NPIMap

Organization Active NPI

Smart Sports Medicine Clinic PC

  • Sports Physical Therapist
  • Cheyenne, WY
National Provider Identifier
1376690214
Registry record updated Apr 15, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Physical TherapistTaxonomy code 2251S0007X
Legal business name
SMART SPORTS MEDICINE CLINIC PC
Practice address
5307 Yellowstone Rd
Cheyenne, WY 82009-4736
Phone
(307) 632-7677
Fax
(307) 778-8292
NPI assigned
Jan 4, 2007
Last updated
Apr 15, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 15, 2026

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

Authorized official

Name
Vincent John RossNPI 1366525339
Title
Owner
Phone
(307) 632-7677

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 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X
Sports Medicine (Physical Medicine & Rehabilitation) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2081S0010X
Sports Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 2251S0007X Primary

Addresses

Primary practice location

5307 Yellowstone Rd
Cheyenne, WY 82009-4736

Mailing address

5307 Yellowstone Rd
Cheyenne, WY 82009-4736
Phone (307) 632-7677

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031203000027 WY Part B Supplier - Clinic/Group Practice 2062317142 Receives reassigned benefits from 8 practitioners
Practice locations: Cheyenne, WY

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 19

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1167868800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1776211200000",
    "number": "1376690214",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5307 YELLOWSTONE RD",
            "city": "CHEYENNE",
            "state": "WY",
            "postal_code": "820094736",
            "telephone_number": "307-632-7677",
            "fax_number": "307-778-8292"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5307 YELLOWSTONE RD",
            "city": "CHEYENNE",
            "state": "WY",
            "postal_code": "820094736",
            "telephone_number": "307-632-7677",
            "fax_number": "307-778-8292"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SMART SPORTS MEDICINE CLINIC PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-04",
        "last_updated": "2026-04-15",
        "certification_date": "2026-04-15",
        "status": "A",
        "authorized_official_last_name": "ROSS",
        "authorized_official_first_name": "VINCENT",
        "authorized_official_middle_name": "JOHN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "307-632-7677"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2081S0010X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation, Sports Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2251S0007X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist, Sports",
            "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 Apr 15, 2026; 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.