Individual provider Active NPI

Meghann Mara McAndrew, DPT

  • Physician Assistant
  • Douglas, WY
National Provider Identifier
1265669287
Registry record updated Apr 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
1259 Issued in WY
Practice address
111 S 5TH St
Douglas, WY 82633-2434
Phone
(307) 358-9464
Fax
(307) 358-9330
NPI assigned
Jun 17, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 1280 WY
Physician Assistant 363A00000X 1259 WY Primary

Addresses

Primary practice location

111 S 5TH St
Douglas, WY 82633-2434

Mailing address

PO Box 1790
Douglas, WY 82633-1790
Phone (307) 358-9464

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WY2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20090826000885 WY Practitioner - Physical Therapist in Private Practice 1254486251 Reassigns benefits to 2 organizations
I20240716001372 WY Practitioner - Physician Assistant 1254486251 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Yale University School of Medicine, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Senior Health LLCGroup PAC ID 6305260746, 27 clinicians

Practice addresses (Care Compare)

475 Yellow Creek Rd
Evanston, WY 82930-5109
Phone (307) 789-0726

Hospital & facility affiliations

  • Memorial Hospital of Converse County Hospital, Douglas, WY, CCN 531302

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1280WYMDPhysical Therapist
1259WYMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Senior Health LLC CurrentSince Sep 23, 2025 Accepting new patients
Bear Lodge Rehabilitation Services, LLC Physical Therapist CurrentSince Mar 1, 2017 Accepting new patients
Big Country Rehabilitation,LLC Physical Therapist CurrentSince Mar 11, 2019 Accepting new patients
Douglas Med Spa LLC CurrentSince Jan 1, 2024 Accepting new patients
Memorial Hospital of Converse County CurrentSince Sep 24, 2024 Accepting new patients

Locations

598 W 900 S
Ste 230
Woods Cross, UT 84010
Phone (385) 403-0410

700 E Center St
Douglas, WY 82633
Phone (307) 352-8946

119 N 3rd St
Douglas, WY 82633
Phone (307) 358-5244

111 S 5th St
Douglas, WY 82633
Phone (307) 358-6200

475 Yellow Creek Rd
Evanston, WY 82930
Phone (307) 789-0726

Interoperability endpoints

  • Direct secure messaging: meghann.boggs.1@14719.direct.athenahealth.com

Organizations & group practices 6

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.

Hospital & facility affiliations 1

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": "1245196800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744070400000",
    "number": "1265669287",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1790",
            "city": "DOUGLAS",
            "state": "WY",
            "postal_code": "826331790",
            "telephone_number": "307-358-9464",
            "fax_number": "307-358-9330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 S 5TH ST",
            "city": "DOUGLAS",
            "state": "WY",
            "postal_code": "826332434",
            "telephone_number": "307-358-9464",
            "fax_number": "307-358-9330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCANDREW",
        "first_name": "MEGHANN",
        "middle_name": "MARA",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-17",
        "last_updated": "2025-04-08",
        "certification_date": "2025-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WY",
            "license": "1280",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WY",
            "license": "1259",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Douglas, WY

Sources for this page

Verify at the official NPI Registry.