Vein Treatment Center of Cheyenne

Primary specialty

Vascular Surgery PhysicianTaxonomy code 2086S0129X

Legal business name

VEIN TREATMENT CENTER OF CHEYENNE

Practice address

4003 Rawlins St. Suite B
Cheyenne, WY 82001

Phone

(307) 637-5600

Fax

(307) 637-0249

NPI assigned

Mar 31, 2006

Organization subpart

No

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

Authorized official

Name

Sandra K Surbrugg, MDNPI 1699742957

Title

Managing Partner

Phone

(307) 635-0226

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in WY

Enrollment records 1

Locations

Practitioners 2

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

• Sandra K Surbrugg, MD

  • Dermatology Physician
  • Cheyenne, WY
  • NPI 1699742957
  Medicare reassignment NPD Authorized official
• Lawrence William O Holleran, MD

  • Surgery Physician
  • Cheyenne, WY
  • NPI 1225004187
  Medicare reassignment NPD

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

{
    "created_epoch": "1143763200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1687478400000",
    "number": "1295796050",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "123 WESTERN HILLS BLVD.",
            "city": "CHEYENNE",
            "state": "WY",
            "postal_code": "820093446",
            "telephone_number": "307-638-5149",
            "fax_number": "307-635-1924"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4003 RAWLINS ST. SUITE B",
            "city": "CHEYENNE",
            "state": "WY",
            "postal_code": "82001",
            "telephone_number": "307-637-5600",
            "fax_number": "307-637-0249"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VEIN TREATMENT CENTER OF CHEYENNE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-31",
        "last_updated": "2023-06-23",
        "certification_date": "2023-06-23",
        "status": "A",
        "authorized_official_last_name": "SURBRUGG",
        "authorized_official_first_name": "SANDRA",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "MANAGING PARTNER",
        "authorized_official_telephone_number": "307-635-0226",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery, Vascular Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "121833600",
            "state": "WY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sumerlee Varos
• Eloy A Vasquez, DPT
• Sarai Vasquez
• Christopher Vaughn, RD
• Toni Rae Vavra-Wilder
• Maria Velasco, LCSW
• Stacey K Veltman
• Erin Verburg, PT, DPT, ATC
• Aaron Brent Vernon, DPT
• Veronica Pedersen, LCSW, LLC

• Vascular Surgery Physician in Cheyenne, WY
• Providers in Cheyenne, WY by specialty
• Vascular Surgery Physician in Wyoming

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2023; 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.