Mattie Raydon Johnson

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

44901 Issued in WY

Practice address

625 Albany Ave
Torrington, WY 82240-1530

Phone

(307) 532-2107

NPI assigned

Sep 2, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Cheyenne Health and Wellness CenterGroup PAC ID 7315985942, 7 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Cheyenne Regional Medical Center Hospital, Cheyenne, WY, CCN 530014

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mwilmore33072@direct.crmcwy.org

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.

• Cheyenne Health & Wellness Center

  • Community Health Clinic/Center
  • Cheyenne, WY
  • NPI 1386632594
  Medicare reassignment Care Compare group NPD
• Cheyenne Health & Wellness Center

  • Community/Retail Pharmacy
  • Cheyenne, WY
  • NPI 1417123167
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Memorial Hospital of Laramie County

  • General Acute Care Hospital
  • Cheyenne, WY
  • NPI 1285621839
  Care Compare affiliation

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

{
    "created_epoch": "1662076800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662076800000",
    "number": "1003537564",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "625 ALBANY AVE",
            "city": "TORRINGTON",
            "state": "WY",
            "postal_code": "822401530"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "625 ALBANY AVE",
            "city": "TORRINGTON",
            "state": "WY",
            "postal_code": "822401530",
            "telephone_number": "307-532-2107"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "MATTIE",
        "middle_name": "RAYDON",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-09-02",
        "last_updated": "2022-09-02",
        "certification_date": "2022-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WY",
            "license": "44901",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kerry Jinks, BA
• Samantha Marie Joe
• Amy Lawan Johansson, FNP-C
• Ryan Christopher Johns
• Angela Johnson
• Ty Everette Johnson
• Grant William Jones, O.D.
• Lynda Lea Jones, O.D.
• Andrew M Juarez Jr.
• Issifi Karimou, M.D.

• Family Nurse Practitioner in Torrington, WY
• Providers in Torrington, WY by specialty
• Family Nurse Practitioner in Wyoming

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.