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General NPI Number Information
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NPI Number | 1902565534
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Entity Type | Organization
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Legal Business Name | CHEYENNE REGIONAL PHYSICIANS GROUP, LLC
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Dates
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Enumeration Date | 12/10/2021
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Last Update Date | 10/06/2025
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Provider Practice Location Address
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Address Line | 2301 HOUSE AVE STE 507
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City | CHEYENNE
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State | WY
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Zip | 82001-3179
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Country | US
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Telephone | 307-635-2562
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Fax | 307-638-2074
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Provider Business Mailing Address
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Address Line | PO BOX 20970
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City | CHEYENNE
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State | WY
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Zip | 82003-7020
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Country | US
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Telephone | 307-996-4777
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Fax | 307-773-8013
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Authorized Official
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Title or Position | PAYER ENROLLMENT SPECIALIST
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Name | ERIN PETERSEN
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Credential |
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Telephone | 307-432-3664
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207LP2900X
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Taxonomy Name | Pain Medicine (Anesthesiology) Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 2086S0105X
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Taxonomy Name | Surgery of the Hand (Surgery) Physician
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number |
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License Number State |
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