NPIMap

Individual provider Active NPI

Corey A Page, PAC

  • Physician Assistant
  • Cheyenne, WY
National Provider Identifier
1003096959
Registry record updated Sep 13, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
378 Issued in WY
Practice address
2030 Bluegrass Cir
Cheyenne, WY 82009-7328
Phone
(307) 286-8236
NPI assigned
Nov 8, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 13, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 378 WY Primary

Addresses

Primary practice location

2030 Bluegrass Cir
Cheyenne, WY 82009-7328

Mailing address

539 W 3Rd St
Cheyenne, WY 82007-1591
Phone (307) 286-8236

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150618002124 TX Practitioner - Physician Assistant 1759479165 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
378WYMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Frontier Medical Providers Past Accepting new patients
Cheyenne Regional Urgent Care, LLC Past Accepting new patients
Medi Horizons Inc Past Accepting new patients
Frontier Emergency Physicians, LLP Past Accepting new patients
Peak Emergency Physicians LLC Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: cpage457871@direct.stlukeshealth.org

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1194480000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1315872000000",
    "number": "1003096959",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "539 W 3RD ST",
            "city": "CHEYENNE",
            "state": "WY",
            "postal_code": "820071591",
            "telephone_number": "307-286-8236"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2030 BLUEGRASS CIR",
            "city": "CHEYENNE",
            "state": "WY",
            "postal_code": "820097328",
            "telephone_number": "307-286-8236"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAGE",
        "first_name": "COREY",
        "middle_name": "A",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-11-08",
        "last_updated": "2011-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WY",
            "license": "378",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cheyenne, WY

Sources for this page

Verify at the official NPI Registry.