NPIMap

Individual provider Active NPI

Emily Jean Gallegos, MD

  • Family Medicine Physician
  • Cheyenne, WY
National Provider Identifier
1972170058
Registry record updated Sep 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
16112A Issued in WY
Practice address
5416 Education Dr
Cheyenne, WY 82009-4094
Phone
(307) 778-3675
Fax
(307) 632-3302
NPI assigned
Jun 8, 2021
Last updated
Sep 16, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 16, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 16112A WY Primary

Addresses

Primary practice location

5416 Education Dr
Cheyenne, WY 82009-4094

Mailing address

PO Box 20970
Cheyenne, WY 82003-7020
Phone (307) 996-4777

Other practice location 1

820 E 17th St
Cheyenne, WY 82001-4714
Phone (307) 632-2434

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address egallegos46331@direct.crmcwy.org Health Information Exchange (HIE) Cheyenne Regional Physicians Group, LLC
Direct Messaging Address egallegos46331@direct.crmcwy.org Direct Cheyenne Regional Physicians Group, LLC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240812001349 WY Practitioner - Family Practice 7214308824 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cheyenne Regional Physicians Group LLCGroup PAC ID 2961403639, 101 clinicians

Practice addresses (Care Compare)

4116 Laramie St
Cheyenne, WY 82001-1969
Phone (307) 635-7961

5416 Education Dr
Cheyenne, WY 82009-4094
Phone (307) 778-3675

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
16112AWYMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Wyoming Speech and Hearing Clinic CurrentSince Aug 15, 2024 Accepting new patients
Cheyenne Regional Physicians Group, LLC Family Medicine CurrentSince Aug 26, 2024 Accepting new patients
University of Wyoming Family Medicine CurrentSince Aug 15, 2024 Accepting new patients
Cheyenne Children's Clinic, PC Past Accepting new patients
Cheyenne Regional Physicians Group, LLC PastSince Dec 12, 2021 Accepting new patients
University of Wyoming Family Medicine Past Accepting new patients

Locations

4116 Laramie St
Cheyenne, WY 82001
Phone (307) 634-9311

5416 Education Dr
Cheyenne, WY 82009
Phone (307) 778-3675

820 E 17th St
Cheyenne, WY 82001
Phone (307) 431-5055

Organizations & group practices 6

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

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1623110400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726444800000",
    "number": "1972170058",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 20970",
            "city": "CHEYENNE",
            "state": "WY",
            "postal_code": "820037020",
            "telephone_number": "307-996-4777",
            "fax_number": "307-773-8013"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5416 EDUCATION DR",
            "city": "CHEYENNE",
            "state": "WY",
            "postal_code": "820094094",
            "telephone_number": "307-778-3675",
            "fax_number": "307-632-3302"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "820 E 17th St",
            "address_purpose": "LOCATION",
            "city": "Cheyenne",
            "state": "WY",
            "postal_code": "820014714",
            "country_code": "US",
            "telephone_number": "307-632-2434",
            "fax_number": "307-634-3510",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GALLEGOS",
        "first_name": "EMILY",
        "middle_name": "JEAN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-06-08",
        "last_updated": "2024-09-16",
        "certification_date": "2024-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WY",
            "license": "16112A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "egallegos46331@direct.crmcwy.org",
            "affiliation": "Y",
            "endpointDescription": "CRMC Direct Address",
            "affiliationName": "Cheyenne Regional Physicians Group, LLC",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "5416 Education Dr",
            "city": "Cheyenne",
            "state": "WY",
            "country_code": "US",
            "postal_code": "820094094",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "egallegos46331@direct.crmcwy.org",
            "affiliation": "Y",
            "endpointDescription": "CRMC Direct Address",
            "affiliationName": "Cheyenne Regional Physicians Group, LLC",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "5416 Education Dr",
            "city": "Cheyenne",
            "state": "WY",
            "country_code": "US",
            "postal_code": "820094094",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Cheyenne, WY

Sources for this page

Verify at the official NPI Registry.