Thomas Etter, LLC

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

Legal business name

THOMAS ETTER, LLC

Practice address

902 Blackburn St
Cody, WY 82414-8494

Phone

(307) 296-1355

Fax

(307) 586-5464

NPI assigned

Apr 9, 2021

Organization subpart

No

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

Authorized official

Name

Thomas H Etter, DONPI 1154562791

Title

Owner

Phone

(307) 296-1355

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WY

Enrollment records 1

Locations

Practitioners 2

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

• Thomas H Etter, D.O.

  • Surgery Physician
  • Cody, WY
  • NPI 1154562791
  Medicare reassignment NPD Authorized official
• Jennifer Lindsay Warner, PA-C

  • Physician Assistant
  • Cody, WY
  • NPI 1306405790
  Medicare reassignment

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

{
    "created_epoch": "1617926400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1660089600000",
    "number": "1275113706",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9 CONAGHER RD",
            "city": "CODY",
            "state": "WY",
            "postal_code": "824148232"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "902 BLACKBURN ST",
            "city": "CODY",
            "state": "WY",
            "postal_code": "824148494",
            "telephone_number": "307-296-1355",
            "fax_number": "307-586-5464"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THOMAS ETTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-04-09",
        "last_updated": "2022-08-10",
        "certification_date": "2022-08-10",
        "status": "A",
        "authorized_official_last_name": "ETTER",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "307-296-1355",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• H. David Taylor, DDS
• Jennifer Tella
• Shannon Terry
• Theo Riley PHD LLC
• Christopher Franklin Thoma, D.C.
• Rebecca L. Thomas, M.ED, PPC
• Lauren S Thompson, M.S., PPC
• Allison Tipton, OTR/L
• Nathan Tomisich
• Alicia Torres, MS, CCC-SLP

• Surgery Physician in Cody, WY
• Providers in Cody, WY by specialty
• Surgery Physician in Wyoming

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.