NPIMap

Individual provider Active NPI

Joseph Rollin McColley, DDS

  • Dentist
  • Sheridan, WY
National Provider Identifier
1487938858
Registry record updated Dec 31, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
1281 Issued in WY
Practice address
642 Val Vista St
Stuite #a
Sheridan, WY 82801-3659
Phone
(307) 746-5372
Fax
(307) 674-1765
NPI assigned
Oct 4, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 31, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 1281 WY Primary

Addresses

Primary practice location

642 Val Vista St
Stuite #a
Sheridan, WY 82801-3659

Mailing address

642 Val Vista St
Stuite #a
Sheridan, WY 82801-3659
Phone (307) 746-5372

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
1281WYMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Creekside Dental LLC Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1317686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1419984000000",
    "number": "1487938858",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "642 VAL VISTA ST",
            "address_2": "STUITE #A",
            "city": "SHERIDAN",
            "state": "WY",
            "postal_code": "828013659",
            "telephone_number": "307-746-5372",
            "fax_number": "307-674-1765"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "642 VAL VISTA ST",
            "address_2": "STUITE #A",
            "city": "SHERIDAN",
            "state": "WY",
            "postal_code": "828013659",
            "telephone_number": "307-746-5372",
            "fax_number": "307-674-1765"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCOLLEY",
        "first_name": "JOSEPH",
        "middle_name": "ROLLIN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-10-04",
        "last_updated": "2014-12-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WY",
            "license": "1281",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sheridan, WY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.