Kodiak Anesthesia PC

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

Legal business name

KODIAK ANESTHESIA PC

Practice address

111 W 2ND St
Suite 415
Casper, WY 82601-2454

Phone

(307) 237-5848

Fax

(307) 237-5848

NPI assigned

Sep 22, 2006

Organization subpart

No

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

Authorized official

Name

Matthew D. Chynoweth, D.O.

Title

MD

Phone

(307) 473-8173

Specialties & licenses 2

Addresses

Locations

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

{
    "created_epoch": "1158883200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1634601600000",
    "number": "1710087689",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4850 CHINOOK TRL",
            "city": "CASPER",
            "state": "WY",
            "postal_code": "826045201",
            "telephone_number": "307-473-8173"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 W 2ND ST",
            "address_2": "SUITE 415",
            "city": "CASPER",
            "state": "WY",
            "postal_code": "826012454",
            "telephone_number": "307-237-5848",
            "fax_number": "307-237-5848"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KODIAK ANESTHESIA PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-22",
        "last_updated": "2021-10-19",
        "certification_date": "2021-10-19",
        "status": "A",
        "authorized_official_last_name": "CHYNOWETH",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_middle_name": "D.",
        "authorized_official_title_or_position": "MD",
        "authorized_official_telephone_number": "307-473-8173",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "170100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Medical Genetics, Ph.D. Medical Genetics",
            "state": "WY",
            "license": "7192A",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Anesthesiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Daniel B Knox, M.D.
• Jacqueline R Knox
• Melissa M. Knudson-Johnson, M.D.
• Tara L Kobielusz, CASE MANAGER
• Kodiak Anesthesia PC
• John Phillip Koffman, EDUCATION SPECIALIST
• Patricia Ann Kolarik, BA
• Susan Kay Kollmann, RN
• Daphne Kontos
• Laura A Koopmeiners, PA

• Anesthesiology Physician in Casper, WY
• Providers in Casper, WY by specialty
• Anesthesiology Physician in Wyoming

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2021; 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.