NPIMap

Organization Active NPI

College Drive Urgent Care LLC

  • Urgent Care Clinic/Center
  • Cheyenne, WY
National Provider Identifier
1467601765
Registry record updated Apr 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urgent Care Clinic/CenterTaxonomy code 261QU0200X
Legal business name
COLLEGE DRIVE URGENT CARE LLC
Practice address
2030 Bluegrass Cir
Cheyenne, WY 82009-7328
Phone
(307) 635-3500
Fax
(307) 635-2199
NPI assigned
Sep 11, 2008
Last updated
Apr 29, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2025

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

Authorized official

Name
Mr. Chris M Kane
Title
Authorized Official
Phone
(888) 705-8558

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urgent Care Clinic/Center 261QU0200X Primary

Addresses

Primary practice location

2030 Bluegrass Cir
Cheyenne, WY 82009-7328

Mailing address

2145 E Baseline Rd Ste 303
Tempe, AZ 85283-1515
Phone (888) 705-8558

Other identifiers 4

IdentifierTypeStateIssuer
314338OtherWYBSWY
315527OtherWYBSWY
314333OtherWYBLUE CROSS BLUE SHIELD
314332OtherWYBLUE CROSS BLUE SHIELD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090113000850 WY Part B Supplier - Clinic/Group Practice 1456414788 Receives reassigned benefits from 39 practitioners
Practice locations: Cheyenne, WY

National Provider Directory

National Provider Directory

Locations

2145 E Baseline Rd
Ste 303
Tempe, AZ 85283

4136 Laramie St
Cheyenne, WY 82001

4136 Laramie St
Unit B
Cheyenne, WY 82001
Phone (307) 637-2800

4140 Laramie St
#A
Cheyenne, WY 82001
Phone (307) 637-2800

Practitioners & affiliated clinicians

Practitioners 72

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.

View all 72

NPI Registry JSON

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

{
    "created_epoch": "1221091200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1745884800000",
    "number": "1467601765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2145 E BASELINE RD STE 303",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "852831515",
            "telephone_number": "888-705-8558",
            "fax_number": "480-776-0025"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2030 BLUEGRASS CIR",
            "city": "CHEYENNE",
            "state": "WY",
            "postal_code": "820097328",
            "telephone_number": "307-635-3500",
            "fax_number": "307-635-2199"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLLEGE DRIVE URGENT CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-09-11",
        "last_updated": "2025-04-29",
        "certification_date": "2025-04-29",
        "status": "A",
        "authorized_official_last_name": "KANE",
        "authorized_official_first_name": "CHRIS",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "888-705-8558",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BSWY",
            "identifier": "314338",
            "state": "WY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BSWY",
            "identifier": "315527",
            "state": "WY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "314333",
            "state": "WY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "314332",
            "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 Apr 29, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.