Organization Active NPI

Villa Anesthesia PC

  • Anesthesiology Physician
  • Casper, WY
National Provider Identifier
1194210328
Registry record updated Jun 29, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
TL4408 Issued in WY
Legal business name
VILLA ANESTHESIA PC
Practice address
1233 E 2ND St
Casper, WY 82601-2926
Phone
(307) 577-7201
NPI assigned
Jun 29, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2018

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

Authorized official

Name
Mrs. Marguerite Hardy
Title
Authorized Official
Phone
(307) 234-9657

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207L00000X TL4408 WY Primary

Addresses

Primary practice location

1233 E 2ND St
Casper, WY 82601-2926

Mailing address

742 S David St
Casper, WY 82601-3137
Phone (307) 234-9657

Other identifiers 1

IdentifierTypeStateIssuer
1407913270MedicaidIL

National Provider Directory

National Provider Directory

Locations

742 S David St
Casper, WY 82601

NPI Registry JSON

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

{
    "created_epoch": "1530230400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1530230400000",
    "number": "1194210328",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "742 S DAVID ST",
            "city": "CASPER",
            "state": "WY",
            "postal_code": "826013137",
            "telephone_number": "307-234-9657",
            "fax_number": "307-234-0306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1233 E 2ND ST",
            "city": "CASPER",
            "state": "WY",
            "postal_code": "826012926",
            "telephone_number": "307-577-7201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VILLA ANESTHESIA PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-06-29",
        "last_updated": "2018-06-29",
        "status": "A",
        "authorized_official_last_name": "HARDY",
        "authorized_official_first_name": "MARGUERITE",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "307-234-9657",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Anesthesiology",
            "state": "WY",
            "license": "TL4408",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1407913270",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Casper, WY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2018; 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.