Sky Wolf

Primary specialty

Military Health Care ProviderTaxonomy code 171000000X

Practice address

6900 Alden Dr BLDG 160
Cheyenne, WY 82005-2945

Phone

(307) 773-2779

NPI assigned

Mar 25, 2009

Sex

Female

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in WY, CA2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Specialty

Family Practice

Education

Other, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Southern California Permanente Medical GroupGroup PAC ID 6002729175, 11,250 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

Practice roles

Locations

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.

• Southern California Permanente Medical Group

  • Health Maintenance Organization
  • Riverside, CA
  • NPI 1316979834
  Medicare reassignment Care Compare group NPD
• University of Wyoming

  • Federally Qualified Health Center (FQHC)
  • Cheyenne, WY
  • NPI 1770681439

  Family Medicine

  Medicare reassignment NPD
• College Drive Urgent Care LLC

  • Urgent Care Clinic/Center
  • Cheyenne, WY
  • NPI 1467601765
  NPD
• University of Wyoming Speech and Hearing Clinic

  • Audiologist
  • Laramie, WY
  • NPI 1184760993
  NPD
• Southern California Permanente Medical Group

  • Health Maintenance Organization
  • Santa Clarita, CA
  • NPI 1316409410
  NPD
• Southern California Permanente Medical Group

  • Health Maintenance Organization
  • Bakersfield, CA
  • NPI 1861424376
  NPD
• University of Wyoming

  • Federally Qualified Health Center (FQHC)
  • Laramie, WY
  • NPI 1639617061

  Family Medicine

  NPD (past)

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

{
    "created_epoch": "1237939200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698364800000",
    "number": "1174765093",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6900 ALDEN DR BLDG 160",
            "city": "CHEYENNE",
            "state": "WY",
            "postal_code": "820052945",
            "telephone_number": "307-773-2779"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6900 ALDEN DR BLDG 160",
            "city": "CHEYENNE",
            "state": "WY",
            "postal_code": "820052945",
            "telephone_number": "307-773-2779"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "820 E 17th St",
            "address_purpose": "LOCATION",
            "city": "Cheyenne",
            "state": "WY",
            "postal_code": "820014714",
            "country_code": "US",
            "telephone_number": "307-632-2434",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "9500 Gilman Dr",
            "address_purpose": "LOCATION",
            "city": "LA Jolla",
            "state": "CA",
            "postal_code": "920930811",
            "country_code": "US",
            "telephone_number": "858-534-9540",
            "fax_number": "858-534-9404",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WOLF",
        "first_name": "SKY",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-03-25",
        "last_updated": "2023-10-27",
        "certification_date": "2020-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WY",
            "license": "12285A",
            "primary": false
        },
        {
            "code": "2083P0901X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Public Health & General Preventive Medicine",
            "state": "CA",
            "license": "20A11115",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "171000000X",
            "taxonomy_group": "",
            "desc": "Military Health Care Provider",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Southern California Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "3733 San Dimas St",
            "city": "Bakersfield",
            "state": "CA",
            "country_code": "US",
            "postal_code": "933011407",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Elizabeth Withrow
• Bailey E Wofford
• Dawn Marie Wold, APRN, MSN, NP-C
• Katie Wolf
• Melanie Wolf
• Jeni Marie Wolfe, FNP-C
• Michelle L Wolff, PPC
• Jennifer Marie Wood
• Joseph Wood
• Lee Anthony Woodard, DDS

• Military Health Care Provider in Cheyenne, WY
• Providers in Cheyenne, WY by specialty
• Military Health Care Provider in Wyoming

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2023; 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.