NPIMap

Organization Active NPI

Riverton Physician Practices LLC

Doing business as Fremont Pathology

  • Anatomic Pathology & Clinical Pathology Physician
  • Riverton, WY
National Provider Identifier
1174858302
Registry record updated Mar 29, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
Legal business name
RIVERTON PHYSICIAN PRACTICES LLC
Doing business as
Fremont Pathology
Practice address
2100 W Sunset Dr
Riverton, WY 82501-2274
Phone
(307) 857-5280
Fax
(307) 857-5215
NPI assigned
Oct 6, 2009
Last updated
Mar 29, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 29, 2011

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

Authorized official

Name
Mr. Jess N Judy
Title
President
Phone
(615) 372-8508

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207ZP0102X Primary

Addresses

Primary practice location

2100 W Sunset Dr
Riverton, WY 82501-2274

Mailing address

2100 W Sunset Dr
Riverton, WY 82501-2274
Phone (307) 857-5280

Other names 1

  • Fremont Pathology Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040505000232 WY Part B Supplier - Clinic/Group Practice 8426954496 Receives reassigned benefits from 51 practitioners
6 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Riverton, WY; Lander, WY

Other NPIs on the same Medicare enrollment 6

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

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, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1254787200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1301356800000",
    "number": "1174858302",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 W SUNSET DR",
            "city": "RIVERTON",
            "state": "WY",
            "postal_code": "825012274",
            "telephone_number": "307-857-5280",
            "fax_number": "307-857-5215"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 W SUNSET DR",
            "city": "RIVERTON",
            "state": "WY",
            "postal_code": "825012274",
            "telephone_number": "307-857-5280",
            "fax_number": "307-857-5215"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RIVERTON PHYSICIAN PRACTICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-10-06",
        "last_updated": "2011-03-29",
        "status": "A",
        "authorized_official_last_name": "JUDY",
        "authorized_official_first_name": "JESS",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "615-372-8508",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Fremont Pathology",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Riverton, WY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2011; 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.