Individual provider Active NPI

Jalyn M Anderson, PT, DPT

  • Physical Therapist
  • Laramie, WY
National Provider Identifier
1710317797
Registry record updated Sep 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT-1339 Issued in WY
Practice address
3905 E Grand Ave Ste 200
Laramie, WY 82070-5189
Phone
(307) 742-2082
Fax
(307) 426-4148
NPI assigned
Nov 12, 2013
Last updated
Sep 22, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 22, 2022

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT-1339 WY Primary
Geriatric Physical Therapist 2251G0304X PT-1339 WY
Neurology Physical Therapist 2251N0400X PT-1339 WY
Orthopedic Physical Therapist 2251X0800X PT-1339 WY

Addresses

Primary practice location

3905 E Grand Ave Ste 200
Laramie, WY 82070-5189

Mailing address

1722 Barratt St
Laramie, WY 82070-5431
Phone (307) 761-3110

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20131219000898 WY Practitioner - Physical Therapist in Private Practice 1052548054 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Spine and Injury Clinic of Laramie PCGroup PAC ID 0941387997, 9 clinicians

Practice addresses (Care Compare)

3905 E Grand Ave
Suite 200
Laramie, WY 82070-5189
Phone (307) 742-2082

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT-1339WYMDNeurology Physical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Spine & Injury Clinic of Laramie, PC Physical Therapist CurrentSince Nov 1, 2013 Accepting new patients

Locations

3905 E Grand Ave
Ste 200
Laramie, WY 82070
Phone (307) 742-2082

409 S 4th St
Laramie, WY 82070
Phone (307) 742-2082

Organizations & group practices 1

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": "1384214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663804800000",
    "number": "1710317797",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1722 BARRATT ST",
            "city": "LARAMIE",
            "state": "WY",
            "postal_code": "820705431",
            "telephone_number": "307-761-3110",
            "fax_number": "307-426-4148"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3905 E GRAND AVE STE 200",
            "city": "LARAMIE",
            "state": "WY",
            "postal_code": "820705189",
            "telephone_number": "307-742-2082",
            "fax_number": "307-426-4148"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "JALYN",
        "middle_name": "M",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-11-12",
        "last_updated": "2022-09-22",
        "certification_date": "2022-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WY",
            "license": "PT-1339",
            "primary": true
        },
        {
            "code": "2251G0304X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Geriatrics",
            "state": "WY",
            "license": "PT-1339",
            "primary": false
        },
        {
            "code": "2251N0400X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Neurology",
            "state": "WY",
            "license": "PT-1339",
            "primary": false
        },
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "WY",
            "license": "PT-1339",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Laramie, WY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.