NPIMap

Individual provider Active NPI

Erin Marie Henderson, M.D.

  • Internal Medicine Physician
  • Sheridan, WY
National Provider Identifier
1063663102
Registry record updated Dec 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
16319A Issued in WY
Practice address
61 S Gould St
Sheridan, WY 82801-6304
Phone
(307) 675-2690
Fax
(307) 675-2691
NPI assigned
Oct 7, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 27, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 50126 CO
Internal Medicine Physician 207R00000X TL7953 WY
Internal Medicine Physician 207R00000X 16319A WY Primary

Addresses

Primary practice location

61 S Gould St
Sheridan, WY 82801-6304

Mailing address

61 S Gould St
Sheridan, WY 82801-6304
Phone (307) 675-2690

Other identifiers 1

IdentifierTypeStateIssuer
46054561MedicaidCO

Other names 1

  • Erin Marie Brandl Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231114001344 WY Practitioner - Internal Medicine 2163694803 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Colorado School of Medicine, Denver, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Big Horn Health NetworkGroup PAC ID 1254476484, 84 clinicians

Practice addresses (Care Compare)

61 S Gould St
Sheridan, WY 82801-6304
Phone (307) 675-2690

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
86.66 of 100Reported as group
Quality
82.09
Promoting interoperability
98
Improvement activities
40
Cost
75.1

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
50126COMDInternal Medicine Physician
16319AWYMDInternal Medicine Physician
TL7953WYMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Big Horn Health Network Internal Medicine CurrentSince Dec 1, 2023 Accepting new patients

Locations

1333 W 5th St
Ste 110
Sheridan, WY 82801
Phone (307) 675-4610

61 S Gould St
Sheridan, WY 82801
Phone (307) 675-2690

1401 W 5th St
Sheridan, WY 82801
Phone (307) 672-1000

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.

Hospital & facility affiliations 13

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1223337600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703635200000",
    "number": "1063663102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "61 S GOULD ST",
            "city": "SHERIDAN",
            "state": "WY",
            "postal_code": "828016304",
            "telephone_number": "307-675-2690",
            "fax_number": "307-675-2691"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "61 S GOULD ST",
            "city": "SHERIDAN",
            "state": "WY",
            "postal_code": "828016304",
            "telephone_number": "307-675-2690",
            "fax_number": "307-675-2691"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENDERSON",
        "first_name": "ERIN",
        "middle_name": "MARIE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-10-07",
        "last_updated": "2023-12-27",
        "certification_date": "2023-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CO",
            "license": "50126",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WY",
            "license": "TL7953",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WY",
            "license": "16319A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "46054561",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ERIN",
            "last_name": "BRANDL",
            "middle_name": "MARIE",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Sheridan, WY

Sources for this page

Verify at the official NPI Registry.