Individual provider Active NPI

Cheryl C Portwood, M.D.

  • Psychiatry Physician
  • Lander, WY
National Provider Identifier
1639246044
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
6499A Issued in WY
Practice address
315 Main St.
Suite 6-12
Lander, WY 82520
Phone
(307) 332-4515
Fax
(307) 332-4899
NPI assigned
Nov 29, 2006
Last updated
Mar 7, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 6499A WY Primary

Addresses

Primary practice location

315 Main St.
Suite 6-12
Lander, WY 82520

Mailing address

315 Main St.
Suite 6-12
Lander, WY 82520
Phone (307) 332-4515

Other identifiers 1

IdentifierTypeStateIssuer
6499AOtherWYBOARD OF MEDICINE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WY, TX2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20070326000248 WY Practitioner - Psychiatry 0840394219 Practice locations: Lander, WY
I20120402000260 TX Practitioner - Psychiatry 0840394219 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
University of North Dakota School of Medicine, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

315 Main St
6 12
Lander, WY 82520-3151
Phone (307) 332-4515

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
6499AWYMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
US Health Dept of Health & Human Services CurrentSince Jul 1, 2001 Accepting new patients
Wind River Family & Community Healthc Care CurrentSince Feb 16, 2016 Accepting new patients
U S Health Dept of Health & Human Services CurrentSince Jul 1, 2001 Accepting new patients
US Health Dept of Health & Human Services Current Accepting new patients
Alternative Counseling Associates Psychiatry Past Accepting new patients
US Health Dept of Health & Human Services Past Accepting new patients

Locations

669 Agency Main St
Harlem, MT 59526
Phone (406) 353-3100

14 Great Plains Rd
Arapahoe, WY 82510

Organizations & group practices 6

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": "1164758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1639246044",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "315 MAIN ST.",
            "address_2": "SUITE 6-12",
            "city": "LANDER",
            "state": "WY",
            "postal_code": "82520",
            "telephone_number": "307-332-4515",
            "fax_number": "307-332-4899"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "315 MAIN ST.",
            "address_2": "SUITE 6-12",
            "city": "LANDER",
            "state": "WY",
            "postal_code": "82520",
            "telephone_number": "307-332-4515",
            "fax_number": "307-332-4899"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PORTWOOD",
        "first_name": "CHERYL",
        "middle_name": "C",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-29",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "WY",
            "license": "6499A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BOARD OF MEDICINE",
            "identifier": "6499A",
            "state": "WY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lander, WY

Sources for this page

Verify at the official NPI Registry.