NPIMap

Organization Active NPI

Wyoming Regional Anesthesia LLC

  • Certified Registered Nurse Anesthetist
  • Douglas, WY
National Provider Identifier
1013080688
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
Legal business name
WYOMING REGIONAL ANESTHESIA LLC
Practice address
111 S 5TH Street
Douglas, WY 82633
Phone
(307) 358-2122
NPI assigned
Nov 15, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. Jeffrey L Green, MS CRNA
Title
Managing Member
Phone
(307) 358-5590

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X NU Primary

Addresses

Primary practice location

111 S 5TH Street
Douglas, WY 82633

Mailing address

PO Box 1780
Douglas, WY 82633-1780
Phone (307) 358-5590

Other identifiers 2

IdentifierTypeStateIssuer
0616001OtherWYBCBS
DA5920OtherRAILROAD MC

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1163548800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1013080688",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1780",
            "city": "DOUGLAS",
            "state": "WY",
            "postal_code": "826331780",
            "telephone_number": "307-358-5590",
            "fax_number": "307-358-5590"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 S 5TH STREET",
            "city": "DOUGLAS",
            "state": "WY",
            "postal_code": "82633",
            "telephone_number": "307-358-2122"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WYOMING REGIONAL ANESTHESIA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-15",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GREEN",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "307-358-5590",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MS CRNA"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "0616001",
            "state": "WY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MC",
            "identifier": "DA5920",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Douglas, WY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.