Active NPI
Kenneth L. Chastek, P.A-C
- Medical Physician Assistant
- Casper, WY
National Provider Identifier
1811094154
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Physician Assistant
- License
- 642
- Practice address
- Employee Health Solutions
245 South Fenway
Casper, WY 82601 - Phone
- (307) 577-4300
- Fax
- (307) 577-4305
- NPI assigned
- Sep 20, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | 642 | AK | Primary |
Addresses
Primary practice location
Employee Health Solutions
245 South Fenway
Casper, WY 82601
Mailing address
11314 Lake Katherine Cir
Clermont, FL 34711-5003
Phone (352) 432-2578
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 642 | AK | MD | Clinical Social Worker |
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": "1184716800000",
"number": "1811094154",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11314 LAKE KATHERINE CIR",
"city": "CLERMONT",
"state": "FL",
"postal_code": "347115003",
"telephone_number": "352-432-2578"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "EMPLOYEE HEALTH SOLUTIONS",
"address_2": "245 SOUTH FENWAY",
"city": "CASPER",
"state": "WY",
"postal_code": "82601",
"telephone_number": "307-577-4300",
"fax_number": "307-577-4305"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHASTEK",
"first_name": "KENNETH",
"middle_name": "L.",
"credential": "P.A-C",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-09-20",
"last_updated": "2007-07-18",
"status": "A"
},
"taxonomies": [
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "AK",
"license": "642",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Casper, WY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.