Antelope Medical Consultants LLC
Organization Active NPI Cardiovascular Disease Physician · Gillette, WY
NPI 1124188545 · NPPES record last updated Sep 11, 2025
Key facts
- NPI
- 1124188545
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Cardiovascular Disease Physician 207RC0000X
- License
- 5853A (WY)
- Legal business name
- ANTELOPE MEDICAL CONSULTANTS LLC
- Practice address
- 430 S Medical Arts CT
Gillette, WY 82716-3364 - Phone
- (307) 682-7661
- Fax
- (307) 682-5074
- NPI assigned
- Dec 8, 2006
- Organization subpart
- No
Authorized official
- Name
- Dr. Lisa Anne Malody, M.D.
- Title
- Owner
- Phone
- (307) 682-7661
Practitioners 3
-
Kenneth Wayne Sickel, PA-C
-
Lisa Anne Malody, M.D.
National Provider Directory
Locations
518 N US Highway 14-16
Unit D
Gillette, WY 82716
Phone (307) 682-7661
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician |
207R00000X | 5806A | WY | |
| Cardiovascular Disease Physician |
207RC0000X | 5853A | WY | Yes |
| Family Nurse Practitioner |
363LF0000X | 18882.269 | WY |
Addresses
Primary practice location
430 S Medical Arts CT
Gillette, WY 82716-3364
Mailing address
430 S Medical Arts CT
Gillette, WY 82716-3364
Phone (307) 682-7661
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 7088727 | Medicaid | WA | |
| 00783001 | Other | WY | BLUE CROSS CLINIC NUMBER |
Other providers in Gillette, WY
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- Thomas Todd Andrew
- Gwen A Andrews
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- Aoc Medical LLC
- Casey Armstrong
- Matthew David Arnio
- Aspire Counseling, LLC
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All providers in Gillette, WY · Cardiovascular Disease Physician in Wyoming
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 11, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.