Active NPI
Connie Thompson, PT 1165
- Physical Therapist
- Casper, WY
National Provider Identifier
1326459249
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT 1165
- Practice address
- 1020 E 2ND St
Casper, WY 82601-2946 - Phone
- (307) 577-8832
- Fax
- (307) 237-5421
- NPI assigned
- May 13, 2014
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT 1165 | WY | Primary |
Addresses
Primary practice location
1020 E 2ND St
Casper, WY 82601-2946
Mailing address
167 S Conwell St Ste 3
Casper, WY 82601-2749
Phone (307) 233-0246
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| PT 1165 | Other | WY | WYOMING STATE LICENSE NUMBER |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT 1165 | WY | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1399939200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1399939200000",
"number": "1326459249",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "167 S CONWELL ST STE 3",
"city": "CASPER",
"state": "WY",
"postal_code": "826012749",
"telephone_number": "307-233-0246",
"fax_number": "307-237-5421"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1020 E 2ND ST",
"city": "CASPER",
"state": "WY",
"postal_code": "826012946",
"telephone_number": "307-577-8832",
"fax_number": "307-237-5421"
}
],
"practiceLocations": [],
"basic": {
"last_name": "THOMPSON",
"first_name": "CONNIE",
"credential": "PT 1165",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-05-13",
"last_updated": "2014-05-13",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "WY",
"license": "PT 1165",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "WYOMING STATE LICENSE NUMBER",
"identifier": "PT 1165",
"state": "WY"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Casper, WY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.