Marti Jo Sidwell

Primary specialty

Case Management AgencyTaxonomy code 251B00000X

Practice address

400 N 100 E
Suite 205
Green River, WY 82935

Phone

(307) 362-2424

Fax

(307) 222-0614

NPI assigned

Feb 19, 2016

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Marti Jo Tyler Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1455840000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599091200000",
    "number": "1174982045",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "688 ANTELOPE DR LOT 21",
            "city": "ROCK SPRINGS",
            "state": "WY",
            "postal_code": "829013016",
            "telephone_number": "307-274-7500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 N 100 E",
            "address_2": "SUITE 205",
            "city": "GREEN RIVER",
            "state": "WY",
            "postal_code": "82935",
            "telephone_number": "307-362-2424",
            "fax_number": "307-222-0614"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIDWELL",
        "first_name": "MARTI",
        "middle_name": "JO",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-02-19",
        "last_updated": "2020-09-03",
        "certification_date": "2020-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARTI",
            "last_name": "TYLER",
            "middle_name": "JO",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Case Management Agency in Green River, WY
• Providers in Green River, WY by specialty
• Case Management Agency in Wyoming

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2020; 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.