NPIMap

Individual provider Active NPI

Mark Scott Cardinal, M.D.

  • Family Medicine Physician
  • Fort Washakie, WY
National Provider Identifier
1508931981
Registry record updated Nov 17, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
6899A Issued in WY
Practice address
29 Black Coal Dr
Fort Washakie, WY 82514-0128
Phone
(307) 332-7300
NPI assigned
Nov 21, 2006
Last updated
Nov 17, 2011By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 17, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 6899A WY Primary

Addresses

Primary practice location

29 Black Coal Dr
Fort Washakie, WY 82514-0128

Mailing address

29 Black Coal Dr
Fort Washakie, WY 82514-0128
Phone (307) 332-7300

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100826000998 TX Practitioner - Family Practice 0547384604 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Perelman School of Med at the University of Pennsylvania, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Eastern Shoshone TribeGroup PAC ID 7810422193, 17 clinicians

Practice addresses (Care Compare)

PO Box
Suite 128
Fort Washakie, WY 82514-0128
Phone (307) 332-7300

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal of nail tissue1-10
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
US Health Dept of Health & Human Services CurrentSince Aug 4, 2003 Accepting new patients
Wind River Family & Community Healthc Care CurrentSince Feb 16, 2016 Accepting new patients
U S Health Dept of Health & Human Services CurrentSince Aug 4, 2003 Accepting new patients
Eastern Shoshone Tribe Family Medicine CurrentSince Nov 7, 2024 Accepting new patients
US Health Dept of Health & Human Services Current Accepting new patients
US Health Dept of Health & Human Services Past Accepting new patients
Lancaster General Health - Columbia Center Family Medicine Past Accepting new patients
Lancaster General Medical Group Family Medicine Past Accepting new patients
Lancaster General Health - Columbia Center Family Medicine Past Accepting new patients
Morning Star Care Center Past Accepting new patients

Locations

669 Agency Main St
Harlem, MT 59526
Phone (406) 353-3100

14 Great Plains Rd
Arapahoe, WY 82510

Organizations & group practices 10

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1164067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1321488000000",
    "number": "1508931981",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29 BLACK COAL DR",
            "city": "FORT WASHAKIE",
            "state": "WY",
            "postal_code": "825140128",
            "telephone_number": "307-332-7300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29 BLACK COAL DR",
            "city": "FORT WASHAKIE",
            "state": "WY",
            "postal_code": "825140128",
            "telephone_number": "307-332-7300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARDINAL",
        "first_name": "MARK",
        "middle_name": "SCOTT",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-21",
        "last_updated": "2011-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WY",
            "license": "6899A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Washakie, WY

Sources for this page

Verify at the official NPI Registry.