Individual provider Active NPI

Diane E Hattel, FNP-C

  • Family Nurse Practitioner
  • Cheyenne, WY
National Provider Identifier
1003951229
Registry record updated Feb 27, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
16129.0890 Issued in WY
Practice address
3235 Sparks Rd
Suite 200
Cheyenne, WY 82001-6151
Phone
(307) 638-8975
Fax
(307) 634-9267
NPI assigned
Feb 21, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 16129.0890 WY Primary

Addresses

Primary practice location

3235 Sparks Rd
Suite 200
Cheyenne, WY 82001-6151

Mailing address

4003 Rawlins St
Cheyenne, WY 82001-1800
Phone (307) 638-8975

Other identifiers 2

IdentifierTypeStateIssuer
P00605061OtherRAILROAD MEDICARE - PALMETTO GBA
124192300MedicaidWY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070525000095 WY Practitioner - Nurse Practitioner 2961509989 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

4003 Rawlins St
Cheyenne, WY 82001-1800

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
16129.0890WYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Willow Creek Family Medicine, P.C. Family CurrentSince Dec 20, 2007 Accepting new patients
Mountain West Surgical Specialists LLC CurrentSince Mar 1, 2024 Accepting new patients
Mountain Falls Clinic, P.C. Past Accepting new patients

Locations

3235 Sparks Rd
Ste 200
Cheyenne, WY 82001
Phone (307) 638-7757

2029 Bluegrass Cir
Ste 200
Cheyenne, WY 82009
Phone (307) 778-7666

2232 Dell Range Blvd
Ste 100
Cheyenne, WY 82009
Phone (307) 638-6624

4003 Rawlins St
Cheyenne, WY 82001
Phone (307) 323-2679

Interoperability endpoints

  • FHIR API: https://soap.crmcwy.org/fhirproxy/api/FHIR/R4

Organizations & group practices 3

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

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1172016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1488153600000",
    "number": "1003951229",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4003 RAWLINS ST",
            "city": "CHEYENNE",
            "state": "WY",
            "postal_code": "820011800",
            "telephone_number": "307-638-8975",
            "fax_number": "307-634-9267"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3235 SPARKS RD",
            "address_2": "SUITE 200",
            "city": "CHEYENNE",
            "state": "WY",
            "postal_code": "820016151",
            "telephone_number": "307-638-8975",
            "fax_number": "307-634-9267"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HATTEL",
        "first_name": "DIANE",
        "middle_name": "E",
        "name_prefix": "Mrs.",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-21",
        "last_updated": "2017-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WY",
            "license": "16129.0890",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE - PALMETTO GBA",
            "identifier": "P00605061",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "124192300",
            "state": "WY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cheyenne, WY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.