Gary Mundy MD LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

5258A Issued in WY

Legal business name

GARY MUNDY MD LLC

Practice address

1955 Coffeen Ave
Sheridan, WY 82801-5713

Phone

(307) 673-7560

NPI assigned

Apr 24, 2007

Organization subpart

No

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

Authorized official

Name

Gary D Mundy, MDNPI 1275567018

Title

Owner

Phone

(307) 673-7560

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Gary Duane Mundy, M.D.

  • Internal Medicine Physician
  • Sheridan, WY
  • NPI 1275567018
  NPD (past) Authorized official

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

{
    "created_epoch": "1177372800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1245459775",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1955 COFFEEN AVE",
            "city": "SHERIDAN",
            "state": "WY",
            "postal_code": "828015713",
            "telephone_number": "307-673-7560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1955 COFFEEN AVE",
            "city": "SHERIDAN",
            "state": "WY",
            "postal_code": "828015713",
            "telephone_number": "307-673-7560"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GARY MUNDY MD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-24",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MUNDY",
        "authorized_official_first_name": "GARY",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "307-673-7560",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "WY",
            "license": "5258A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "304445",
            "state": "WY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "DC7593",
            "state": "WY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Misty D Gardner, MS, DPT
• Ladonna Garneau, OT/L
• Candace Garner, MS, RDN
• Ashly Rose Garretson
• Linda Denise Garretson
• Jordan Gayer, PT
• Patricia A Gibbs, M.S., CCCA
• Giddy Up Wellness & Therapy Services
• Edward K Gifford, R.PH
• Derek Gilbert, M.D.

• Family Medicine Physician in Sheridan, WY
• Providers in Sheridan, WY by specialty
• Family Medicine Physician in Wyoming

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.