Individual provider Active NPI

Ellen C Wilhelm, APRN

  • Obstetrics & Gynecology Nurse Practitioner
  • Cheyenne, WY
National Provider Identifier
1962698514
Registry record updated Feb 1, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology Nurse PractitionerTaxonomy code 363LX0001X
License
14569.0146 Issued in WY
Practice address
3235 Sparks Rd
Suite 200
Cheyenne, WY 82001-6158
Phone
(307) 638-8975
Fax
(307) 634-9267
NPI assigned
Sep 18, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 1, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Nurse Practitioner 363LX0001X 14569.146 WY
Obstetrics & Gynecology Nurse Practitioner 363LX0001X 14569.0146 WY Primary

Addresses

Primary practice location

3235 Sparks Rd
Suite 200
Cheyenne, WY 82001-6158

Mailing address

4003 Rawlins St.
Cheyenne, WY 82001-1800
Phone (307) 638-8975

Other identifiers 2

IdentifierTypeStateIssuer
313702OtherWYBLUE CROSS BLUE SHIELD
121720800MedicaidWY

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

State licenses

LicenseStateTypeSpecialty
14569.0146WYMDObstetrics & Gynecology Nurse Practitioner
14569.146WYMDObstetrics & Gynecology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mountain Falls Clinic, P.C. Past Accepting new patients
Willow Creek Family Medicine, P.C. PastSince Jan 8, 2008 Accepting new patients
Mountain West Surgical Specialists LLC PastSince Mar 1, 2024 Accepting new patients

Interoperability endpoints

  • FHIR API: https://soap.crmcwy.org/fhirproxy/api/FHIR/R4

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1190073600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1328054400000",
    "number": "1962698514",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4003 RAWLINS ST.",
            "city": "CHEYENNE",
            "state": "WY",
            "postal_code": "820011800",
            "telephone_number": "307-638-8975",
            "fax_number": "307-634-9267"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3235 SPARKS RD",
            "address_2": "SUITE 200",
            "city": "CHEYENNE",
            "state": "WY",
            "postal_code": "820016158",
            "telephone_number": "307-638-8975",
            "fax_number": "307-634-9267"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILHELM",
        "first_name": "ELLEN",
        "middle_name": "C",
        "name_prefix": "Mrs.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-09-18",
        "last_updated": "2012-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LX0001X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Obstetrics & Gynecology",
            "state": "WY",
            "license": "14569.146",
            "primary": false
        },
        {
            "code": "363LX0001X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Obstetrics & Gynecology",
            "state": "WY",
            "license": "14569.0146",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "313702",
            "state": "WY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "121720800",
            "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 Feb 1, 2012; 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.