Daniel W. Fedore, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

247 Issued in WY

Practice address

4140 Centennial Hills Blvd
Ste a
Casper, WY 82609

Phone

(307) 265-7205

Fax

(307) 235-6262

NPI assigned

Aug 23, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Interoperability endpoints

• Direct secure messaging: dfedore@yourcarecommunity.org
• Direct secure messaging: daniel.fedore@direct.wyomingmedicalcenter.org
• Direct secure messaging: danielfedore@casperorth.allscriptsdirect.net

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

{
    "created_epoch": "1124755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1528675200000",
    "number": "1902899230",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4140 CENTENNIAL HILLS BLVD",
            "address_2": "STE A",
            "city": "CASPER",
            "state": "WY",
            "postal_code": "826093265",
            "telephone_number": "307-265-7205",
            "fax_number": "307-235-6262"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4140 CENTENNIAL HILLS BLVD",
            "address_2": "STE A",
            "city": "CASPER",
            "state": "WY",
            "postal_code": "82609",
            "telephone_number": "307-265-7205",
            "fax_number": "307-235-6262"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1001 W Main St",
            "address_purpose": "LOCATION",
            "city": "Riverton",
            "state": "WY",
            "postal_code": "825013230",
            "country_code": "US",
            "telephone_number": "307-265-7205",
            "fax_number": "307-235-6262",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FEDORE",
        "first_name": "DANIEL",
        "middle_name": "W.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-23",
        "last_updated": "2018-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WY",
            "license": "247",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "312443",
            "state": "WY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00059533",
            "state": "WY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "117270100",
            "state": "WY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sharon Fancher, LCSW
• Jared Farnum
• Daniel Everett Farrer, LPC
• Jody Faxon, PTA
• Nikki Lynn Fedel, PAC
• Stephanie R Fegler, MSW, LCSW
• Reim Fehringer, P.T.
• Julie A Feiler, LPC, NBCC, CCMHC
• Deborah Ellen Ferguson, DPT
• Jamie Marie Ferguson, RN

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 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.