Pony Express Pediatrics, LLC

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

Legal business name

PONY EXPRESS PEDIATRICS, LLC

Practice address

1307 Crook Ave
Cheyenne, WY 82001-5412

Phone

(321) 313-3595

NPI assigned

Aug 8, 2019

Organization subpart

Yes

Parent organization

PONY EXPRESS PEDIATRICS, LLCAs reported in NPPES

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

Authorized official

Name

Christa Jayleen Kovachevich, APRNNPI 1649642034

Title

Owner/Aprn CPNP-PC

Phone

(321) 313-3595

Specialties & licenses 1

Addresses

Other identifiers 1

Part of

Pony Express Pediatrics LLC

Practitioners 1

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

• Christa J Kovachevich, ARNP, CPNP-PC

  • Pediatric Nurse Practitioner
  • Cheyenne, WY
  • NPI 1649642034

  Pediatrics

  NPD Authorized official

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

{
    "created_epoch": "1565222400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1565222400000",
    "number": "1265087993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2076 PAINTED SKY RD",
            "city": "CHEYENNE",
            "state": "WY",
            "postal_code": "820099196",
            "telephone_number": "321-313-3595"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1307 CROOK AVE",
            "city": "CHEYENNE",
            "state": "WY",
            "postal_code": "820015412",
            "telephone_number": "321-313-3595"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PONY EXPRESS PEDIATRICS, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PONY EXPRESS PEDIATRICS, LLC",
        "enumeration_date": "2019-08-08",
        "last_updated": "2019-08-08",
        "status": "A",
        "authorized_official_last_name": "KOVACHEVICH",
        "authorized_official_first_name": "CHRISTA",
        "authorized_official_middle_name": "JAYLEEN",
        "authorized_official_title_or_position": "OWNER/APRN CPNP-PC",
        "authorized_official_telephone_number": "321-313-3595",
        "authorized_official_credential": "APRN"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "016218600",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Pogue LLC
• Therese J Pohl
• Elizabeth A Pollnow, MSW LCSW
• Alexandria Marie Lee Polson, PT, DPT
• Trevor J Polson, PT, DPT
• Gergana Patrova Popova-Orahovats, MD
• Sarah Popp, RN
• Secia Porreco, DPT
• Danielle Porter
• Judith Porter

• Pediatric Nurse Practitioner in Cheyenne, WY
• Providers in Cheyenne, WY by specialty
• Pediatric Nurse Practitioner in Wyoming

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2019; 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.