CREEKSIDE MEDICAL LLC
NPI 1487167052
Electrodiagnostic Medicine in Cheyenne, WY

Active since November 06, 2017
1910 THOMES AVE, CHEYENNE, WY 82001(425) 890-6239 Get Directions Write a Review

NPPES record last updated: September 20, 2018. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Sep 20, 2018, Mar 22, 2018, Feb 26, 2018 and 1 more (4 updates tracked since 2017).

About Creekside Medical Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

CREEKSIDE MEDICAL LLC (NPI 1487167052) is a healthcare organization registered as an electrodiagnostic medicine in Cheyenne, Wyoming and active in the NPI registry since November 2017. The organization lists Matthew Wavra, Managing Member, as its authorized official.

NPPES Registry Identity

NPI1487167052
Entity TypeOrganization
Primary Taxonomy204R00000X
Legal Business NameCREEKSIDE MEDICAL LLC
Location Address1910 THOMES AVECheyenne, WY 82001-3527
Mailing Address4580 Klahanie Dr Se # 252Issaquah, WA 98029-5812 · (833) 613-9084
Organization SubpartNo
Authorized OfficialMatthew WavraManaging Member · (425) 890-6239
Enumeration DateNovember 6, 2017
Last NPPES UpdateSeptember 20, 20184 updates tracked since enumeration
NPI 1487167052 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyElectrodiagnostic MedicineAllopathic & Osteopathic Physicians
Taxonomy Code204R00000X
Definition
Electrodiagnostic medicine is the medical subspecialty that applies neurophysiologic techniques to diagnose, evaluate, and treat patients with impairments of the neurologic, neuromuscular, and/or muscular systems. Qualified physicians are trained in performing electrophysiological testing and interpretation of the test data. They require knowledge in anatomy, physiology, kinesiology, histology, and pathology of the brain, spinal cord, autonomic nerves, cranial nerves, peripheral nerves, neuromuscular junction, and muscles. They must know clinical features and treatment of diseases of the central, peripheral, and autonomic nervous systems, as well as those of neuromuscular junction and muscle. Physicians also require special knowledge about electric signal processing, including waveform analysis, electronics and instrumentation, stimulation and recording equipment, and statistics.
1910 THOMES AVE, Cheyenne, WY 82001

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X MULTIPLE SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Electrodiagnostic Medicine
1910 THOMES AVE
CHEYENNE, WY 82001
Physiological Laboratory
1910 THOMES AVE
CHEYENNE, WY 82001
Specialist/Technologist, Other (Electroneurodiagnostic)
1910 THOMES AVE
CHEYENNE, WY 82001

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Creekside Medical LLC's NPI number?

The NPI number for Creekside Medical LLC is 1487167052. It was assigned to this organization in the NPPES registry on November 6, 2017.

Where is Creekside Medical LLC located?

Creekside Medical LLC is located at 1910 Thomes Ave, Cheyenne, WY 82001. The listed phone number is (425) 890-6239.

What is Creekside Medical LLC's specialty?

The primary specialty registered for this NPI is Electrodiagnostic Medicine with taxonomy code 204R00000X.

When was this NPI record last updated?

The NPPES record for Creekside Medical LLC was last updated on September 20, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.