Individual provider Active NPI

Kiechel Craig Valentine, PHARM.D

  • Pharmacist
  • Cheyenne, WY
National Provider Identifier
1073894150
Registry record updated Sep 2, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
2901 Issued in WY
Practice address
5353 Yellowstone Rd
Cheyenne, WY 82009-4178
Phone
(307) 433-3668
Fax
(303) 370-1694
NPI assigned
Sep 2, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 2, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 2901 WY Primary

Addresses

Primary practice location

5353 Yellowstone Rd
Cheyenne, WY 82009-4178

Mailing address

5353 Yellowstone Rd
Cheyenne, WY 82009-4178
Phone (307) 433-3668

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
2901WYMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1314921600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1314921600000",
    "number": "1073894150",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5353 YELLOWSTONE RD",
            "city": "CHEYENNE",
            "state": "WY",
            "postal_code": "820094178",
            "telephone_number": "307-433-3668",
            "fax_number": "303-370-1694"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5353 YELLOWSTONE RD",
            "city": "CHEYENNE",
            "state": "WY",
            "postal_code": "820094178",
            "telephone_number": "307-433-3668",
            "fax_number": "303-370-1694"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VALENTINE",
        "first_name": "KIECHEL",
        "middle_name": "CRAIG",
        "credential": "PHARM.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-09-02",
        "last_updated": "2011-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "WY",
            "license": "2901",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cheyenne, WY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.