Individual provider Active NPI

Stephanie Marie Pierce, P.A.

  • Surgical Physician Assistant
  • Casper, WY
National Provider Identifier
1255768644
Registry record updated Aug 16, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
TL581 Issued in WY
Practice address
6600 E 2ND St
Central Wyoming Neurosurgery
Casper, WY 82609
Phone
(307) 266-4000
Fax
(307) 473-6793
NPI assigned
Oct 1, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 16, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X PA.0001733 CO
Surgical Physician Assistant 363AS0400X TL581 WY Primary

Addresses

Primary practice location

6600 E 2ND St
Central Wyoming Neurosurgery
Casper, WY 82609

Mailing address

6600 E 2ND St
Central Wyoming Neurosurgery
Casper, WY 82609-4348
Phone (307) 266-4000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
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

Enrollment IDStateProvider typePAC IDDetails
I20150709001328 CO Practitioner - Physician Assistant 0446480016 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Portercare Adventist Health System CurrentSince Oct 1, 2018 Accepting new patients
Portercare Adventist Health System CurrentSince Oct 1, 2018 Accepting new patients

Locations

8200 E Belleview Ave
Ste 400E
Greenwood Village, CO 80111
Phone (303) 790-2225

7750 S Broadway
Ste 260
Littleton, CO 80122
Phone (303) 734-8650

Organizations & group practices 3

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": "1380585600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534377600000",
    "number": "1255768644",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6600 E 2ND ST",
            "address_2": "CENTRAL WYOMING NEUROSURGERY",
            "city": "CASPER",
            "state": "WY",
            "postal_code": "826094348",
            "telephone_number": "307-266-4000",
            "fax_number": "307-473-6793"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6600 E 2ND ST",
            "address_2": "CENTRAL WYOMING NEUROSURGERY",
            "city": "CASPER",
            "state": "WY",
            "postal_code": "82609",
            "telephone_number": "307-266-4000",
            "fax_number": "307-473-6793"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PIERCE",
        "first_name": "STEPHANIE",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-10-01",
        "last_updated": "2018-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "CO",
            "license": "PA.0001733",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "WY",
            "license": "TL581",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Casper, WY

Sources for this page

Verify at the official NPI Registry.