NPIMap

Organization Active NPI

Cheyenne Regional Physicians Group, LLC

  • Pediatrics Physician
  • Cheyenne, WY
National Provider Identifier
1356009294
Registry record updated Jul 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
CHEYENNE REGIONAL PHYSICIANS GROUP, LLC
Practice address
2301 House Ave Ste 405
Cheyenne, WY 82001-3180
Phone
(307) 635-7961
Fax
(307) 778-5812
NPI assigned
Dec 7, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 3, 2026

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

Authorized official

Name
Brad White
Title
Administrator of Revenue
Phone
(307) 633-6198

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208000000X Primary

Addresses

Primary practice location

2301 House Ave Ste 405
Cheyenne, WY 82001-3180

Mailing address

PO Box 20970
Cheyenne, WY 82003-7020
Phone (307) 635-7961

Other names 1

  • Cheyenne Children's Clinic (MOB) Other name

National Provider Directory

National Provider Directory
Tax ID family
Summit Spine and Neurosurgery Associates17 organizations share this tax ID, including this one
Part of
Summit Spine and Neurosurgery Associates

Other organizations with this tax ID 16

Organizations that report the same tax identification number in the National Provider Directory.

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1638835200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1783036800000",
    "number": "1356009294",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 20970",
            "city": "CHEYENNE",
            "state": "WY",
            "postal_code": "820037020",
            "telephone_number": "307-635-7961",
            "fax_number": "307-778-5812"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2301 HOUSE AVE STE 405",
            "city": "CHEYENNE",
            "state": "WY",
            "postal_code": "820013180",
            "telephone_number": "307-635-7961",
            "fax_number": "307-778-5812"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHEYENNE REGIONAL PHYSICIANS GROUP, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-12-07",
        "last_updated": "2026-07-03",
        "certification_date": "2026-07-03",
        "status": "A",
        "authorized_official_last_name": "WHITE",
        "authorized_official_first_name": "BRAD",
        "authorized_official_title_or_position": "ADMINISTRATOR OF REVENUE",
        "authorized_official_telephone_number": "307-633-6198"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Cheyenne Children's Clinic (MOB)",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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 Jul 3, 2026; 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.