Ann H Thedieck, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

6716A Issued in WY

Practice address

1400 Uinta Dr
Green River, WY 82935-5046

Phone

(307) 872-4500

Fax

(307) 872-4595

NPI assigned

May 25, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Pine Ridge Indian Health Service Hospital

  • General Acute Care Hospital
  • Pine Ridge, SD
  • NPI 1497786412

  TX

  Medicare reassignment NPD
• Quentin N Burdick Comprehensive Health Care Facility

  • Rural Acute Care Hospital
  • Belcourt, ND
  • NPI 1952346934

  TX

  Medicare reassignment NPD
• Pine Ridge Indian Health Service Hospital

  • Clinic/Center
  • Martin, SD
  • NPI 1003208257
  NPD
• Pine Ridge Indian Health Service Hospital

  • Clinic/Center
  • Wanblee, SD
  • NPI 1962559518
  NPD
• Rangeland Inpatient Services LLC

  • Hospitalist Physician
  • Newcastle, WY
  • NPI 1104191352
  NPD (past)

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

{
    "created_epoch": "1148515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1073569745",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 219",
            "city": "GREEN RIVER",
            "state": "WY",
            "postal_code": "829350219",
            "telephone_number": "307-872-4500",
            "fax_number": "307-872-4595"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 UINTA DR",
            "city": "GREEN RIVER",
            "state": "WY",
            "postal_code": "829355046",
            "telephone_number": "307-872-4500",
            "fax_number": "307-872-4595"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THEDIECK",
        "first_name": "ANN",
        "middle_name": "H",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-25",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WY",
            "license": "6716A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "313158",
            "state": "WY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Michael Ross Svejcar, MPT
• Sweetwater County Child Developmental Center
• Sweetwater Radiology, PC
• Tanner Family Dentistry, Devin K. Tanner DDS, LLC
• Devin K. Tanner, DDS
• Estevia Thibeault
• Marlena Thompson
• Sara R Thompson, P T
• Stacy Renee Thompson, APRN
• Malinda Ranee Tollefson, MSW, LCSW

• Family Medicine Physician in Green River, WY
• Providers in Green River, WY by specialty
• Family Medicine Physician in Wyoming

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.