Active NPI
Andrew Marcarelli
- Radiologic Technologist
- Fort Washakie, WY
National Provider Identifier
1285087684
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Radiologic Technologist
- License
- 365673
- Practice address
- 29 Black Coal Dr
Ft Washakie, WY 82514 - Phone
- (307) 332-7300
- NPI assigned
- Jul 20, 2016
- Last updated
- Jul 20, 2016
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Radiologic Technologist | 247100000X | 365673 | CO | Primary |
Addresses
Primary practice location
29 Black Coal Dr
Ft Washakie, WY 82514
Mailing address
696 Canyon St
Lander, WY 82520-3230
Phone (714) 475-4227
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 365673 | CO | MD | Radiologic Technologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1468972800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1468972800000",
"number": "1285087684",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "696 CANYON ST",
"city": "LANDER",
"state": "WY",
"postal_code": "825203230",
"telephone_number": "714-475-4227"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "29 BLACK COAL DR",
"city": "FT WASHAKIE",
"state": "WY",
"postal_code": "82514",
"telephone_number": "307-332-7300"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARCARELLI",
"first_name": "ANDREW",
"name_prefix": "Mr.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2016-07-20",
"last_updated": "2016-07-20",
"status": "A"
},
"taxonomies": [
{
"code": "247100000X",
"taxonomy_group": "",
"desc": "Radiologic Technologist",
"state": "CO",
"license": "365673",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Washakie, WY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.