Individual provider Active NPI

Samantha Wagner Yung, AU.D.

  • Audiologist
  • Cheyenne, WY
National Provider Identifier
1780035352
Registry record updated Nov 16, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
A-1019 Issued in WY
Practice address
7215 Commons Cir Unit C
Cheyenne, WY 82009-2666
Phone
(307) 426-4327
NPI assigned
Jun 24, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 16, 2020

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist-Hearing Aid Fitter 237600000X A-1019 WY
Audiologist 231H00000X A-1019 WY Primary
Assistive Technology Practitioner Audiologist 231HA2400X A-1019 WY
Speech/Language/Hearing Specialist/Technologist 235500000X A-1019 WY

Addresses

Primary practice location

7215 Commons Cir Unit C
Cheyenne, WY 82009-2666

Mailing address

7215 Commons Cir Unit C
Cheyenne, WY 82009-2666
Phone (307) 426-4327

Other practice location 1

115 W 22nd Ave
Torrington, WY 82240-2301
Phone (307) 426-4327

Other identifiers 1

IdentifierTypeStateIssuer
143657100MedicaidWY

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160816002052 WY Practitioner - Qualified Audiologist 0749574630 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Audiologist
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Brant Audiology, LLCGroup PAC ID 1254405657, 4 clinicians

Practice addresses (Care Compare)

115 W 22ND Ave
Torrington, WY 82240-2301
Phone (307) 235-1901

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
A-1019WYMDSpeech/Language/Hearing Specialist/Technologist
340NEMDCardiovascular-Interventional Technology Radiologic Technologist

Practice roles

OrganizationSpecialtyStatusNew patients
Brant Audiology, LLC Audiologist CurrentSince Jun 14, 2016 Accepting new patients

Locations

1655 E 2nd St
Casper, WY 82601
Phone (307) 265-5400

115 W 22nd Ave
Torrington, WY 82240
Phone (307) 235-1901

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1466726400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605484800000",
    "number": "1780035352",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7215 COMMONS CIR UNIT C",
            "city": "CHEYENNE",
            "state": "WY",
            "postal_code": "820092666",
            "telephone_number": "307-426-4327"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7215 COMMONS CIR UNIT C",
            "city": "CHEYENNE",
            "state": "WY",
            "postal_code": "820092666",
            "telephone_number": "307-426-4327"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "115 W 22nd Ave",
            "address_purpose": "LOCATION",
            "city": "Torrington",
            "state": "WY",
            "postal_code": "822402301",
            "country_code": "US",
            "telephone_number": "307-426-4327",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "YUNG",
        "first_name": "SAMANTHA",
        "middle_name": "WAGNER",
        "name_prefix": "Mrs.",
        "credential": "AU.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-24",
        "last_updated": "2020-11-16",
        "certification_date": "2020-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "237600000X",
            "taxonomy_group": "",
            "desc": "Audiologist-Hearing Aid Fitter",
            "state": "WY",
            "license": "A-1019",
            "primary": false
        },
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "WY",
            "license": "A-1019",
            "primary": true
        },
        {
            "code": "231HA2400X",
            "taxonomy_group": "",
            "desc": "Audiologist, Assistive Technology Practitioner",
            "state": "WY",
            "license": "A-1019",
            "primary": false
        },
        {
            "code": "235500000X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist",
            "state": "WY",
            "license": "A-1019",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "143657100",
            "state": "WY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cheyenne, WY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2020; 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.