NPIMap

Organization Active NPI

Urgent Care of Jackson Hole, LLC

  • Urgent Care Clinic/Center
  • Jackson, WY
National Provider Identifier
1104032416
Registry record updated Apr 18, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urgent Care Clinic/CenterTaxonomy code 261QU0200X
License
5551A Issued in WY
Legal business name
URGENT CARE OF JACKSON HOLE, LLC
Practice address
1415 South Highway 89
Jackson, WY 83001
Phone
(307) 739-8999
NPI assigned
May 15, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 18, 2008

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

Authorized official

Name
Dr. Franklin Musser Rivers Jr., MDNPI 1710984315
Title
President
Phone
(307) 739-8999

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X 5551A WY
Urgent Care Clinic/Center 261QU0200X 5551A WY Primary

Addresses

Primary practice location

1415 South Highway 89
Jackson, WY 83001

Mailing address

PO Box 8640
Jackson, WY 83002-8640
Phone (307) 739-8999

Other identifiers 1

IdentifierTypeStateIssuer
1104032416MedicaidWY

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1179187200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208476800000",
    "number": "1104032416",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8640",
            "city": "JACKSON",
            "state": "WY",
            "postal_code": "830028640",
            "telephone_number": "307-739-8999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1415 SOUTH HIGHWAY 89",
            "city": "JACKSON",
            "state": "WY",
            "postal_code": "83001",
            "telephone_number": "307-739-8999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "URGENT CARE OF JACKSON HOLE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-15",
        "last_updated": "2008-04-18",
        "status": "A",
        "authorized_official_last_name": "RIVERS",
        "authorized_official_first_name": "FRANKLIN",
        "authorized_official_middle_name": "MUSSER",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "307-739-8999",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "WY",
            "license": "5551A",
            "primary": false
        },
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": "WY",
            "license": "5551A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1104032416",
            "state": "WY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, WY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2008; 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.