Individual provider Active NPI

Cynthia S. White, PA-C

  • Medical Physician Assistant
  • Cheyenne, WY
National Provider Identifier
1699050096
Registry record updated Jan 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
3307 Issued in CO
Practice address
1330 Prairie Ave
Cheyenne, WY 82009-4842
Phone
(307) 778-8997
Fax
(706) 270-0487
NPI assigned
Oct 17, 2011
Last updated
Jan 4, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 4, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 3307 CO Primary

Addresses

Primary practice location

1330 Prairie Ave
Cheyenne, WY 82009-4842

Mailing address

PO Box 2153 Dept 40339
Birmingham, AL 35287-9387
Phone (706) 271-0100

Other identifiers 1

IdentifierTypeStateIssuer
21920851MedicaidCO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO, WY2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20120105000884 CO Practitioner - Physician Assistant 0042486490 Reassigns benefits to 2 organizations
I20120222000050 WY Practitioner - Physician Assistant 0042486490 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Life Care Physician Services LLCGroup PAC ID 5395861306, 18 clinicians

Practice addresses (Care Compare)

1200 Village Rd
Carbondale, CO 81623-1564
Phone (970) 963-1500

1250 Village Rd
Carbondale, CO 81623-1564
Phone (970) 963-1500

530 W 16TH St
Salida, CO 81201-2240
Phone (719) 539-6112

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
540WYMDMental Health Counselor
3307COMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Inpatient Consultants of Colorado PC CurrentSince Oct 18, 2011 Accepting new patients
Physician Onsite, Inc Past Accepting new patients
Inpatient Consultants of Colorado, PC Past Accepting new patients

Locations

2000 S Colorado Blvd
Ste 420
Denver, CO 80222
Phone (720) 524-1550

Organizations & group practices 4

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1318809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672790400000",
    "number": "1699050096",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2153 DEPT 40339",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352879387",
            "telephone_number": "706-271-0100",
            "fax_number": "706-270-0487"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1330 PRAIRIE AVE",
            "city": "CHEYENNE",
            "state": "WY",
            "postal_code": "820094842",
            "telephone_number": "307-778-8997",
            "fax_number": "706-270-0487"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITE",
        "first_name": "CYNTHIA",
        "middle_name": "S.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-10-17",
        "last_updated": "2023-01-04",
        "certification_date": "2023-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CO",
            "license": "3307",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "21920851",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cheyenne, WY

Sources for this page

Verify at the official NPI Registry.