Penny Marie Sanderson, APRN, FNP-C
Individual provider Active NPI Family Nurse Practitioner · Cheyenne, WY
NPI 1013249929 · NPPES record last updated Oct 9, 2024
Key facts
- NPI
- 1013249929
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 30342.1158 (WY)
- Practice address
- 2500 Dell Range Blvd
Cheyenne, WY 82009-5273 - Phone
- (307) 630-4729
- Fax
- (307) 632-3298
- NPI assigned
- Feb 2, 2010
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 7
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2008
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Liv in-Home Counseling and Care Management, LLC
Practice addresses (Care Compare)
2500 Dell Range Blvd
Cheyenne, WY 82009-5273
Phone (307) 630-4729
Merit-based Incentive Payment System (MIPS)
- Final score
- 96.38 of 100
- Quality
- 92.76
- Improvement activities
- 40
Merit-based Incentive Payment System (MIPS)
- Final score
- 33.71 of 100
- Quality
- 39.66
- Improvement activities
- 0
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WY
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20180222002540 | WY | Practitioner - Nurse Practitioner | 8426186230 | Reassigns benefits to 5 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 30342.1158 | WY | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ivinson Memorial Hospital | Current |
Accepting new patients | |
| Digestive Health Associates of Cheyenne | Current |
Accepting new patients | |
| Memorial Hospital of Carbon County | Current | Accepting new patients | |
| Internal Medicine Group PC | Current |
Accepting new patients | |
| Ivinson Memorial Hospital | Current |
Accepting new patients | |
| Memorial Hospital of Carbon County | Current | Accepting new patients | |
| Liv in-Home Counseling & Care Management, LLC | Current |
Accepting new patients |
Locations
7212 Commons Cir
Cheyenne, WY 82009
Phone (307) 635-4141
2500 Dell Range Blvd
Cheyenne, WY 82009
Phone (307) 630-4729
3116 Willett Dr
Laramie, WY 82072
Phone (307) 742-6319
255 N 30th St
Laramie, WY 82072
Phone (307) 742-2141
300 3rd St
Rawlins, WY 82301
Phone (307) 324-3403
2221 Elm St
Rawlins, WY 82301
Phone (307) 324-2221
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 111108 | NE | |
| Family Nurse Practitioner | 363LF0000X | 30342.1158 | WY | Yes |
Addresses
Primary practice location
2500 Dell Range Blvd
Cheyenne, WY 82009-5273
Mailing address
PO Box 20092
Cheyenne, WY 82003-7002
Phone (307) 630-4729
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 10025914400 | Medicaid | NE | |
| 47051963312 | Medicaid | NE |
Other providers in Cheyenne, WY
- Justin M Sanchez
- Kristin Sanchez
- Leo Shane Sanchez
- Loree D Sanchez
- Susan Emillia Sanchez
- Stanley M Sandick
- Daffney Lauren Sandoval
- Sandra a Guidry
- Sandra a Guidry MD
- Andrea Sands
All providers in Cheyenne, WY · Family Nurse Practitioner in Wyoming
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 9, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.