Lyndie N Gore, PHARM D

Primary specialty

Pharmacist Clinician (PhC)/ Clinical Pharmacy SpecialistTaxonomy code 1835P0018X

License

3977 Issued in WY

Practice address

2360 E Pershing Blvd
Cheyenne, WY 82001-5356

Phone

(307) 778-7550

NPI assigned

Jun 23, 2022

Sex

Female

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 1

Other names 1

• Lyndie N Petersen Former name

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy

State licenses

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

{
    "created_epoch": "1655942400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655942400000",
    "number": "1942931449",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "457 S WHEATLAND HWY",
            "city": "WHEATLAND",
            "state": "WY",
            "postal_code": "822018520",
            "telephone_number": "303-396-9109"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2360 E PERSHING BLVD",
            "city": "CHEYENNE",
            "state": "WY",
            "postal_code": "820015356",
            "telephone_number": "307-778-7550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORE",
        "first_name": "LYNDIE",
        "middle_name": "N",
        "name_prefix": "Dr.",
        "credential": "PHARM D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-23",
        "last_updated": "2022-06-23",
        "certification_date": "2022-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1835P0018X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
            "state": "WY",
            "license": "3977",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WYOMING BOARD OF PHARMACY",
            "identifier": "3977",
            "state": "WY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "unknown",
            "affiliation": "N",
            "address_1": "2360 E Pershing Blvd",
            "city": "Cheyenne",
            "state": "WY",
            "country_code": "US",
            "postal_code": "820015356",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "LYNDIE",
            "last_name": "PETERSEN",
            "middle_name": "N",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Goodwill Industries of Wy, Inc.
• Goodwill Industries of Wyoming Inc.
• Mary Therese Goodwin
• Courtney Jayanna Gore, PHARM.D
• Jacqueline Gore, LPN
• Stevana Gosbee, NP-C
• Elle Gouso
• Grace Home Hospice Inc.
• Uriah Gracia-Salinas, DPT
• Trent Graff

• Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist in Cheyenne, WY
• Providers in Cheyenne, WY by specialty
• Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist in Wyoming

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 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.

Verify at the official NPI Registry.