PEDIATRIC ASSOCIATES OF WYOMING (NPI# 1205386281) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1205386281 |
| Entity Type | Organization |
| Organization Name | PEDIATRIC ASSOCIATES OF WYOMING |
| Other Organization Name | DELL RANGE PEDIATRICS |
| Practice Address |
4605 N College Dr Cheyenne WY 82009-5455 |
| Practice Telephone | 3074595437 |
| Mailing Telephone | 3074595437 |
| Enumeration Date | 2016-10-13 |
| Last Update Date | 2016-10-13 |
| Authorized Official Name | DR. BRAHMANANDA KIRAN KODURI (MEDICAL DIRECTOR) |
| Authorized Official Telephone | 3073658789 |
| Authorized Official Credential | M.D |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM2500X |
Clinic/Center Specialization: Medical Specialty |
WY | Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Dell Range Pediatrics | Doing Business As Name - Organization |
| Street Address |
4605 N COLLEGE DR |
| City | CHEYENNE |
| State | WY |
| Zip Code | 82009-5455 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659840841 | King & Associates LLC | Private Vehicle | 2232 Dell Range Blvd 245 #3083 Cheyenne, Cheyenne, WY 82009 | 2018-11-16 |
| 1710495700 | Wyoming Endoscopy Center LLC | Clinic/Center | 7220 Comons Circle, Cheyenne, WY 82009 | 2018-01-12 |
| 1912442682 | Lindsey Thurmes Mccoy | Dietitian, Registered | 2232 Dell Range Blvd Ste 282, Cheyenne, WY 82009 | 2017-01-04 |
| 1306380696 | Alexandra Gill | Social Worker | 3304 East 1-80 Service Rd., Cheyenne, WY 82009 | 2016-12-06 |
| 1104213859 | Jennifer Schwartz | Specialist | 2601 Plain View Rd, Cheyenne, WY 82009 | 2015-04-21 |
| 1861830465 | Tyler Boyd | Dentist | 7209 Commons Cir Unit A, Cheyenne, WY 82009 | 2013-06-05 |
| 1639513351 | Gene E Darnell | Pharmacist | 3702 Del Range Blvd, Cheyenne, WY 82009 | 2013-04-24 |
| 1376891952 | Robert R Kanard | Internal Medicine | 714 Edward Dr, Cheyenne, WY 82009 | 2012-08-29 |
| 1639443336 | Jennifer Alam | Case Manager/Care Coordinator | 3304 E. I80 Service Rd, Cheyenne, WY 82009 | 2012-02-28 |
| 1376815357 | Christina Kay Brown | Licensed Practical Nurse | 3304 E I80 Service Rd, Cheyenne, WY 82009 | 2012-02-06 |
| Find all providers in zip 82009 | ||||
| Taxonomy Code | 261QM2500X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Medical Specialty |
| An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer). |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720054802 | Cheyenne Eye Clinic, LLC | Clinic/Center | 1300 E 20th St, Cheyenne, WY 82001-4021 | 2006-02-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467925545 | Indian Creek Health System LLC | Clinic/Center | 10717c Highway 230, Riverside, WY 82325 | 2019-01-10 |
| 1316120991 | Nephrology Clinic PC | Clinic/Center | 3116 Willet Dr, Laramie, WY 82072 | 2007-12-06 |
| 1578181467 | American Thyroid Institute LLC | Clinic/Center | 30 N Gould St Ste R, Sheridan, WY 82801-6317 | 2020-07-08 |
| 1194044750 | Teton Dermatology Inc | Clinic/Center | 984 West Broadway, Suite 4, Jackson, WY 83001-0000 | 2010-05-21 |
| 1053554162 | Double Rainbow Sciences, LLC | Clinic/Center | 555 E. Broadway, Suite 108, Jackson, WY 83001 | 2009-04-20 |
| 1871741322 | Huxford Chiropractic Clinic | Clinic/Center | 706 Elk St, Rock Springs, WY 82901-5247 | 2008-09-08 |
| 1841452000 | Abc Pediatrics LLC | Clinic/Center | 1300 W 4th St, Gillette, WY 82716-3339 | 2008-06-30 |
| 1760650980 | Richardson Family Health Center, P.C. | Clinic/Center | 430 Broadway St, Rock Springs, WY 82901-6269 | 2008-02-11 |
| 1093998098 | Thomas E Spicer, Md-pc | Clinic/Center | 1208 Hilltop Dr, Suite 103, Rock Springs, WY 82901-5857 | 2007-12-12 |
| 1982755096 | Central Wyoming Eye Clinic, PC | Clinic/Center | 1705 E 12th St, Casper, WY 82601-4038 | 2007-01-15 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.