Individual provider Active NPI

Stephanie I Knodel

  • Emergency Medicine Physician
  • Cody, WY
National Provider Identifier
1205079902
Registry record updated Oct 5, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
10969A Issued in WY
Practice address
707 Sheridan Ave
Cody, WY 82414-3409
Phone
(307) 578-2000
NPI assigned
Apr 9, 2009
Last updated
Oct 5, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 5, 2020

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Emergency Medicine Physician 207P00000X DR.0054837 CO
Emergency Medicine Physician 207P00000X A128792 CA
Emergency Medicine Physician 207P00000X 10969A WY Primary

Addresses

Primary practice location

707 Sheridan Ave
Cody, WY 82414-3409

Mailing address

707 Sheridan Ave
Cody, WY 82414-3409

Other names 1

  • Stephanie I Knodel Professional name

Medicare participation

Medicare enrollment files
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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170425001374 WY Practitioner - Emergency Medicine 1850519703 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
West Park Hospital DistrictGroup PAC ID 7315855624, 85 clinicians

Practice addresses (Care Compare)

424 Yellowstone Ave
Suite 120
Cody, WY 82414-9311
Phone (307) 578-2903

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
80.79 of 100Reported as group
Quality
72.82
Promoting interoperability
100
Improvement activities
40
Cost
63.14

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
54446CAMDDentist
A128792CAMDEmergency Medicine Physician
10969AWYMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cody Regional Health EMS CurrentSince Mar 19, 2017 Accepting new patients
West Park Hospital District CurrentSince Mar 19, 2017 Accepting new patients
West Park Hospital District Emergency Medicine CurrentSince Mar 19, 2017 Accepting new patients
West Park Hospital District Past Accepting new patients

Locations

424 Yellowstone Ave
Cody, WY 82414
Phone (307) 578-2903

424 Yellowstone Ave
Ste 120
Cody, WY 82414
Phone (307) 578-2903

707 Sheridan Ave
Cody, WY 82414
Phone (307) 527-7561

Organizations & group practices 4

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.

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1239235200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601856000000",
    "number": "1205079902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "707 SHERIDAN AVE",
            "city": "CODY",
            "state": "WY",
            "postal_code": "824143409"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "707 SHERIDAN AVE",
            "city": "CODY",
            "state": "WY",
            "postal_code": "824143409",
            "telephone_number": "307-578-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KNODEL",
        "first_name": "STEPHANIE",
        "middle_name": "I",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-04-09",
        "last_updated": "2020-10-05",
        "certification_date": "2020-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CO",
            "license": "DR.0054837",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "A128792",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "WY",
            "license": "10969A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STEPHANIE",
            "last_name": "KNODEL",
            "middle_name": "I",
            "credential": "M.D.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Cody, WY

Sources for this page

Verify at the official NPI Registry.