Kodiak Anesthesia PC

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

License

7192A Issued in WY

Legal business name

KODIAK ANESTHESIA PC

Doing business as

Matthew D.Chynoweth

Practice address

4850 Chinook TRL
Casper, WY 82604-5201

Phone

(307) 473-8173

NPI assigned

Oct 8, 2014

Last updated

Dec 4, 2019By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Matthew D ChynowethNPI 1376658104

Title

President

Phone

(307) 473-8173

Specialties & licenses 1

Addresses

Other names 1

• Matthew D.Chynoweth Doing business as

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Matthew D Chynoweth, DO

  • Anesthesiology Physician
  • Casper, WY
  • NPI 1376658104
  NPD Authorized official

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

{
    "created_epoch": "1412726400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1575417600000",
    "number": "1295138972",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4850 CHINOOK TRL",
            "city": "CASPER",
            "state": "WY",
            "postal_code": "826045201",
            "telephone_number": "307-473-8173"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4850 CHINOOK TRL",
            "city": "CASPER",
            "state": "WY",
            "postal_code": "826045201",
            "telephone_number": "307-473-8173"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "111 W 2nd St",
            "address_2": "#415",
            "address_purpose": "LOCATION",
            "city": "Casper",
            "state": "WY",
            "postal_code": "826012454",
            "country_code": "US",
            "telephone_number": "307-237-5848",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "KODIAK ANESTHESIA PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-10-08",
        "last_updated": "2019-12-04",
        "status": "A",
        "authorized_official_last_name": "CHYNOWETH",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "307-473-8173",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Anesthesiology",
            "state": "WY",
            "license": "7192A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Matthew D.Chynoweth",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Matthew D.Chynoweth",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Robert Denis Knowles, PSY D
• Daniel B Knox, M.D.
• Jacqueline R Knox
• Melissa M. Knudson-Johnson, M.D.
• Tara L Kobielusz, CASE MANAGER
• Kodiak Anesthesia PC
• John Phillip Koffman, EDUCATION SPECIALIST
• Patricia Ann Kolarik, BA
• Susan Kay Kollmann, RN
• Daphne Kontos

• Anesthesiology Physician in Casper, WY
• Providers in Casper, WY by specialty
• Anesthesiology Physician in Wyoming

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.