Individual provider Active NPI

Connie Thompson, PT 1165

  • Physical Therapist
  • Casper, WY
National Provider Identifier
1326459249
Registry record updated May 13, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT 1165 Issued in WY
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

Updated by the provider on May 13, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
PT 1165OtherWYWYOMING 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

LicenseStateTypeSpecialty
PT 1165WYMDPhysical 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.

Verify at the official NPI Registry.