Active NPI
Reed Clifton Shafer, MD
- Neurology Physician
- Cheyenne, WY
National Provider Identifier
1316920549
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neurology Physician
- License
- 2910A
- Practice address
- 5050 Powderhouse Rd
Cheyenne, WY 82009-4800 - Phone
- (307) 634-1311
- Fax
- (307) 634-1271
- NPI assigned
- Nov 22, 2005
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Neurology Physician | 2084N0400X | 2910A | WY | Primary |
Addresses
Primary practice location
5050 Powderhouse Rd
Cheyenne, WY 82009-4800
Mailing address
5050 Powderhouse Rd
Cheyenne, WY 82009-4800
Phone (307) 634-1311
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 101850700 | Medicaid | WY | |
| 2910A | Other | WY | STATE LICENSE |
| 511RS92 | Other | WY | SUBSTANCE CONTROL |
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2910A | WY | MD | Neurology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1132617600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1260316800000",
"number": "1316920549",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5050 POWDERHOUSE RD",
"city": "CHEYENNE",
"state": "WY",
"postal_code": "820094800",
"telephone_number": "307-634-1311",
"fax_number": "307-634-1271"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5050 POWDERHOUSE RD",
"city": "CHEYENNE",
"state": "WY",
"postal_code": "820094800",
"telephone_number": "307-634-1311",
"fax_number": "307-634-1271"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHAFER",
"first_name": "REED",
"middle_name": "CLIFTON",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-11-22",
"last_updated": "2009-12-09",
"status": "A"
},
"taxonomies": [
{
"code": "2084N0400X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Neurology",
"state": "WY",
"license": "2910A",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "101850700",
"state": "WY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE LICENSE",
"identifier": "2910A",
"state": "WY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "SUBSTANCE CONTROL",
"identifier": "511RS92",
"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 Dec 9, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.