| Digestive Health Associates Of Cheyenne | |
|
7212 Commons Cir Cheyenne WY 82009-2667 | |
| (307) 635-4141 | |
| (307) 635-6587 |
| Full Name | Digestive Health Associates Of Cheyenne |
|---|---|
| Speciality | Clinic/Center |
| Location | 7212 Commons Cir, Cheyenne, Wyoming |
| Authorized Official Name and Position | Scott Mcrae (PRESIDENT) |
| Authorized Official Contact | 3076354141 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Digestive Health Associates Of Cheyenne 7212 Commons Cir Cheyenne WY 82009-2667 Ph: (307) 635-4141 | Digestive Health Associates Of Cheyenne 7212 Commons Cir Cheyenne WY 82009-2667 Ph: (307) 635-4141 |
| NPI Number | 1508808239 |
|---|---|
| Provider Enumeration Date | 06/10/2006 |
| Last Update Date | 10/03/2022 |
| Medicare PECOS PAC ID | 9032100557 |
|---|---|
| Medicare Enrollment ID | O20040521001051 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508808239 | NPI | - | NPPES |
| 106239500 | Medicaid | WY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | (* (Not Available)) | Secondary |
| 261QM2500X | Clinic/center - Medical Specialty | (* (Not Available)) | Primary |
| Provider Name | Kenneth R Kranz |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1740222462 PECOS PAC ID: 9436140969 Enrollment ID: I20040521001102 |
| Provider Name | Scott V Mcrae |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1144390006 PECOS PAC ID: 0941440283 Enrollment ID: I20130709000546 |
| Provider Name | Kenneth S Buran |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1033129390 PECOS PAC ID: 6709772098 Enrollment ID: I20160115001620 |
| Provider Name | Brian J Horner |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1336465939 PECOS PAC ID: 4587804406 Enrollment ID: I20170728001221 |
| Provider Name | Penny M Sanderson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013249929 PECOS PAC ID: 8426186230 Enrollment ID: I20180222002540 |
| Provider Name | Jennifer A Martin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831660430 PECOS PAC ID: 8426391848 Enrollment ID: I20190528000582 |
| Provider Name | Jamie L Skrove |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1033524095 PECOS PAC ID: 6709181530 Enrollment ID: I20200806001528 |
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