NPIMap

Individual provider Active NPI

Christopher B Reyburn, M.D

  • Psychiatry Physician
  • Laramie, WY
National Provider Identifier
1770624017
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
5975A Issued in WY
Practice address
1277 N 15TH St
Laramie, WY 82072-2343
Phone
(307) 742-6222
Fax
(307) 742-6414
NPI assigned
Feb 9, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 5975A WY Primary

Addresses

Primary practice location

1277 N 15TH St
Laramie, WY 82072-2343

Mailing address

1277 N 15TH St
Laramie, WY 82072-2343
Phone (307) 742-6222

Other identifiers 1

IdentifierTypeStateIssuer
113944401MedicaidWY

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111014000037 CO Practitioner - Psychiatry 6901880897 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Creighton University School of Medicine, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Boulder Community HealthGroup PAC ID 6800707233, 260 clinicians

Practice addresses (Care Compare)

4801 Riverbend Rd
Boulder, CO 80301-2613

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5975AWYMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Boulder Community Health CurrentSince Sep 7, 2014 Accepting new patients
Boulder Community Health CurrentSince Sep 7, 2014 Accepting new patients
Med Management Associates of Colorado LLC Psychiatry CurrentSince May 29, 2019 Accepting new patients
Boulder Community Health Past Accepting new patients
Boulder Community Health Past Accepting new patients
Boulder Community Health Past Accepting new patients
Pendley & Associates Inc Past Accepting new patients
Boulder Community Health Past Accepting new patients
Frank Guerra MD PC Past Accepting new patients
Pendley and Associates, Inc Past Accepting new patients
Psychology Clinic PC Past Accepting new patients

Locations

1155 Alpine Ave
Ste 385
Boulder, CO 80304
Phone (303) 440-2456

4747 Arapahoe Ave
Boulder, CO 80303
Phone (303) 415-7000

4801 Riverbend Rd
Ste 300
Boulder, CO 80301
Phone (303) 415-8621

4801 Riverbend Rd
Ste 120A
Boulder, CO 80301
Phone (303) 415-4299

4801 Riverbend Rd
Ste 100
Boulder, CO 80301
Phone (303) 415-8611

290 S Monaco Street Pkwy
Denver, CO 80224
Phone (303) 355-2525

5301 W 1st Ave
Lakewood, CO 80226
Phone (303) 238-8323

9398 Crown Crest Blvd
Parker, CO 80138
Phone (303) 577-7239

7272 Wurzbach Rd
Ste 601
San Antonio, TX 78240
Phone (210) 615-3472

Organizations & group practices 11

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 34

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 34

NPI Registry JSON

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

{
    "created_epoch": "1170979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1770624017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1277 N 15TH ST",
            "city": "LARAMIE",
            "state": "WY",
            "postal_code": "820722343",
            "telephone_number": "307-742-6222",
            "fax_number": "307-742-6414"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1277 N 15TH ST",
            "city": "LARAMIE",
            "state": "WY",
            "postal_code": "820722343",
            "telephone_number": "307-742-6222",
            "fax_number": "307-742-6414"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REYBURN",
        "first_name": "CHRISTOPHER",
        "middle_name": "B",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-09",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "WY",
            "license": "5975A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "113944401",
            "state": "WY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Laramie, WY

Sources for this page

Verify at the official NPI Registry.