Smart Sports Medicine LLC

Primary specialty

Sports Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081S0010X

License

3871A Issued in WY

Legal business name

SMART SPORTS MEDICINE LLC

Practice address

5307 Yellowstone Rd
Cheyenne, WY 82009-4736

Phone

(307) 632-7677

Fax

(307) 778-8292

NPI assigned

Aug 22, 2018

Organization subpart

No

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

Authorized official

Name

Dr. Vincent J. Ross, MDNPI 1366525339

Title

President

Phone

(307) 632-7677

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WY

Enrollment records 1

Practitioners 4

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

• Justin Brink, PT

  • Physical Therapist
  • Cheyenne, WY
  • NPI 1528138732
  Medicare reassignment Care Compare group NPD
• Samantha Olive Gibbard, DPT

  • Physical Therapist
  • Cheyenne, WY
  • NPI 1457090516
  Medicare reassignment Care Compare group NPD
• Vincent John Ross, M.D.

  • Sports Medicine (Family Medicine) Physician
  • Fort Collins, CO
  • NPI 1366525339
  NPD Authorized official
• Sheena Lee Pacheco, FNP

  • Nurse Practitioner
  • Cheyenne, WY
  • NPI 1306483300
  Medicare reassignment

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

{
    "created_epoch": "1534896000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1775692800000",
    "number": "1114408739",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5307 YELLOWSTONE RD",
            "city": "CHEYENNE",
            "state": "WY",
            "postal_code": "820094736",
            "telephone_number": "307-632-7677",
            "fax_number": "307-778-8292"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5307 YELLOWSTONE RD",
            "city": "CHEYENNE",
            "state": "WY",
            "postal_code": "820094736",
            "telephone_number": "307-632-7677",
            "fax_number": "307-778-8292"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SMART SPORTS MEDICINE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-08-22",
        "last_updated": "2026-04-09",
        "certification_date": "2026-04-09",
        "status": "A",
        "authorized_official_last_name": "ROSS",
        "authorized_official_first_name": "VINCENT",
        "authorized_official_middle_name": "J.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "307-632-7677",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2081S0010X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation, Sports Medicine",
            "state": "WY",
            "license": "3871A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jamie Skrove, D.O.
• Tena P Slizeski
• Michael L Sloan, M.D.
• Alexander Antoni Slota, MD
• Smart Sports Medicine Clinic PC
• Edward N Smedley, PHARMD
• Jerrad Barton Smedley, PHARMD
• Smith Psychological Services
• Gwendolyn L Smith-Russell, LPC
• Brian C Smith, D.C.

• Sports Medicine (Physical Medicine & Rehabilitation) Physician in Cheyenne, WY
• Providers in Cheyenne, WY by specialty
• Sports Medicine (Physical Medicine & Rehabilitation) Physician in Wyoming

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.