NPIMap

Organization Active NPI

Synergist Laboratories, LLC

  • Physiological Laboratory
  • Cheyenne, WY
National Provider Identifier
1285153593
Registry record updated Mar 22, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physiological LaboratoryTaxonomy code 293D00000X
Legal business name
SYNERGIST LABORATORIES, LLC
Practice address
1910 Thomes Ave
Cheyenne, WY 82001-3527
Phone
(307) 201-2610
NPI assigned
Sep 18, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 22, 2018

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

Authorized official

Name
Matthew Wavra
Title
Partner
Phone
(307) 201-2610

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Electroneurodiagnostic Specialist/TechnologistGroup: 193400000X SINGLE SPECIALTY GROUP 246ZE0600X
EEG TechnicianGroup: 193400000X SINGLE SPECIALTY GROUP 2472E0500X
Physiological Laboratory 293D00000X Primary

Addresses

Primary practice location

1910 Thomes Ave
Cheyenne, WY 82001-3527

Mailing address

4580 Klahanie Dr SE
Issaquah, WA 98029-5812
Phone (425) 890-6239

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1505692800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1521676800000",
    "number": "1285153593",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4580 KLAHANIE DR SE",
            "city": "ISSAQUAH",
            "state": "WA",
            "postal_code": "980295812",
            "telephone_number": "425-890-6239"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1910 THOMES AVE",
            "city": "CHEYENNE",
            "state": "WY",
            "postal_code": "820013527",
            "telephone_number": "307-201-2610"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SYNERGIST LABORATORIES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-09-18",
        "last_updated": "2018-03-22",
        "status": "A",
        "authorized_official_last_name": "WAVRA",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "307-201-2610"
    },
    "taxonomies": [
        {
            "code": "246ZE0600X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist/Technologist, Other, Electroneurodiagnostic",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2472E0500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Technician, Other, EEG",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "293D00000X",
            "taxonomy_group": "",
            "desc": "Physiological Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cheyenne, WY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2018; 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.