Individual provider Active NPI

Brandon Tyler Johnson, DNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Cheyenne, WY
National Provider Identifier
1043943996
Registry record updated May 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
52996 Issued in WY
Practice address
510 W 29TH St
Cheyenne, WY 82001-2760
Phone
(307) 632-9362
NPI assigned
Jul 7, 2022
Last updated
May 6, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 6, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 52996 WY Primary

Addresses

Primary practice location

510 W 29TH St
Cheyenne, WY 82001-2760

Mailing address

510 W 29TH St
Cheyenne, WY 82001-2760
Phone (307) 632-9362

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
I20231024003725 WY Practitioner - Nurse Practitioner 6204282411 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

510 W 29TH St
Cheyenne, WY 82001-2760
Phone (307) 632-9362

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
University of Wyoming Speech and Hearing Clinic CurrentSince Sep 18, 2023 Accepting new patients
Volunteers of America Northern Rockies CurrentSince May 1, 2025 Accepting new patients
Volunteers of America Northern Rockies CurrentSince May 1, 2025 Accepting new patients
University of Wyoming CurrentSince Sep 18, 2023 Accepting new patients
University of Wyoming Past Accepting new patients

Locations

510 W 29th St
Cheyenne, WY 82001
Phone (307) 426-4728

820 E 17th St
Cheyenne, WY 82001
Phone (307) 431-5055

1174 N 22nd St
Laramie, WY 82072
Phone (307) 745-3704

2710 Harney St
Ste 202
Laramie, WY 82072
Phone (307) 742-3242

Organizations & group practices 5

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": "1657152000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746489600000",
    "number": "1043943996",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "510 W 29TH ST",
            "city": "CHEYENNE",
            "state": "WY",
            "postal_code": "820012760",
            "telephone_number": "307-632-9362"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "510 W 29TH ST",
            "city": "CHEYENNE",
            "state": "WY",
            "postal_code": "820012760",
            "telephone_number": "307-632-9362"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "BRANDON",
        "middle_name": "TYLER",
        "name_prefix": "Dr.",
        "credential": "DNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-07-07",
        "last_updated": "2025-05-06",
        "certification_date": "2025-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "WY",
            "license": "52996",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cheyenne, WY

Sources for this page

Verify at the official NPI Registry.