Active NPI
Mark S Daugherity, MPT
- Physical Therapist
- Casper, WY
National Provider Identifier
1043579667
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT-0500
- Practice address
- 201 E 2ND St
Suite 14
Casper, WY 82601-2582 - Phone
- (307) 337-1624
- NPI assigned
- May 16, 2012
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT-0500 | WY | Primary |
Addresses
Primary practice location
201 E 2ND St
Suite 14
Casper, WY 82601-2582
Mailing address
201 E 2ND St
Suite 14
Casper, WY 82601-2582
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT-0500 | WY | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Wyoming Home Health Inc | Past | Accepting new patients |
Organizations & group practices 1
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": "1337126400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1337126400000",
"number": "1043579667",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "201 E 2ND ST",
"address_2": "SUITE 14",
"city": "CASPER",
"state": "WY",
"postal_code": "826012582"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "201 E 2ND ST",
"address_2": "SUITE 14",
"city": "CASPER",
"state": "WY",
"postal_code": "826012582",
"telephone_number": "307-337-1624"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAUGHERITY",
"first_name": "MARK",
"middle_name": "S",
"credential": "MPT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2012-05-16",
"last_updated": "2012-05-16",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "WY",
"license": "PT-0500",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Casper, WY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.