Teresa Beth Connelly

Primary specialty

Developmentally Disabled Services Day Training AgencyTaxonomy code 251C00000X

License

106607583 Issued in WY

Practice address

10113 Beulah Ave
Cheyenne, WY 82009-8960

Phone

(307) 221-1644

NPI assigned

Nov 29, 2010

Last updated

Nov 29, 2010By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1290988800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1290988800000",
    "number": "1952603813",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10113 BEULAH AVE",
            "city": "CHEYENNE",
            "state": "WY",
            "postal_code": "820098960",
            "telephone_number": "307-221-1644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10113 BEULAH AVE",
            "city": "CHEYENNE",
            "state": "WY",
            "postal_code": "820098960",
            "telephone_number": "307-221-1644"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONNELLY",
        "first_name": "TERESA",
        "middle_name": "BETH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-11-29",
        "last_updated": "2010-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": "WY",
            "license": "106607583",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Developmentally Disabled Services Day Training Agency in Cheyenne, WY
• Providers in Cheyenne, WY by specialty
• Developmentally Disabled Services Day Training Agency in Wyoming

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2010; 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.