Active NPI
Robyn Carroll Yetka, PA-C
- Medical Physician Assistant
- Cheyenne, WY
National Provider Identifier
1407015308
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Physician Assistant
- License
- 118
- Practice address
- 714 W Fox Farm Rd
Cheyenne, WY 82007-2360 - Phone
- (130) 777-8783
- Fax
- (130) 777-8257
- NPI assigned
- Jun 5, 2008
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | 118 | WY | Primary |
Addresses
Primary practice location
714 W Fox Farm Rd
Cheyenne, WY 82007-2360
Mailing address
714 W Fox Farm Rd
Cheyenne, WY 82007-2360
Phone (130) 777-8783
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 54RCY07M | Other | WY | WYOMING CONTROLLED SUBSTANCE |
| 118 | Other | WY | WYOMING BOARD OF MEDICINE |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 118 | WY | MD | Medical Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Attention Homes, Inc. | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Psychiatry Physician
- Cheyenne, WY
- NPI 1619097755
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1212624000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1678147200000",
"number": "1407015308",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "714 W FOX FARM RD",
"city": "CHEYENNE",
"state": "WY",
"postal_code": "820072360",
"telephone_number": "130-777-8783",
"fax_number": "130-777-8257"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "714 W FOX FARM RD",
"city": "CHEYENNE",
"state": "WY",
"postal_code": "820072360",
"telephone_number": "130-777-8783",
"fax_number": "130-777-8257"
}
],
"practiceLocations": [],
"basic": {
"last_name": "YETKA",
"first_name": "ROBYN",
"middle_name": "CARROLL",
"name_prefix": "Ms.",
"credential": "PA-C",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-06-05",
"last_updated": "2023-03-07",
"status": "A"
},
"taxonomies": [
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "WY",
"license": "118",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "WYOMING CONTROLLED SUBSTANCE",
"identifier": "54RCY07M",
"state": "WY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "WYOMING BOARD OF MEDICINE",
"identifier": "118",
"state": "WY"
}
],
"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 Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.