Active NPI
Arthur J Farrell, PAC
- Physician Assistant
- Cheyenne, WY
National Provider Identifier
1609849199
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 206
- Practice address
- 4136 Laramie St
Suite B
Cheyenne, WY 82001-1969 - Phone
- (307) 637-2800
- Fax
- (307) 637-2867
- NPI assigned
- Feb 7, 2006
- Last updated
- Mar 15, 2016
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 206 | WY | Primary |
Addresses
Primary practice location
4136 Laramie St
Suite B
Cheyenne, WY 82001-1969
Mailing address
5307 Yellowstone Rd
Suite B
Cheyenne, WY 82009-4736
Phone (307) 632-7677
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 315527 | Other | WY | BSWY |
| 314333 | Other | WY | BLUE CROSS BLUE SHIELD |
| 121860300 | Medicaid | WY |
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
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 206 | WY | MD | Addiction (Substance Use Disorder) Counselor |
| 209 | WY | MD | Hearing Instrument Specialist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Medi Horizons Inc | Past | Accepting new patients | |
| Medihorizons Inc | Past | Accepting new patients |
Interoperability endpoints
- arthur.farrell.1@29403.direct.athenahealth.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": "1139270400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1458000000000",
"number": "1609849199",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5307 YELLOWSTONE RD",
"address_2": "SUITE B",
"city": "CHEYENNE",
"state": "WY",
"postal_code": "820094736",
"telephone_number": "307-632-7677"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4136 LARAMIE ST",
"address_2": "SUITE B",
"city": "CHEYENNE",
"state": "WY",
"postal_code": "820011969",
"telephone_number": "307-637-2800",
"fax_number": "307-637-2867"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FARRELL",
"first_name": "ARTHUR",
"middle_name": "J",
"credential": "PAC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-02-07",
"last_updated": "2016-03-15",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "WY",
"license": "206",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BSWY",
"identifier": "315527",
"state": "WY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "314333",
"state": "WY"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "121860300",
"state": "WY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Cheyenne, WY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.