Individual provider Active NPI

Laura Ann Martin, MD

  • Pulmonary Disease Physician
  • Cheyenne, WY
National Provider Identifier
1184607152
Registry record updated Jun 17, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
5157A Issued in WY
Practice address
5050 Powderhouse Rd
Cheyenne, WY 82009-4800
Phone
(307) 772-8226
Fax
(307) 634-1271
NPI assigned
Nov 23, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pulmonary Disease Physician 207RP1001X 5157A WY Primary

Addresses

Primary practice location

5050 Powderhouse Rd
Cheyenne, WY 82009-4800

Mailing address

2360 E Pershing Blvd
Cheyenne, WY 82001-5356
Phone (307) 778-7322

Other identifiers 3

IdentifierTypeStateIssuer
104601200MedicaidWY
222LB92OtherWYSUBSTANCE CONTROL
5157AOtherWYSTATE LICENSE

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
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
5157AWYMDPulmonary Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Memorial Hospital of Laramie County Current Accepting new patients
Wops Inc Current Accepting new patients

Locations

4116 Laramie St
Cheyenne, WY 82001
Phone (307) 634-9311

214 E 23rd St
Cheyenne, WY 82001
Phone (307) 324-2221

5050 Powderhouse Rd
Cheyenne, WY 82009
Phone (307) 634-1311

Organizations & group practices 2

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": "1132704000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1308268800000",
    "number": "1184607152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2360 E PERSHING BLVD",
            "city": "CHEYENNE",
            "state": "WY",
            "postal_code": "820015356",
            "telephone_number": "307-778-7322",
            "fax_number": "307-778-7531"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5050 POWDERHOUSE RD",
            "city": "CHEYENNE",
            "state": "WY",
            "postal_code": "820094800",
            "telephone_number": "307-772-8226",
            "fax_number": "307-634-1271"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "LAURA",
        "middle_name": "ANN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-23",
        "last_updated": "2011-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "WY",
            "license": "5157A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "104601200",
            "state": "WY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SUBSTANCE CONTROL",
            "identifier": "222LB92",
            "state": "WY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "5157A",
            "state": "WY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cheyenne, WY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2011; 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.