NPIMap

Organization Active NPI

Rocky Mountain Vein Clinic, P.C.

  • Vascular Surgery Physician
  • Cody, WY
National Provider Identifier
1326089137
Registry record updated Oct 1, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
License
6172A Issued in WY
Legal business name
ROCKY MOUNTAIN VEIN CLINIC, P.C.
Practice address
125 W Yellowstone Ave
Cody, WY 82414-8723
Phone
(307) 527-7129
Fax
(307) 587-7394
NPI assigned
Jun 10, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2020

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

Authorized official

Name
James L Johnson II, M.D.NPI 1215926985
Title
President
Phone
(307) 527-7129

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2086S0129X 6172A WY Primary

Addresses

Primary practice location

125 W Yellowstone Ave
Cody, WY 82414-8723

Mailing address

2820 Central Ave Ste a
Billings, MT 59102-8624
Phone (406) 896-2447

Other identifiers 1

IdentifierTypeStateIssuer
123009300MedicaidWY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MT, WY2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20060719000063 MT Part B Supplier - Clinic/Group Practice 7113930025 Receives reassigned benefits from 11 practitioners
Practice locations: Billings, MT
O20060817000034 WY Part B Supplier - Clinic/Group Practice 7113930025 Receives reassigned benefits from 3 practitioners
Practice locations: Cody, WY

National Provider Directory

National Provider Directory

Locations

2820 Central Ave
Ste A
Billings, MT 59102
Phone (406) 252-8346

Practitioners & affiliated clinicians

Practitioners 14

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

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1149897600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1601510400000",
    "number": "1326089137",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2820 CENTRAL AVE STE A",
            "city": "BILLINGS",
            "state": "MT",
            "postal_code": "591028624",
            "telephone_number": "406-896-2447",
            "fax_number": "406-896-2491"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 W YELLOWSTONE AVE",
            "city": "CODY",
            "state": "WY",
            "postal_code": "824148723",
            "telephone_number": "307-527-7129",
            "fax_number": "307-587-7394"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROCKY MOUNTAIN VEIN CLINIC, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-10",
        "last_updated": "2020-10-01",
        "certification_date": "2020-10-01",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "307-527-7129",
        "authorized_official_name_suffix": "II",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery, Vascular Surgery",
            "state": "WY",
            "license": "6172A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "123009300",
            "state": "WY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cody, WY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2020; 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.