Active NPI
Jackson Hole Surgery
- Surgery Physician
- Jackson, WY
National Provider Identifier
1437321650
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- 6475A
- Legal business name
- JACKSON HOLE SURGERY
- Practice address
- 555 E. Broadway
Suite 212
Jackson, WY 83001 - Phone
- (307) 734-1600
- Fax
- (307) 733-7679
- NPI assigned
- Mar 27, 2008
- Last updated
- Mar 27, 2008
- 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
- James M. Balliro, M.D.
- Title
- Owner
- Phone
- (307) 734-1600
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | 6475A | WY | Primary |
Addresses
Primary practice location
555 E. Broadway
Suite 212
Jackson, WY 83001
Mailing address
PO Box 12976
Jackson, WY 83002-2976
Phone (307) 734-1600
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1206576000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1206576000000",
"number": "1437321650",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 12976",
"city": "JACKSON",
"state": "WY",
"postal_code": "830022976",
"telephone_number": "307-734-1600",
"fax_number": "307-733-7679"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "555 E. BROADWAY",
"address_2": "SUITE 212",
"city": "JACKSON",
"state": "WY",
"postal_code": "83001",
"telephone_number": "307-734-1600",
"fax_number": "307-733-7679"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "JACKSON HOLE SURGERY",
"organizational_subpart": "NO",
"enumeration_date": "2008-03-27",
"last_updated": "2008-03-27",
"status": "A",
"authorized_official_last_name": "BALLIRO",
"authorized_official_first_name": "JAMES",
"authorized_official_middle_name": "M.",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "307-734-1600",
"authorized_official_credential": "M.D."
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "WY",
"license": "6475A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jackson, WY
- Jackson Hole Medical Imaging, PC (JH Medical Imaging PC)
- Jackson Hole Mental Health LLC
- Jackson Hole OBGYN PC
- Jackson Hole Physical Therapy, PC
- Jackson Hole Sports Recovery LLC
- Jackson Pediatric Associates, LLC (Jackson Pediatrics)
- Jackson Pediatrics P.C.
- Jackson Whole Family Health, Inc.
- William Jackson, RPH
- James L. Derrico DDS LLC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.