Individual provider Active NPI

Kathryn S. Dehn, O.D.

  • Optometrist
  • Sheridan, WY
National Provider Identifier
1538245584
Registry record updated Jul 24, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
291T Issued in WY
Practice address
1033 Coffeen Avenue
Sheridan, WY 82801
Phone
(307) 674-0444
Fax
(307) 673-0860
NPI assigned
Oct 31, 2006
Last updated
Jul 24, 2008By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 291T WY Primary

Addresses

Primary practice location

1033 Coffeen Avenue
Sheridan, WY 82801

Mailing address

1033 Coffeen Avenue
Sheridan, WY 82801
Phone (307) 674-0444

Other identifiers 1

IdentifierTypeStateIssuer
120328200MedicaidWY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050105000250 WY Practitioner - Optometry 3274581426 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pacific University - College of Optometry, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Eye Care of the Big Horns LLCGroup PAC ID 8820196876, 2 clinicians

Practice addresses (Care Compare)

1033 Coffeen Ave
Sheridan, WY 82801-5321
Phone (307) 674-0444

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery109

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2290COMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Eye Care of the Big Horns LLC Optometrist CurrentSince May 9, 2007 Accepting new patients
Wyovision Associates Inc Optometrist PastSince Oct 1, 2007 Accepting new patients

Locations

1033 Coffeen Ave
Sheridan, WY 82801
Phone (307) 674-0444

Interoperability endpoints

  • Direct secure messaging: kathryn.dehn@direct.revolutionehr.com

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1162252800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1216857600000",
    "number": "1538245584",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1033 COFFEEN AVENUE",
            "city": "SHERIDAN",
            "state": "WY",
            "postal_code": "82801",
            "telephone_number": "307-674-0444",
            "fax_number": "307-673-0860"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1033 COFFEEN AVENUE",
            "city": "SHERIDAN",
            "state": "WY",
            "postal_code": "82801",
            "telephone_number": "307-674-0444",
            "fax_number": "307-673-0860"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEHN",
        "first_name": "KATHRYN",
        "middle_name": "S.",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-31",
        "last_updated": "2008-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WY",
            "license": "291T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "120328200",
            "state": "WY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sheridan, WY

Sources for this page

Verify at the official NPI Registry.