DANIEL RYAN KISICKI (NPI# 1902060833) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1902060833 |
| Entity Type | Individual |
| Full Name | DANIEL RYAN KISICKI |
| Credential | MD |
| Practice Address |
1950 Bluegrass Cir Suite 200 Cheyenne WY 82009-7323 |
| Practice Telephone | 3077782577 |
| Mailing Telephone | 3077782577 |
| Enumeration Date | 2008-07-10 |
| Last Update Date | 2014-09-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207Q00000X | Family Medicine | 4301092823 | MI | Allopathic & Osteopathic Physicians |
| Y | 207QS0010X |
Family Medicine Specialization: Sports Medicine |
9010A | WY | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WY | 1902060833 | 05 |
| Street Address |
1950 BLUEGRASS CIR SUITE 200 |
| City | CHEYENNE |
| State | WY |
| Zip Code | 82009-7323 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386603553 | Judson Howard Cook | Neurological Surgery | 1950 Bluegrass Cir, Ste 170, Cheyenne, WY 82009 | 2006-03-17 |
| 1982003463 | Jessica Annette Britton | Massage Therapist | 1950 Bluegrass Cir, Suite 110, Cheyenne, WY 82009-7323 | 2014-08-20 |
| 1245670231 | Bodybalance | Chiropractor | 1950 Bluegrass Cir, Suite 110, Cheyenne, WY 82009-7363 | 2013-07-05 |
| 1376891226 | Sunflower Kaste | Nurse Practitioner | 1950 Bluegrass Cir, Suite 200, Cheyenne, WY 82009-7323 | 2012-08-27 |
| 1881996254 | Kylie A Brough | Physician Assistant | 1950 Bluegrass Cir, Suite 170, Cheyenne, WY 82009-7323 | 2010-11-17 |
| 1730407495 | Wyoming Spine & Neurosurgery | Neurological Surgery | 1950 Bluegrass Cir, Suite 170, Cheyenne, WY 82009-7323 | 2010-05-05 |
| 1295976322 | Wyoming Neuromonitoring, LLC | Rehabilitation Practitioner | 1950 Bluegrass Cir, Suite170, Cheyenne, WY 82009-7323 | 2009-03-19 |
| 1750521969 | Wyoming Neuromonitoring, LLC | Durable Medical Equipment & Medical Supplies | 1950 Bluegrass Cir, 170, Cheyenne, WY 82009-7323 | 2009-02-27 |
| 1114106283 | Leslie M. Valente | Physical Therapist | 1950 Bluegrass Cir, Suite 110, Cheyenne, WY 82009-7323 | 2007-10-25 |
| 1720296130 | Wyoming Spine and Neurosurgery LLC | Neurological Surgery | 1950 Bluegrass Cir, Ste 170, Cheyenne, WY 82009-7323 | 2007-05-18 |
| Find all providers in the same location | ||||
| 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 | 207QS0010X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Specialization | Sports Medicine |
| A family medicine physician that is trained to be responsible for continuous care in the field of sports medicine, not only for the enhancement of health and fitness, but also for the prevention of injury and illness. A sports medicine physician must have knowledge and experience in the promotion of wellness and the prevention of injury. Knowledge about special areas of medicine such as exercise physiology, biomechanics, nutrition, psychology, physical rehabilitation, epidemiology, physical evaluation, injuries (treatment and prevention and referral practice) and the role of exercise in promoting a healthy lifestyle are essential to the practice of sports medicine. The sports medicine physician requires special education to provide the knowledge to improve the health care of the individual engaged in physical exercise (sports) whether as an individual or in team participation. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Family Medicine, 2007. http://www.theabfm.org/. American Osteopathic Board of Family Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Medicine. |
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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.