Individual provider Active NPI

Patrick Fitzgerald, APRN

  • Nurse Practitioner
  • Cheyenne, WY
National Provider Identifier
1043687395
Registry record updated Aug 21, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
30766.1423 Issued in WY
Practice address
2508 E Fox Farm Rd
Cheyenne, WY 82007-2559
Phone
(307) 635-3618
Fax
(307) 635-1442
NPI assigned
Aug 21, 2015
Last updated
Aug 21, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 21, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 30766.1423 WY Primary

Addresses

Primary practice location

2508 E Fox Farm Rd
Cheyenne, WY 82007-2559

Mailing address

2508 E Fox Farm Rd
Cheyenne, WY 82007-2559
Phone (307) 635-3618

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20150917003138 WY Practitioner - Nurse Practitioner 2567779804 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Cheyenne Health & Wellness Center CurrentSince Aug 20, 2015 Accepting new patients
Cheyenne Health & Wellness Center CurrentSince Aug 20, 2015 Accepting new patients

Locations

2508 E Fox Farm Rd
Ste 1A
Cheyenne, WY 82007
Phone (307) 635-3618

Interoperability endpoints

  • Direct secure messaging: pfitzgerald20592@direct.crmcwy.org

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1440115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1440115200000",
    "number": "1043687395",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2508 E FOX FARM RD",
            "city": "CHEYENNE",
            "state": "WY",
            "postal_code": "820072559",
            "telephone_number": "307-635-3618",
            "fax_number": "307-635-1442"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2508 E FOX FARM RD",
            "city": "CHEYENNE",
            "state": "WY",
            "postal_code": "820072559",
            "telephone_number": "307-635-3618",
            "fax_number": "307-635-1442"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FITZGERALD",
        "first_name": "PATRICK",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-08-21",
        "last_updated": "2015-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WY",
            "license": "30766.1423",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cheyenne, WY

Sources for this page

Verify at the official NPI Registry.