Lisa Kae Brandes, MD
Individual provider Active NPI Family Medicine Physician · Cheyenne, WY
NPI 1720186471 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1720186471
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 7417A (WY)
- Practice address
- 820 East 17TH Street
Cheyenne, WY 82001-4797 - Phone
- (307) 632-2434
- Fax
- (307) 634-9295
- NPI assigned
- Sep 20, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 6
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WY
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20100608000477 | WY | Practitioner - Family Practice | 8527049584 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7417A | WY | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| University of Wyoming | Family Medicine | Current | Accepting new patients |
| University of Wyoming Speech and Hearing Clinic | Current |
Accepting new patients | |
| Family Care Associates LLC | Family Medicine | Past |
Accepting new patients |
| Emergency Services of Kansas, PA | Family Medicine | Past | Accepting new patients |
| Wholewoman Center, PLLC | Past | Accepting new patients | |
| University of Wyoming | Family Medicine | Past | Accepting new patients |
Locations
214 E 23rd St
Cheyenne, WY 82001
Phone (307) 324-2221
820 E 17th St
Cheyenne, WY 82001
Phone (307) 431-5055
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 7417A | WY | Yes |
Addresses
Primary practice location
820 East 17TH Street
Cheyenne, WY 82001-4797
Mailing address
820 East 17TH Street
Cheyenne, WY 82001-4797
Phone (307) 777-7911
Other providers in Cheyenne, WY
- Caleb Brackett
- Deborah Susan Brackett
- Braden Partners LP
- Cheyanna Brady
- Brain Advancement Center, LLC
- Macy Amanda Brandwein
- Jenna Nicole Brannock
- George Brannon
- Brant Audiology, LLC
- Sarah Ann Braten
All providers in Cheyenne, WY · Family Medicine Physician in Wyoming
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.