Individual provider Active NPI

Sandee K Lewis, NP

  • Family Nurse Practitioner
  • Riverton, WY
National Provider Identifier
1972642700
Registry record updated Jan 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
15065.0882 Issued in WY
Practice address
1035 Rose LN
Riverton, WY 82501-2291
Phone
(307) 857-6685
Fax
(307) 857-9927
NPI assigned
Feb 6, 2007
Last updated
Jan 8, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 8, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 15065.0882 WY Primary

Addresses

Primary practice location

1035 Rose LN
Riverton, WY 82501-2291

Mailing address

5000 Blackmore Rd
Casper, WY 82609-3345
Phone (307) 233-6000

Other identifiers 1

IdentifierTypeStateIssuer
124167200MedicaidWY

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address credentialing@chccw.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070517000294 WY Practitioner - Nurse Practitioner 5294764726 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

5647 US Hwy 26
Dubois, WY 82513-9607
Phone (307) 455-2516

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
15065.0882WYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Community Health Center of Central Wyoming, Inc. Current Accepting new patients
Community Health Center of Central Wyoming Inc Past Accepting new patients

Locations

5000 Blackmore Rd
Casper, WY 82609
Phone (307) 233-6000

1035 Rose Ln
Riverton, WY 82501
Phone (307) 463-6300

1035 Rose Ln
Ste B
Riverton, WY 82501
Phone (307) 856-0382

Organizations & group practices 2

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 1

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": "1170720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610064000000",
    "number": "1972642700",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5000 BLACKMORE RD",
            "city": "CASPER",
            "state": "WY",
            "postal_code": "826093345",
            "telephone_number": "307-233-6000",
            "fax_number": "307-233-6089"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1035 ROSE LN",
            "city": "RIVERTON",
            "state": "WY",
            "postal_code": "825012291",
            "telephone_number": "307-857-6685",
            "fax_number": "307-857-9927"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEWIS",
        "first_name": "SANDEE",
        "middle_name": "K",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-06",
        "last_updated": "2021-01-08",
        "certification_date": "2021-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WY",
            "license": "15065.0882",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "124167200",
            "state": "WY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "credentialing@chccw.org",
            "affiliation": "N",
            "address_1": "1035 Rose Ln",
            "city": "Riverton",
            "state": "WY",
            "country_code": "US",
            "postal_code": "825012291",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Riverton, WY

Sources for this page

Verify at the official NPI Registry.