Individual provider Active NPI

Lisa Kae Brandes, MD

  • Family Medicine Physician
  • Cheyenne, WY
National Provider Identifier
1720186471
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
7417A Issued in WY
Practice address
820 East 17TH Street
Cheyenne, WY 82001-4797
Phone
(307) 632-2434
Fax
(307) 634-9295
NPI assigned
Sep 20, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 7417A WY Primary

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

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100608000477 WY Practitioner - Family Practice 8527049584 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
7417AWYMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Wyoming Speech and Hearing Clinic CurrentSince Apr 11, 2010 Accepting new patients
University of Wyoming Family Medicine Current Accepting new patients
Emergency Services of Kansas, PA Family Medicine Past Accepting new patients
Family Care Associates LLC Family Medicine PastSince Aug 1, 2001 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

Organizations & group practices 6

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": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1720186471",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "820 EAST 17TH STREET",
            "city": "CHEYENNE",
            "state": "WY",
            "postal_code": "820014797",
            "telephone_number": "307-777-7911",
            "fax_number": "307-638-3616"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "820 EAST 17TH STREET",
            "city": "CHEYENNE",
            "state": "WY",
            "postal_code": "820014797",
            "telephone_number": "307-632-2434",
            "fax_number": "307-634-9295"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRANDES",
        "first_name": "LISA",
        "middle_name": "KAE",
        "name_prefix": "Mrs.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WY",
            "license": "7417A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cheyenne, WY

Sources for this page

Verify at the official NPI Registry.