NPIMap

Organization Active NPI

Avenues Physical Therapy Inc PC

  • Physical Therapist
  • Cheyenne, WY
National Provider Identifier
1467559310
Registry record updated Nov 19, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
160 Issued in WY
Legal business name
AVENUES PHYSICAL THERAPY INC PC
Practice address
611 W 18TH St
Cheyenne, WY 82001-4304
Phone
(307) 634-0298
Fax
(307) 634-0837
NPI assigned
Sep 20, 2006
Last updated
Nov 19, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 19, 2019

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

Authorized official

Name
Walynn C Smith, LPTNPI 1780632794
Title
President
Phone
(307) 634-0298

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 160 WY Primary

Addresses

Primary practice location

611 W 18TH St
Cheyenne, WY 82001-4304

Mailing address

611 W 18TH St
Cheyenne, WY 82001-4304
Phone (307) 634-0298

Other practice location 1

4000 Central Ave
Suite 3
Cheyenne, WY 82001-1376
Phone (307) 634-0298

Other identifiers 1

IdentifierTypeStateIssuer
107090800MedicaidWY

National Provider Directory

National Provider Directory

Locations

4000 Central Ave
Ste 3
Cheyenne, WY 82001
Phone (307) 634-0298

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1574121600000",
    "number": "1467559310",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "611 W 18TH ST",
            "city": "CHEYENNE",
            "state": "WY",
            "postal_code": "820014304",
            "telephone_number": "307-634-0298",
            "fax_number": "307-634-0837"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "611 W 18TH ST",
            "city": "CHEYENNE",
            "state": "WY",
            "postal_code": "820014304",
            "telephone_number": "307-634-0298",
            "fax_number": "307-634-0837"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4000 Central Ave",
            "address_2": "Suite 3",
            "address_purpose": "LOCATION",
            "city": "Cheyenne",
            "state": "WY",
            "postal_code": "820011376",
            "country_code": "US",
            "telephone_number": "307-634-0298",
            "fax_number": "307-634-0837",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "AVENUES PHYSICAL THERAPY INC PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-20",
        "last_updated": "2019-11-19",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "WALYNN",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "307-634-0298",
        "authorized_official_credential": "LPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WY",
            "license": "160",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "107090800",
            "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 Nov 19, 2019; 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.