Wyoming Surgical Center MRI

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

35-2-904 Issued in WY

Legal business name

WYOMING SURGICAL CENTER MRI

Practice address

4140 Centennial Hills Blvd
#C
Casper, WY 82609-3265

Phone

(307) 472-8781

Fax

(307) 472-8887

NPI assigned

Nov 30, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Charles Robertson

Title

Administrator

Phone

(307) 472-8781

Specialties & licenses 1

Addresses

Other identifiers 2

Practitioners 1

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

• Jerome A Behrens, MD

  • Orthopaedic Surgery Physician
  • Casper, WY
  • NPI 1578565172
  NPD (past)

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

{
    "created_epoch": "1164844800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1215388800000",
    "number": "1164599379",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4140 CENTENNIAL HILLS BLVD #C",
            "city": "CASPER",
            "state": "WY",
            "postal_code": "82609",
            "telephone_number": "307-472-8781",
            "fax_number": "307-472-8887"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4140 CENTENNIAL HILLS BLVD",
            "address_2": "#C",
            "city": "CASPER",
            "state": "WY",
            "postal_code": "826093265",
            "telephone_number": "307-472-8781",
            "fax_number": "307-472-8887"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WYOMING SURGICAL CENTER MRI",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-30",
        "last_updated": "2008-07-07",
        "status": "A",
        "authorized_official_last_name": "ROBERTSON",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "307-472-8781",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "WY",
            "license": "35-2-904",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD OF WYOMING",
            "identifier": "WY00549",
            "state": "WY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00092902",
            "state": "WY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Wyoming Reconstructive & Plastic Surgery LLC
• Wyoming Retina Associates, PC
• Wyoming Sleep Diagnostics, Inc.
• Wyoming Surgical Associates PC
• Wyoming Surgical Center LLC
• Wyoming Trauma Treatment Center
• Wyoming Wound Care Center PC
• Demian Matthew Yakel, D.O.
• Shelby Yates, MSN, FNP-BC
• Samantha Yeager

• Diagnostic Radiology Physician in Casper, WY
• Providers in Casper, WY by specialty
• Diagnostic Radiology Physician in Wyoming

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 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.