Paul D Malsom, PHYSICIAN ASSISTANT

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA643 Issued in WY

Practice address

5000 Blackmore Rd
Casper, WY 82609-3345

Phone

(307) 233-6000

Fax

(307) 233-6089

NPI assigned

Jul 30, 2012

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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

{
    "created_epoch": "1343606400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1543363200000",
    "number": "1720334543",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5000 BLACKMORE RD",
            "city": "CASPER",
            "state": "WY",
            "postal_code": "826093345",
            "telephone_number": "307-233-6000",
            "fax_number": "307-233-6089"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5000 BLACKMORE RD",
            "city": "CASPER",
            "state": "WY",
            "postal_code": "826093345",
            "telephone_number": "307-233-6000",
            "fax_number": "307-233-6089"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALSOM",
        "first_name": "PAUL",
        "middle_name": "D",
        "credential": "PHYSICIAN ASSISTANT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-07-30",
        "last_updated": "2018-11-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CO",
            "license": "PA.0003502",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NC",
            "license": "0010-04186",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "WY",
            "license": "PA643",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael C Magee, RPH
• Magellan Healthcare
• Laurel Mahoney
• Megan Louise Makelky
• Jack Dempsey Malone III, DO
• Sara E Malsom, PA-C
• Steven L. Malson, PHARMD, RPH
• Kelsey L Mammen, PPC
• Jennifer Lynn Mandros, DPT
• William Martin Manker III

• Medical Physician Assistant in Casper, WY
• Providers in Casper, WY by specialty
• Medical Physician Assistant in Wyoming

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2018; 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.