Wyoming Psychiatry & Consultation LLC

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

Legal business name

WYOMING PSYCHIATRY & CONSULTATION LLC

Practice address

2862 Ardon LN
Casper, WY 82609-3900

Phone

(307) 690-0263

NPI assigned

Nov 12, 2021

Organization subpart

No

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

Authorized official

Name

Anna Cummings Rork, MDNPI 1457882722

Title

Owner

Phone

(307) 264-2423

Specialties & licenses 1

Addresses

Other names 1

• Cordillera Mental Health Services Doing business as

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Anna Cummings Rork, MD

  • Psychiatry Physician
  • Bozeman, MT
  • NPI 1457882722
  NPD Authorized official
• Carly Jane Wasserbach, APRN

  • Psychiatric/Mental Health Nurse Practitioner
  • Casper, WY
  • NPI 1962265793
  NPD

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

{
    "created_epoch": "1636675200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1700265600000",
    "number": "1083370258",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2862 ARDON LN",
            "city": "CASPER",
            "state": "WY",
            "postal_code": "826093900",
            "telephone_number": "307-690-0263"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2862 ARDON LN",
            "city": "CASPER",
            "state": "WY",
            "postal_code": "826093900",
            "telephone_number": "307-690-0263"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3403 S 21st Ave",
            "address_purpose": "LOCATION",
            "city": "Bozeman",
            "state": "MT",
            "postal_code": "597186698",
            "country_code": "US",
            "telephone_number": "307-264-2423",
            "fax_number": "904-748-2569",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "WYOMING PSYCHIATRY & CONSULTATION LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-11-12",
        "last_updated": "2023-11-18",
        "certification_date": "2023-11-18",
        "status": "A",
        "authorized_official_last_name": "RORK",
        "authorized_official_first_name": "ANNA",
        "authorized_official_middle_name": "CUMMINGS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "307-264-2423",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Cordillera Mental Health Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Providers in Casper, WY by specialty
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2023; 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.