Individual provider Active NPI

Carla Jill Leinen, FNP

  • Family Nurse Practitioner
  • Laramie, WY
National Provider Identifier
1386725653
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
16074.262 Issued in WY
Practice address
504 E Lyons St
Laramie, WY 82072-2132
Phone
(307) 745-0085
Fax
(307) 745-0084
NPI assigned
Oct 17, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 16074.262 WY Primary

Addresses

Primary practice location

504 E Lyons St
Laramie, WY 82072-2132

Mailing address

504 E Lyons St
Laramie, WY 82072-2132
Phone (307) 745-0085

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101206001064 WY Practitioner - Nurse Practitioner 5799770590 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
16074.262WYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Family Care Clinic, LLC CurrentSince Aug 18, 2003 Accepting new patients
Laramie Clinic, P.C. Past Accepting new patients
Skye Yoga Counseling, LLC PastSince Sep 22, 2024 Accepting new patients

Locations

204 McCullum Dr
Ste 104
Laramie, WY 82070
Phone (307) 745-0085

504 E Lyon St
Laramie, WY 82072
Phone (307) 223-2172

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1161043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1386725653",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "504 E LYONS ST",
            "city": "LARAMIE",
            "state": "WY",
            "postal_code": "820722132",
            "telephone_number": "307-745-0085",
            "fax_number": "307-745-0084"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "504 E LYONS ST",
            "city": "LARAMIE",
            "state": "WY",
            "postal_code": "820722132",
            "telephone_number": "307-745-0085",
            "fax_number": "307-745-0084"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEINEN",
        "first_name": "CARLA",
        "middle_name": "JILL",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WY",
            "license": "16074.262",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Laramie, WY

Sources for this page

Verify at the official NPI Registry.