).
NPI number1962047431
StatusActive
Last updated in NPPESJun 17, 2026
Details
- NPI
- 1962047431
- Entity type
- Organization (NPI-2)
- Legal business name
- Sterling Provider Group
- Organization subpart
- No
- Enumeration date
- Nov 8, 2019
- Certification date
- Jun 17, 2026
- Last updated
- Jun 17, 2026
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QP2300X | Clinic/Center, Primary Care | – | – | Yes |
| 261QM0801X | Clinic/Center, Mental Health (Including Community Mental Health Center) | – | – | |
| 261QX0100X | Clinic/Center, Occupational Medicine | – | – | |
| 261QU0200X | Clinic/Center, Urgent Care | – | – |
Practice location
47 Doc Perkes RdAfton, WY 83110-7703
Phone 307-885-3637 · Fax 307-885-3638
Mailing address
740 S Woodruff AveIdaho Falls, ID 83401-5285
Phone 208-542-9111
Authorized official
Corbin Bunnage
Provider/Owner
2085429111
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