Individual provider Active NPI

Thomas George Cassidy, MD

  • Internal Medicine Physician
  • Cheyenne, WY
National Provider Identifier
1376501999
Registry record updated Apr 26, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
5093A Issued in WY
Practice address
8050 Ridge Rd
Cheyenne, WY 82009-1508
Phone
(307) 421-6627
Fax
(307) 778-7531
NPI assigned
May 3, 2006
Last updated
Apr 26, 2016By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 26, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 5093A WY Primary

Addresses

Primary practice location

8050 Ridge Rd
Cheyenne, WY 82009-1508

Mailing address

8050 Ridge Rd
Cheyenne, WY 82009-1508
Phone (307) 421-6627

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)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
5093AWYMDInternal Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1146614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1461628800000",
    "number": "1376501999",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8050 RIDGE RD",
            "city": "CHEYENNE",
            "state": "WY",
            "postal_code": "820091508",
            "telephone_number": "307-421-6627",
            "fax_number": "307-778-7531"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8050 RIDGE RD",
            "city": "CHEYENNE",
            "state": "WY",
            "postal_code": "820091508",
            "telephone_number": "307-421-6627",
            "fax_number": "307-778-7531"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CASSIDY",
        "first_name": "THOMAS",
        "middle_name": "GEORGE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-03",
        "last_updated": "2016-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WY",
            "license": "5093A",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Apr 26, 2016; 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.