Organization Active NPI

Rural Spine Care PC

  • Orthopaedic Surgery of the Spine Physician
  • Rock Springs, WY
National Provider Identifier
1376079962
Registry record updated Feb 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery of the Spine PhysicianTaxonomy code 207XS0117X
License
10140A Issued in WY
Legal business name
RURAL SPINE CARE PC
Practice address
4401 College Dr
Rock Springs, WY 82901-3507
Phone
(970) 819-0697
NPI assigned
May 3, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 19, 2025

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

Authorized official

Name
Henry Fabian Jr., MD
Title
Owner/Physician
Phone
(970) 819-0697

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery of the Spine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207XS0117X 10140A WY Primary

Addresses

Primary practice location

4401 College Dr
Rock Springs, WY 82901-3507

Mailing address

4401 College Dr
Rock Springs, WY 82901-3507
Phone (307) 352-8946

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170718000923 WY Part B Supplier - Clinic/Group Practice 7416227806 Receives reassigned benefits from 2 practitioners
Practice locations: Douglas, WY; Lander, WY; Rock Springs, WY

National Provider Directory

National Provider Directory

Locations

2624 Commercial Way
Ste B
Rock Springs, WY 82901
Phone (307) 382-3753

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1493769600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1739923200000",
    "number": "1376079962",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4401 COLLEGE DR",
            "city": "ROCK SPRINGS",
            "state": "WY",
            "postal_code": "829013507",
            "telephone_number": "307-352-8946"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4401 COLLEGE DR",
            "city": "ROCK SPRINGS",
            "state": "WY",
            "postal_code": "829013507",
            "telephone_number": "970-819-0697"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RURAL SPINE CARE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-05-03",
        "last_updated": "2025-02-19",
        "certification_date": "2025-02-19",
        "status": "A",
        "authorized_official_last_name": "FABIAN",
        "authorized_official_first_name": "HENRY",
        "authorized_official_title_or_position": "OWNER/PHYSICIAN",
        "authorized_official_telephone_number": "970-819-0697",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207XS0117X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Orthopaedic Surgery, Orthopaedic Surgery of the Spine",
            "state": "WY",
            "license": "10140A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rock Springs, WY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2025; 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.