Individual provider Active NPI

Ann Marie Hart, FNP-BC

  • Nurse Practitioner
  • Laramie, WY
National Provider Identifier
1104999747
Registry record updated Oct 4, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
17320.174 Issued in WY
Practice address
501 S 11TH St
Laramie, WY 82070-4011
Phone
(307) 460-8570
NPI assigned
Nov 15, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 4, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 17320.174 WY Primary

Addresses

Primary practice location

501 S 11TH St
Laramie, WY 82070-4011

Mailing address

501 S 11TH St
Laramie, WY 82070-4011
Phone (307) 745-4460

Other identifiers 1

IdentifierTypeStateIssuer
112888400MedicaidWY

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)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
17320.174WYMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Thomas Perry Goodell, MD, PC Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: ann.hart.2@15734.direct.athenahealth.com

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.

NPI Registry JSON

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

{
    "created_epoch": "1163548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1223078400000",
    "number": "1104999747",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 S 11TH ST",
            "city": "LARAMIE",
            "state": "WY",
            "postal_code": "820704011",
            "telephone_number": "307-745-4460"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 S 11TH ST",
            "city": "LARAMIE",
            "state": "WY",
            "postal_code": "820704011",
            "telephone_number": "307-460-8570"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HART",
        "first_name": "ANN",
        "middle_name": "MARIE",
        "credential": "FNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-15",
        "last_updated": "2008-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WY",
            "license": "17320.174",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "112888400",
            "state": "WY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Laramie, WY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2008; 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.