Individual provider Active NPI

Cara R Pedri

  • Case Manager/Care Coordinator
  • Rock Springs, WY
National Provider Identifier
1588708762
Registry record updated Jan 24, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Manager/Care CoordinatorTaxonomy code 171M00000X
License
123014000 Issued in WY
Practice address
1605 Donalynn Dr Lot 47
Rock Springs, WY 82901-7442
Phone
(307) 922-1596
NPI assigned
Feb 19, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 24, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care Coordinator 171M00000X 123014000 WY Primary

Addresses

Primary practice location

1605 Donalynn Dr Lot 47
Rock Springs, WY 82901-7442

Mailing address

PO Box 104
Rock Springs, WY 82902-0104
Phone (307) 922-1596

Other identifiers 1

IdentifierTypeStateIssuer
123014000MedicaidWY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
123014000WYMDCase Manager/Care Coordinator

NPI Registry JSON

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

{
    "created_epoch": "1171843200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1358985600000",
    "number": "1588708762",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 104",
            "city": "ROCK SPRINGS",
            "state": "WY",
            "postal_code": "829020104",
            "telephone_number": "307-922-1596"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1605 DONALYNN DR LOT 47",
            "city": "ROCK SPRINGS",
            "state": "WY",
            "postal_code": "829017442",
            "telephone_number": "307-922-1596"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEDRI",
        "first_name": "CARA",
        "middle_name": "R",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-19",
        "last_updated": "2013-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "WY",
            "license": "123014000",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "123014000",
            "state": "WY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rock Springs, WY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.