Individual provider Active NPI

Carolyn Marie Buettgenback, PT, DPT

  • Physical Therapist
  • Casper, WY
National Provider Identifier
1063179604
Registry record updated Sep 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
2124 Issued in WY
Practice address
1541 Centennial CT
Casper, WY 82609-7304
Phone
(307) 235-3910
NPI assigned
Nov 18, 2021
Last updated
Sep 18, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 2124 WY Primary

Addresses

Primary practice location

1541 Centennial CT
Casper, WY 82609-7304

Mailing address

3922 Wiseman Blvd
BLDG V, Suite 502
San Antonio, TX 78251
Phone (210) 775-6655

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211220002011 WY Practitioner - Physical Therapist in Private Practice 9830580281 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wind City Physical TherapyGroup PAC ID 9830172055, 16 clinicians

Practice addresses (Care Compare)

1541 Centennial CT
Casper, WY 82609-7304
Phone (307) 235-3910

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Wind City Physical Therapy Physical Therapist CurrentSince Nov 1, 2021 Accepting new patients
Wind City Physical Therapy Physical Therapist CurrentSince Nov 1, 2021 Accepting new patients

Locations

1541 Centennial Ct
Casper, WY 82609
Phone 30723539104151

234 E 1st St
Ste 10
Casper, WY 82601
Phone (307) 266-2891

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/15722/brand/1/csg/1/fhir/r4

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": "1637193600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758153600000",
    "number": "1063179604",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3922 WISEMAN BLVD",
            "address_2": "BLDG V, SUITE 502",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "78251",
            "telephone_number": "210-775-6655",
            "fax_number": "210-761-7291"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1541 CENTENNIAL CT",
            "city": "CASPER",
            "state": "WY",
            "postal_code": "826097304",
            "telephone_number": "307-235-3910"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUETTGENBACK",
        "first_name": "CAROLYN",
        "middle_name": "MARIE",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-11-18",
        "last_updated": "2025-09-18",
        "certification_date": "2025-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WY",
            "license": "2124",
            "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 Sep 18, 2025; 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.