Active NPI
Martha Vantassell, RN
- Registered Nurse
- Cheyenne, WY
National Provider Identifier
1942755293
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- 29775
- Practice address
- 510 W 29TH St
Cheyenne, WY 82001-2760 - Phone
- (307) 632-9362
- NPI assigned
- Aug 16, 2016
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Case Management Registered Nurse | 163WC0400X | 29775 | WY | |
| Registered Nurse | 163W00000X | 29775 | WY | Primary |
Addresses
Primary practice location
510 W 29TH St
Cheyenne, WY 82001-2760
Mailing address
510 W 29TH St
Cheyenne, WY 82001-2760
Phone (307) 632-9362
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1902259203 | Other | WY | NPI |
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)
- Not enrolled
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 29775 | WY | MD | Case Management Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1471305600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1649808000000",
"number": "1942755293",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "510 W 29TH ST",
"city": "CHEYENNE",
"state": "WY",
"postal_code": "820012760",
"telephone_number": "307-632-9362"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "510 W 29TH ST",
"city": "CHEYENNE",
"state": "WY",
"postal_code": "820012760",
"telephone_number": "307-632-9362"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VANTASSELL",
"first_name": "MARTHA",
"credential": "RN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-08-16",
"last_updated": "2022-04-13",
"certification_date": "2022-04-13",
"status": "A"
},
"taxonomies": [
{
"code": "163WC0400X",
"taxonomy_group": "",
"desc": "Registered Nurse, Case Management",
"state": "WY",
"license": "29775",
"primary": false
},
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "WY",
"license": "29775",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NPI",
"identifier": "1902259203",
"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 Apr 13, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.