Carmen Petsch, AGACNP-BC

Primary specialty

Acute Care Nurse PractitionerTaxonomy code 363LA2100X

License

52688 Issued in WY

Practice address

2301 House Ave
Cheyenne, WY 82001-3176

Phone

(307) 634-2273

NPI assigned

Jul 19, 2023

Last updated

Feb 2, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 2

Medicare fee-for-service enrollment

Enrolled in WY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Creighton University School of Medicine, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Cheyenne Regional Physicians Group LLCGroup PAC ID 2961403639, 101 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Cheyenne Regional Medical Center Hospital, Cheyenne, WY, CCN 530014
• Memorial Hospital of Converse County Hospital, Douglas, WY, CCN 531302
• Platte County Hospital Hospital, Wheatland, WY, CCN 531305

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: cpetsch59930@direct.crmcwy.org

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Cheyenne Regional Physicians Group, LLC

  dba Cheyenne Regional Medical Group, LLC

  • Medical Oncology Physician
  • Cheyenne, WY
  • NPI 1659458008
  Medicare reassignment Care Compare group NPD
• Cheyenne Children's Clinic, PC

  • Pediatrics Physician
  • Cheyenne, WY
  • NPI 1073537601
  NPD (past)
• Cheyenne Regional Physicians Group, LLC

  • Pediatrics Physician
  • Cheyenne, WY
  • NPI 1629737259
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Memorial Hospital of Converse County

  • Critical Access Hospital
  • Douglas, WY
  • NPI 1326085408
  Care Compare affiliation
• Memorial Hospital of Laramie County

  dba Cheyenne Regional Medical Center

  • General Acute Care Hospital
  • Cheyenne, WY
  • NPI 1285621839
  Care Compare affiliation
• Platte County Hospital

  • Critical Access Hospital
  • Guernsey, WY
  • NPI 1265469506
  Care Compare affiliation
• Platte County Memorial Nursing Home

  • Skilled Nursing Facility
  • Wheatland, WY
  • NPI 1003951518

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1689724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706832000000",
    "number": "1134809759",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6419 S 108TH AVE",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681374732",
            "telephone_number": "402-216-8360"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2301 HOUSE AVE",
            "city": "CHEYENNE",
            "state": "WY",
            "postal_code": "820013176",
            "telephone_number": "307-634-2273"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETSCH",
        "first_name": "CARMEN",
        "credential": "AGACNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-07-19",
        "last_updated": "2024-02-02",
        "certification_date": "2024-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "WY",
            "license": "52688",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cpetsch59930@direct.crmcwy.org",
            "affiliation": "Y",
            "endpointDescription": "CRMC Direct Address",
            "affiliationName": "Cheyenne Regional Physicians Group, LLC",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "214 E 23rd St",
            "city": "Cheyenne",
            "state": "WY",
            "country_code": "US",
            "postal_code": "820013748",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cpetsch59930@direct.crmcwy.org",
            "affiliation": "Y",
            "endpointDescription": "CRMC Direct Address",
            "affiliationName": "Cheyenne Regional Physicians Group, LLC",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "214 E 23rd St",
            "city": "Cheyenne",
            "state": "WY",
            "country_code": "US",
            "postal_code": "820013748",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Megan E Peterson, RN
• Robyn Lynn Peterson, O.D.
• Steven Peterson, D.M.D.
• Whitney Peterson, DNP, MSN-ED, RN
• Janice J Petrie, LCSW
• Brett Alden Pexton, O.D.
• Alyse Pfankuch, MA
• Dalton James Pfankuch, PT, DPT
• Steven Edward Pflanz, MD
• Pharmakon Solutions, LLC

• Acute Care Nurse Practitioner in Cheyenne, WY
• Providers in Cheyenne, WY by specialty
• Acute Care Nurse Practitioner in Wyoming

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.