Active NPI
Outpatient Radiology LLC
- Diagnostic Radiology Physician
- Casper, WY
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Diagnostic Radiology Physician
- Legal business name
- OUTPATIENT RADIOLOGY LLC
- Practice address
- 419 South Washington Street
Suite 101
Casper, WY 82601 - Phone
- (307) 234-6963
- Fax
- (307) 237-1074
- NPI assigned
- Mar 20, 2006
- Last updated
- Jun 17, 2024
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Jeffrey Rhea, M.D.
- Title
- President
- Phone
- (307) 265-1620
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Diagnostic Radiology Physician | 2085R0202X | Primary |
Addresses
Primary practice location
419 South Washington Street
Suite 101
Casper, WY 82601
Mailing address
419 South Washington Street
Suite 101
Casper, WY 82601
Phone (307) 234-6963
Other practice location 1
820 W 42nd St Ste 1500
Scottsbluff, NE 69361-5017
Phone (307) 265-1620
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 116358200 | Medicaid | WY | |
| 10025260001 | Medicaid | NE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WY, NE, TX
Enrollment records 3
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 28D2305940 | Outpatient Radiology Scottsbluff | Certificate of waiver | Jun 9, 2028 |
| 53D2281744 | Outpatient Radiology LLC | Certificate of waiver | May 10, 2027 |
National Provider Directory
National Provider DirectoryMember of 1
Organizations this organization is a member of, according to the National Provider Directory.
Locations
820 W 42nd St
Ste 150
Scottsbluff, NE 69361
419 S Washington St
Ste 100
Casper, WY 82601
419 S Washington St
Ste 101
Casper, WY 82601
Phone (307) 232-5037
6600 E 2nd St
Ste E
Casper, WY 82609
Phone (307) 232-5012
Practitioners & affiliated clinicians
Practitioners 18
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.
-
- Vascular & Interventional Radiology Physician
- Casper, WY
- NPI 1942513288
Diagnostic Radiology, NE
-
- Diagnostic Radiology Physician
- Cody, WY
- NPI 1417926528
-
- Vascular & Interventional Radiology Physician
- Casper, WY
- NPI 1477082592
Diagnostic Radiology, NE
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1142812800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1718582400000",
"number": "1396704474",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "419 SOUTH WASHINGTON STREET",
"address_2": "SUITE 101",
"city": "CASPER",
"state": "WY",
"postal_code": "82601",
"telephone_number": "307-234-6963",
"fax_number": "307-237-1074"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "419 SOUTH WASHINGTON STREET",
"address_2": "SUITE 101",
"city": "CASPER",
"state": "WY",
"postal_code": "82601",
"telephone_number": "307-234-6963",
"fax_number": "307-237-1074"
}
],
"practiceLocations": [
{
"address_1": "820 W 42nd St Ste 1500",
"address_purpose": "LOCATION",
"city": "Scottsbluff",
"state": "NE",
"postal_code": "693615017",
"country_code": "US",
"telephone_number": "307-265-1620",
"fax_number": "307-237-1074",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"organization_name": "OUTPATIENT RADIOLOGY LLC",
"organizational_subpart": "NO",
"enumeration_date": "2006-03-20",
"last_updated": "2024-06-17",
"certification_date": "2024-06-17",
"status": "A",
"authorized_official_last_name": "RHEA",
"authorized_official_first_name": "JEFFREY",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "307-265-1620",
"authorized_official_credential": "M.D."
},
"taxonomies": [
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "116358200",
"state": "WY"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "10025260001",
"state": "NE"
}
],
"endpoints": [],
"other_names": []
}Other providers in Casper, WY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.