NPIMap

Organization Active NPI

Trenette Ann Larson MD PC

  • Internal Medicine Physician
  • Cheyenne, WY
National Provider Identifier
1659579191
Registry record updated Apr 12, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
3624 Issued in WY
Legal business name
TRENETTE ANN LARSON MD PC
Practice address
10115 Branding Iron Dr
Cheyenne, WY 82009-8614
Phone
(307) 778-8437
Fax
(307) 778-8503
NPI assigned
Jul 6, 2007
Last updated
Apr 12, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 12, 2012

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

Authorized official

Name
Dr. Trenette Ann Larson, M.D.
Title
Owner
Phone
(307) 778-8437

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X 3624 WY Primary

Addresses

Primary practice location

10115 Branding Iron Dr
Cheyenne, WY 82009-8614

Mailing address

10115 Branding Iron Dr
Cheyenne, WY 82009-8614
Phone (307) 778-8437

Other identifiers 2

IdentifierTypeStateIssuer
113966500MedicaidWY
116807000MedicaidWY

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

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": "1183680000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1334188800000",
    "number": "1659579191",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10115 BRANDING IRON DR",
            "city": "CHEYENNE",
            "state": "WY",
            "postal_code": "820098614",
            "telephone_number": "307-778-8437",
            "fax_number": "307-778-8503"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10115 BRANDING IRON DR",
            "city": "CHEYENNE",
            "state": "WY",
            "postal_code": "820098614",
            "telephone_number": "307-778-8437",
            "fax_number": "307-778-8503"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRENETTE ANN LARSON MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-06",
        "last_updated": "2012-04-12",
        "status": "A",
        "authorized_official_last_name": "LARSON",
        "authorized_official_first_name": "TRENETTE",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "307-778-8437",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "WY",
            "license": "3624",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "113966500",
            "state": "WY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "116807000",
            "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 Apr 12, 2012; 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.