Jennifer Favilla, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

1326 Issued in WY

Practice address

800 E 20TH St Ste 300
Cheyenne, WY 82001-3882

Phone

(307) 633-7444

Fax

(307) 996-1595

NPI assigned

Jul 14, 2014

Last updated

Nov 15, 2022By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Electronic endpoints 2

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/19427/brand/1/csg/1/fhir/r4
• FHIR API: https://api.platform.athenahealth.com/22460/brand/1/csg/1/fhir/r4
• FHIR API: https://soap.crmcwy.org/fhirproxy/api/FHIR/R4
• Direct secure messaging: jfavilla5517@direct.crmcwy.org
• Direct secure messaging: renasolve.jenniferfavilla@162057.advancedmd-direct.com

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.

• Smart Sports Medicine Clinic PC

  • Sports Physical Therapist
  • Cheyenne, WY
  • NPI 1376690214
  Medicare reassignment NPD
• Snowy Range Kidney Care LLC

  • Nephrology Physician
  • Laramie, WY
  • NPI 1306461108
  Medicare reassignment NPD
• Mountain West Surgical Specialists LLC

  • Orthopaedic Surgery Physician
  • Cheyenne, WY
  • NPI 1366209645
  NPD
• Cheyenne Children's Clinic, PC

  • Pediatrics Physician
  • Cheyenne, WY
  • NPI 1073537601
  NPD (past)
• Rocky Mountain Kidney Care LLC

  • Nephrology Physician
  • Lone Tree, CO
  • NPI 1861082117
  NPD (past)

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

{
    "created_epoch": "1405296000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668470400000",
    "number": "1568879377",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 20970",
            "city": "CHEYENNE",
            "state": "WY",
            "postal_code": "820037020",
            "telephone_number": "307-996-4777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 E 20TH ST STE 300",
            "city": "CHEYENNE",
            "state": "WY",
            "postal_code": "820013882",
            "telephone_number": "307-633-7444",
            "fax_number": "307-996-1595"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7124 COMMONS DR",
            "address_2": "UNIT C",
            "address_purpose": "LOCATION",
            "city": "CHEYENNE",
            "state": "WY",
            "postal_code": "820092620",
            "country_code": "US",
            "telephone_number": "307-638-8975",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FAVILLA",
        "first_name": "JENNIFER",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-07-14",
        "last_updated": "2022-11-15",
        "certification_date": "2022-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WY",
            "license": "34857.1326",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WY",
            "license": "24857.1326",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WY",
            "license": "1326",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jfavilla5517@direct.crmcwy.org",
            "affiliation": "Y",
            "endpointDescription": "CRMC Direct Address",
            "affiliationName": "Memorial Hospital of Laramie County",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "214 E 23rd St",
            "city": "Cheyenne",
            "state": "WY",
            "country_code": "US",
            "postal_code": "820013748",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jfavilla5517@direct.crmcwy.org",
            "affiliation": "Y",
            "endpointDescription": "CRMC Direct Address",
            "affiliationName": "Memorial Hospital of Laramie County",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "214 E 23rd St",
            "city": "Cheyenne",
            "state": "WY",
            "country_code": "US",
            "postal_code": "820013748",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Arthur J Farrell, PAC
• Tracy A Farrell, MSPT
• Kathleen A Farstad, LPC
• Erin Fausset
• Jill C Favata, M.S. ED, LPC
• Jeff C Fay, MA,LPC
• Georgie E Fear, RD
• Caroline Feer
• Kaelah Feezer
• Jennifer Fehrn

• Family Nurse Practitioner in Cheyenne, WY
• Providers in Cheyenne, WY by specialty
• Family Nurse Practitioner in Wyoming

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2022; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.