Sage Medical Group LLC

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

SAGE MEDICAL GROUP LLC

Practice address

419 S Washington Street
Suite 201
Casper, WY 82601

Phone

(307) 265-8300

Fax

(307) 265-8313

NPI assigned

Feb 5, 2007

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Charles D Moses

Title

Chief Administrative Officer

Phone

(307) 265-8300

Specialties & licenses 1

Addresses

Other names 1

• Sage Medical Group Laboratory Other name

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Practitioners 7

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.

• Paul Thomas Bettinger, M.D.

  • Internal Medicine Physician
  • Casper, WY
  • NPI 1346201076
  NPD (past)
• Terry Robert Donaldson, MD

  • Internal Medicine Physician
  • Rock Springs, WY
  • NPI 1417903709
  NPD (past)
• David J Erk, MD

  • Internal Medicine Physician
  • Casper, WY
  • NPI 1396713046
  NPD (past)
• Jason W Lloyd

  • Family Medicine Physician
  • Casper, WY
  • NPI 1841298536
  NPD (past)
• Stuart J Ruben, M.D.

  • Internal Medicine Physician
  • Casper, WY
  • NPI 1881844645
  NPD (past)
• Robert J Griffin, PAC

  • Physician Assistant
  • Kalispell, MT
  • NPI 1588632236
  NPD (past)
• Joseph G Sramek, MD

  • Neurological Surgery Physician
  • Kalispell, MT
  • NPI 1891763439
  NPD (past)

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

{
    "created_epoch": "1170633600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1164561528",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 50750",
            "city": "CASPER",
            "state": "WY",
            "postal_code": "82605",
            "telephone_number": "307-265-8300",
            "fax_number": "307-265-8313"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "419 S WASHINGTON STREET",
            "address_2": "SUITE 201",
            "city": "CASPER",
            "state": "WY",
            "postal_code": "82601",
            "telephone_number": "307-265-8300",
            "fax_number": "307-265-8313"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAGE MEDICAL GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-05",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MOSES",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "CHIEF ADMINISTRATIVE OFFICER",
        "authorized_official_telephone_number": "307-265-8300",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "WY",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sage Medical Group Laboratory",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Aaron Ray Rutz, FNP
• Melodie Marie Ryan-Rose
• Jennifer Leigh Ryerson-Heaton
• S48Wy1, LLC (Wyoming Recovery)
• Sage Counseling LLC
• Sage Medical Group LLC
• Maxim Eslao Salva, MD
• Rebecca Leigh Samberg, DNP, FNP-C
• Daniel Samelson
• Sams West Inc (Sam's Club Pharmacy 10-6425)

• Clinical Medical Laboratory in Casper, WY
• Providers in Casper, WY by specialty
• Clinical Medical Laboratory in Wyoming

• 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.