Individual provider Active NPI

Gloria Stoddard, FNP-C

  • Family Nurse Practitioner
  • Laramie, WY
National Provider Identifier
1598855314
Registry record updated Sep 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
10494.0283 Issued in WY
Practice address
302 Dinwiddie Rd
Laramie, WY 82070-9768
Phone
(307) 745-0517
Fax
(307) 314-0060
NPI assigned
Oct 13, 2006
Last updated
Sep 29, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 29, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 10494.0283 WY Primary

Addresses

Primary practice location

302 Dinwiddie Rd
Laramie, WY 82070-9768

Mailing address

302 Dinwiddie Rd
Laramie, WY 82070-9768
Phone (307) 745-0517

Other identifiers 1

IdentifierTypeStateIssuer
12212800MedicaidWY

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)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
10494.0283WYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Laramie Valley Medical, PC Past Accepting new patients
Laramie Clinic, P.C. Past Accepting new patients

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": "1160697600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601337600000",
    "number": "1598855314",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "302 DINWIDDIE RD",
            "city": "LARAMIE",
            "state": "WY",
            "postal_code": "820709768",
            "telephone_number": "307-745-0517",
            "fax_number": "307-314-0060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "302 DINWIDDIE RD",
            "city": "LARAMIE",
            "state": "WY",
            "postal_code": "820709768",
            "telephone_number": "307-745-0517",
            "fax_number": "307-314-0060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STODDARD",
        "first_name": "GLORIA",
        "credential": "FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-13",
        "last_updated": "2020-09-29",
        "certification_date": "2020-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WY",
            "license": "10494.0283",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "12212800",
            "state": "WY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Laramie, WY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2020; 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.