Montanna Lee Merrick, PA-C

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

PA1221 Issued in WY

Practice address

4003 Rawlins St
Cheyenne, WY 82001-1800

Phone

(307) 632-1114

NPI assigned

Jan 17, 2024

Last updated

Dec 13, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Montanna Lee Chrystal Former name

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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Creighton University School of Medicine, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mountain West Surgical Specialists LLCGroup PAC ID 3870030471, 3 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Cheyenne Regional Medical Center Hospital, Cheyenne, WY, CCN 530014

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Mountain West Surgical Specialists LLC

  • Orthopaedic Surgery Physician
  • Cheyenne, WY
  • NPI 1366209645
  Medicare reassignment Care Compare group
• Willow Creek Family Medicine, P.C.

  • Family Nurse Practitioner
  • Cheyenne, WY
  • NPI 1184800674
  NPD
• Cheyenne Regional Physicians Group, LLC

  • Pediatrics Physician
  • Cheyenne, WY
  • NPI 1629737259
  NPD (past)

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

• Memorial Hospital of Laramie County

  dba Cheyenne Regional Medical Center

  • General Acute Care Hospital
  • Cheyenne, WY
  • NPI 1285621839
  Care Compare affiliation

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

{
    "created_epoch": "1705449600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734048000000",
    "number": "1205697315",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4811 KESTER ST",
            "city": "CHEYENNE",
            "state": "WY",
            "postal_code": "820012085",
            "telephone_number": "307-274-6576"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4003 RAWLINS ST",
            "city": "CHEYENNE",
            "state": "WY",
            "postal_code": "820011800",
            "telephone_number": "307-632-1114"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MERRICK",
        "first_name": "MONTANNA",
        "middle_name": "LEE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-01-17",
        "last_updated": "2024-12-13",
        "certification_date": "2024-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WY",
            "license": "PA1221",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "WY",
            "license": "PA1221",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MONTANNA",
            "last_name": "CHRYSTAL",
            "middle_name": "LEE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Memorial Hospital of Laramie County (Cheyenne Regional Davis Hospice Center)
• Memorial Hospital of Laramie County (Cheyenne Regional Medical Center-Hospitalists)
• Memorial Hospital of Laramie County
• Megan Marie Mendoza, RN, PMHNP-DNP BC
• Arthur Nelson Merrell, MD
• Brendelyn Merritt, RN
• Emily Metcalf, RN
• Brittany Metz
• Meghan Rebecca Metz, CNA / EKG TECHNICIAN
• Ladonna Metzger

• Surgical Physician Assistant in Cheyenne, WY
• Providers in Cheyenne, WY by specialty
• Surgical Physician Assistant in Wyoming

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2024; 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.