Active NPI
Brant R Christensen, AU.D.
- Audiologist
- Cheyenne, WY
National Provider Identifier
1285639807
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Audiologist
- License
- A-963
- Practice address
- 7215 Commons Cir Unit C
Cheyenne, WY 82009-2666 - Phone
- (307) 426-4327
- Fax
- (307) 426-3277
- NPI assigned
- Jun 20, 2005
- Last updated
- Oct 16, 2020
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Assistive Technology Practitioner Audiologist | 231HA2400X | A963 | WY | |
| Assistive Technology Supplier Audiologist | 231HA2500X | A963 | WY | |
| Audiologist-Hearing Aid Fitter | 237600000X | A963 | WY | |
| Audiologist | 231H00000X | A-963 | WY | Primary |
Addresses
Primary practice location
7215 Commons Cir Unit C
Cheyenne, WY 82009-2666
Mailing address
PO Box 21804
Cheyenne, WY 82003-7073
Phone (307) 426-4327
Other practice location 1
115 W 22nd Ave
Torrington, WY 82240-2301
Phone (307) 426-4327
Other practice location 2
968 Gilchrist St
Wheatland, WY 82201-2932
Phone (307) 322-3332
Other practice location 3
1655 E 2nd St
Casper, WY 82601-3001
Phone (307) 473-5666
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 112860402 | Medicaid | WY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WY
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 283 | NE | MD | Mental Health Counselor |
| A-963 | WY | MD | Audiologist |
| A963 | WY | MD | Assistive Technology Practitioner Audiologist |
Organizations & group practices 4
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1119225600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1602806400000",
"number": "1285639807",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 21804",
"city": "CHEYENNE",
"state": "WY",
"postal_code": "820037073",
"telephone_number": "307-426-4327",
"fax_number": "307-426-3277"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7215 COMMONS CIR UNIT C",
"city": "CHEYENNE",
"state": "WY",
"postal_code": "820092666",
"telephone_number": "307-426-4327",
"fax_number": "307-426-3277"
}
],
"practiceLocations": [
{
"address_1": "115 W 22nd Ave",
"address_purpose": "LOCATION",
"city": "Torrington",
"state": "WY",
"postal_code": "822402301",
"country_code": "US",
"telephone_number": "307-426-4327",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "968 Gilchrist St",
"address_purpose": "LOCATION",
"city": "Wheatland",
"state": "WY",
"postal_code": "822012932",
"country_code": "US",
"telephone_number": "307-322-3332",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1655 E 2nd St",
"address_purpose": "LOCATION",
"city": "Casper",
"state": "WY",
"postal_code": "826013001",
"country_code": "US",
"telephone_number": "307-473-5666",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "CHRISTENSEN",
"first_name": "BRANT",
"middle_name": "R",
"name_prefix": "Mr.",
"credential": "AU.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-06-20",
"last_updated": "2020-10-16",
"certification_date": "2020-10-16",
"status": "A"
},
"taxonomies": [
{
"code": "231HA2400X",
"taxonomy_group": "",
"desc": "Audiologist, Assistive Technology Practitioner",
"state": "WY",
"license": "A963",
"primary": false
},
{
"code": "231HA2500X",
"taxonomy_group": "",
"desc": "Audiologist, Assistive Technology Supplier",
"state": "WY",
"license": "A963",
"primary": false
},
{
"code": "237600000X",
"taxonomy_group": "",
"desc": "Audiologist-Hearing Aid Fitter",
"state": "WY",
"license": "A963",
"primary": false
},
{
"code": "231H00000X",
"taxonomy_group": "",
"desc": "Audiologist",
"state": "WY",
"license": "A-963",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "112860402",
"state": "WY"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Cheyenne, WY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2020; 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.