Active NPI
Richard B Southwell, MD
- Orthopaedic Surgery Physician
- Laramie, WY
National Provider Identifier
1265412225
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthopaedic Surgery Physician
- License
- 3077A
- Practice address
- 1909 Vista Dr
Laramie, WY 82070-5530 - Phone
- (307) 745-8851
- Fax
- (307) 742-0961
- NPI assigned
- Jan 18, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthopaedic Surgery Physician | 207X00000X | 3077A | WY | Primary |
Addresses
Primary practice location
1909 Vista Dr
Laramie, WY 82070-5530
Mailing address
1909 Vista Dr
Laramie, WY 82070-5530
Phone (307) 745-8851
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100342900 | Medicaid | WY | |
| 200009950 | Other | RAILROAD MEDICARE | |
| 305410 | Other | BCBS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1137542400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1244764800000",
"number": "1265412225",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1909 VISTA DR",
"city": "LARAMIE",
"state": "WY",
"postal_code": "820705530",
"telephone_number": "307-745-8851",
"fax_number": "307-742-0961"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1909 VISTA DR",
"city": "LARAMIE",
"state": "WY",
"postal_code": "820705530",
"telephone_number": "307-745-8851",
"fax_number": "307-742-0961"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SOUTHWELL",
"first_name": "RICHARD",
"middle_name": "B",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-01-18",
"last_updated": "2009-06-12",
"status": "A"
},
"taxonomies": [
{
"code": "207X00000X",
"taxonomy_group": "",
"desc": "Orthopaedic Surgery",
"state": "WY",
"license": "3077A",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100342900",
"state": "WY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "200009950",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "305410",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Laramie, WY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.