Organization Active NPI

Lawrence W Oholleran PC

  • Surgery Physician
  • Cheyenne, WY
National Provider Identifier
1649239138
Registry record updated Sep 9, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
6423A Issued in WY
Legal business name
LAWRENCE W OHOLLERAN PC
Practice address
1616 E 19TH St
Ste 8
Cheyenne, WY 82001-4946
Phone
(307) 637-5600
Fax
(307) 637-0249
NPI assigned
Mar 22, 2006
Last updated
Sep 9, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2011

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

Authorized official

Name
Dr. Lawrence William Oholleran, MDNPI 1225004187
Title
Surgeon
Phone
(307) 637-5600

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 208600000X 6423A WY Primary
Surgery PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 208600000X 16963 NE
Surgery PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 208600000X 26688 CO

Addresses

Primary practice location

1616 E 19TH St
Ste 8
Cheyenne, WY 82001-4946

Mailing address

1616 E 19TH St
Ste 8
Cheyenne, WY 82001-4946
Phone (307) 637-5600

Other identifiers 2

IdentifierTypeStateIssuer
COA106329/COA106330OtherMEDICARE/TRAILBLAZER HEALTH ENTERPRISES
115489300MedicaidWY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20161229000441 WY Part B Supplier - Clinic/Group Practice 1355510827 Receives reassigned benefits from 1 practitioner
Practice locations: Cheyenne, WY

National Provider Directory

National Provider Directory

Locations

1616 E 19th St
Ste 8
Cheyenne, WY 82001
Phone (307) 631-8430

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1142985600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1315526400000",
    "number": "1649239138",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1616 E 19TH ST",
            "address_2": "STE 8",
            "city": "CHEYENNE",
            "state": "WY",
            "postal_code": "820014946",
            "telephone_number": "307-637-5600",
            "fax_number": "307-637-0249"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1616 E 19TH ST",
            "address_2": "STE 8",
            "city": "CHEYENNE",
            "state": "WY",
            "postal_code": "820014946",
            "telephone_number": "307-637-5600",
            "fax_number": "307-637-0249"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAWRENCE W OHOLLERAN PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-22",
        "last_updated": "2011-09-09",
        "status": "A",
        "authorized_official_last_name": "OHOLLERAN",
        "authorized_official_first_name": "LAWRENCE",
        "authorized_official_middle_name": "WILLIAM",
        "authorized_official_title_or_position": "SURGEON",
        "authorized_official_telephone_number": "307-637-5600",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Surgery",
            "state": "WY",
            "license": "6423A",
            "primary": true
        },
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Surgery",
            "state": "NE",
            "license": "16963",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Surgery",
            "state": "CO",
            "license": "26688",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE/TRAILBLAZER HEALTH ENTERPRISES",
            "identifier": "COA106329/COA106330",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "115489300",
            "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 Sep 9, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.