Roxanne Leigh Peters, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

479 Issued in WY

Practice address

508 Stocktrail Ave Ste a
Gillette, WY 82716-3582

Phone

(307) 686-1413

Fax

(307) 688-7940

NPI assigned

Aug 20, 2009

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Roxanne Leigh Thiry Former name

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: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 1978

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Campbell County Hospital DistrictGroup PAC ID 2860392529, 128 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Campbell County Health Hospital, Gillette, WY, CCN 530002
• Sheridan Memorial Hospital Hospital, Sheridan, WY, CCN 530006

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: rpeters@pros.emadirect.md

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.

• Campbell County Hospital District

  dba Campbell County Medical Group - Internal Medicine Clinic

  • Internal Medicine Physician
  • Gillette, WY
  • NPI 1710098868
  Medicare reassignment Care Compare group
• Campbell County Hospital District

  dba Campbell County Clinics-Cardiology

  • Cardiovascular Disease Physician
  • Gillette, WY
  • NPI 1386060903
  NPD
• Campbell County Hospital District

  dba Behavioral Health Services

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Gillette, WY
  • NPI 1881730141
  NPD
• Campbell County Hospital District

  dba Campbell County Health

  • Community/Retail Pharmacy
  • Gillette, WY
  • NPI 1992874218
  NPD
• Campbell County Hospital District

  dba The Legacy Living & Rehabilitation Center

  • Skilled Nursing Facility
  • Gillette, WY
  • NPI 1376620989
  NPD (past)

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

• Campbell County Hospital District

  • General Acute Care Hospital
  • Gillette, WY
  • NPI 1487638417
  Care Compare affiliation
• Campbell County Hospital District

  dba Powder River Surgery Center

  • Ambulatory Surgical Clinic/Center
  • Gillette, WY
  • NPI 1780738153

  Hospital

  Care Compare affiliation
• Memorial Hospital of Sheridan County

  dba Sheridan Memorial Hospital

  • General Acute Care Hospital
  • Sheridan, WY
  • NPI 1487707188
  Care Compare affiliation

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

{
    "created_epoch": "1250726400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1562716800000",
    "number": "1558593731",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "508 STOCKTRAIL AVE STE A",
            "city": "GILLETTE",
            "state": "WY",
            "postal_code": "827163582",
            "telephone_number": "307-686-1413",
            "fax_number": "307-688-7940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "508 STOCKTRAIL AVE STE A",
            "city": "GILLETTE",
            "state": "WY",
            "postal_code": "827163582",
            "telephone_number": "307-686-1413",
            "fax_number": "307-688-7940"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERS",
        "first_name": "ROXANNE",
        "middle_name": "LEIGH",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-08-20",
        "last_updated": "2019-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WY",
            "license": "479",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ROXANNE",
            "last_name": "THIRY",
            "middle_name": "LEIGH",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Alicia Marie Perlenfein
• Jason Perry, NRP
• Kelsey Persian
• Personal Frontiers, Inc.
• Kelly Peters
• Petersen Chiropractic LLC
• Chelsey Nicole Petersen, MSN RN
• Clinton Jerome Petersen, D.C.
• Judeth Petersen, M.A., LPC
• Byron James Peterson

• Physician Assistant in Gillette, WY
• Providers in Gillette, WY by specialty
• Physician Assistant in Wyoming

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.