Synergist Monitoring Pro LLC

Primary specialty

Electrodiagnostic Medicine PhysicianTaxonomy code 204R00000X

Legal business name

SYNERGIST MONITORING PRO LLC

Practice address

1910 Thomes Ave
Cheyenne, WY 82001

Phone

(972) 412-5299

NPI assigned

Nov 16, 2017

Organization subpart

No

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

Authorized official

Name

Matthew Wavra

Title

Member

Phone

(307) 310-2610

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1510790400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1535414400000",
    "number": "1104330877",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2928",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972082928",
            "telephone_number": "972-412-5299",
            "fax_number": "469-453-3374"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1910 THOMES AVE",
            "city": "CHEYENNE",
            "state": "WY",
            "postal_code": "82001",
            "telephone_number": "972-412-5299"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SYNERGIST MONITORING PRO LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-11-16",
        "last_updated": "2018-08-28",
        "status": "A",
        "authorized_official_last_name": "WAVRA",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "307-310-2610"
    },
    "taxonomies": [
        {
            "code": "204R00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Electrodiagnostic Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2018; 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.