Rowan E Tichenor, MD

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

2634A Issued in WY

Practice address

1119 E 3Rd St
Casper, WY 82601-2905

Phone

(307) 266-2772

Fax

(307) 266-2076

NPI assigned

Jul 13, 2005

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1121212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1406592000000",
    "number": "1093713067",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1119 E 3RD ST",
            "city": "CASPER",
            "state": "WY",
            "postal_code": "826012905",
            "telephone_number": "307-266-2772",
            "fax_number": "307-266-2076"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1119 E 3RD ST",
            "city": "CASPER",
            "state": "WY",
            "postal_code": "826012905",
            "telephone_number": "307-266-2772",
            "fax_number": "307-266-2076"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TICHENOR",
        "first_name": "ROWAN",
        "middle_name": "E",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-07-13",
        "last_updated": "2014-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "WY",
            "license": "2634A",
            "primary": true
        },
        {
            "code": "207ND0900X",
            "taxonomy_group": "",
            "desc": "Dermatology, Dermatopathology",
            "state": "WY",
            "license": "2634A",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "070011534",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "106641200",
            "state": "WY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Brenda Threlkeld
• June Thresher
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• Christina J. Tiensvold, C.PH.T.
• Mary Louise Tierney
• Ashleigh Tieszen, RBT
• Ashley Timm
• Timothy B Hudson MD PC

• Dermatology Physician in Casper, WY
• Providers in Casper, WY by specialty
• Dermatology Physician in Wyoming

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2014; 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.