Individual provider Active NPI

Brant R Christensen, AU.D.

  • Audiologist
  • Cheyenne, WY
National Provider Identifier
1285639807
Registry record updated Oct 16, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
A-963 Issued in WY
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, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2020

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
112860402MedicaidWY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080804000597 WY Practitioner - Qualified Audiologist 0244304640 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
283NEMDMental Health Counselor
A-963WYMDAudiologist
A963WYMDAssistive 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.

Verify at the official NPI Registry.