Individual provider Active NPI

Jay A Winzenried, M.D.

  • Orthopaedic Surgery Physician
  • Cody, WY
National Provider Identifier
1083603047
Registry record updated Aug 3, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
6422A Issued in WY
Practice address
721 Sheridan Ave Ste 130
Cody, WY 82414-3436
Phone
(307) 527-7100
Fax
(307) 527-7145
NPI assigned
Oct 20, 2005
Last updated
Aug 3, 2010By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 3, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X 4931310001 WY
Orthopaedic Surgery Physician 207X00000X 6422A WY Primary

Addresses

Primary practice location

721 Sheridan Ave Ste 130
Cody, WY 82414-3436

Mailing address

721 Sheridan Ave Ste 130
Cody, WY 82414-3436
Phone (307) 527-7100

Other identifiers 7

IdentifierTypeStateIssuer
0065059MedicaidMT
312326OtherWYBLUE CROSS BLUE SHEILD
4931310001OtherWYDMERC
P00096957OtherWYRAILROAD MEDICARE
115812100MedicaidWY
115812101OtherWYMEDICAID DME
486921300OtherWYFEDERAL WORK COMP

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
034WYMDMidwife
6422AWYMDOrthopaedic Surgery Physician
4931310001WYMDDurable Medical Equipment & Medical Supplies

Practice roles

OrganizationSpecialtyStatusNew patients
Orthopaedics of Jackson Hole PC Orthopaedic Surgery Past Accepting new patients
Frances Mahon Deaconess Hospital Past Accepting new patients

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1129766400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1280793600000",
    "number": "1083603047",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "721 SHERIDAN AVE STE 130",
            "city": "CODY",
            "state": "WY",
            "postal_code": "824143436",
            "telephone_number": "307-527-7100",
            "fax_number": "307-527-7145"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "721 SHERIDAN AVE STE 130",
            "city": "CODY",
            "state": "WY",
            "postal_code": "824143436",
            "telephone_number": "307-527-7100",
            "fax_number": "307-527-7145"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WINZENRIED",
        "first_name": "JAY",
        "middle_name": "A",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-10-20",
        "last_updated": "2010-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "WY",
            "license": "4931310001",
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "WY",
            "license": "6422A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0065059",
            "state": "MT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHEILD",
            "identifier": "312326",
            "state": "WY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DMERC",
            "identifier": "4931310001",
            "state": "WY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00096957",
            "state": "WY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "115812100",
            "state": "WY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID DME",
            "identifier": "115812101",
            "state": "WY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FEDERAL WORK COMP",
            "identifier": "486921300",
            "state": "WY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cody, WY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2010; 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.