Active NPI
Jeanne Marie Raney, MA CCCSLP
- Speech-Language Pathologist
- Pinedale, WY
National Provider Identifier
1457557159
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- SP229
- Practice address
- 317 N Faler Ave
Proactive Physical Therapy PC
Pinedale, WY 82941 - Phone
- (307) 367-6236
- Fax
- (307) 367-3332
- NPI assigned
- Jun 21, 2007
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | SP229 | WY | Primary |
Addresses
Primary practice location
317 N Faler Ave
Proactive Physical Therapy PC
Pinedale, WY 82941
Mailing address
3 E Green River Road
Pinedale, WY 82941
Phone (307) 367-2012
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 312061 | Other | WY | BLUE CROSS BLUE SHIELD |
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)
- Enrolled
- Credentials
- Master of Arts, Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SP229 | WY | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1182384000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1457557159",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3 E GREEN RIVER ROAD",
"city": "PINEDALE",
"state": "WY",
"postal_code": "82941",
"telephone_number": "307-367-2012"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "317 N FALER AVE",
"address_2": "PROACTIVE PHYSICAL THERAPY PC",
"city": "PINEDALE",
"state": "WY",
"postal_code": "82941",
"telephone_number": "307-367-6236",
"fax_number": "307-367-3332"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RANEY",
"first_name": "JEANNE",
"middle_name": "MARIE",
"credential": "MA CCCSLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-06-21",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "WY",
"license": "SP229",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "312061",
"state": "WY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Pinedale, WY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.