Active NPI
Thomas D Concannon, LMFT
- Marriage & Family Therapist
- Jackson, WY
National Provider Identifier
1457510950
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- LMFT 127
- Practice address
- 510 S Cache
Jackson, WY 83001 - Phone
- (307) 733-6440
- Fax
- (307) 733-6374
- NPI assigned
- Jun 9, 2008
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | LMFT 127 | WY | Primary |
Addresses
Primary practice location
510 S Cache
Jackson, WY 83001
Mailing address
PO Box 2631
Jackson, WY 83001-2631
Phone (307) 733-6440
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 |
|---|---|---|---|
| LMFT 127 | WY | MD | Marriage & Family Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Teton Youth and Family Services | 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.
-
- Community/Behavioral Health Agency
- Jackson, WY
- NPI 1720288491
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1212969600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1355356800000",
"number": "1457510950",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 2631",
"city": "JACKSON",
"state": "WY",
"postal_code": "830012631",
"telephone_number": "307-733-6440",
"fax_number": "307-733-6374"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "510 S CACHE",
"city": "JACKSON",
"state": "WY",
"postal_code": "83001",
"telephone_number": "307-733-6440",
"fax_number": "307-733-6374"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CONCANNON",
"first_name": "THOMAS",
"middle_name": "D",
"credential": "LMFT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2008-06-09",
"last_updated": "2012-12-13",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "WY",
"license": "LMFT 127",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jackson, WY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.