NPIMap

Organization Active NPI

Rocky Mountain Sports Medicine and Rehabilitation LLC

  • Physical Therapist
  • Rock Springs, WY
National Provider Identifier
1508979535
Registry record updated Jul 6, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
ROCKY MOUNTAIN SPORTS MEDICINE AND REHABILITATION LLC
Practice address
1401 Gateway Blvd Ste 2
Rock Springs, WY 82901-6786
Phone
(307) 352-3626
Fax
(307) 352-3628
NPI assigned
Aug 16, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 6, 2011

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

Authorized official

Name
Mrs. Jaelyn Ann Knudson
Title
Office Administrator
Phone
(307) 352-3626

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X Primary
Occupational TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225X00000X

Addresses

Primary practice location

1401 Gateway Blvd Ste 2
Rock Springs, WY 82901-6786

Mailing address

1401 Gateway Blvd Unit 2
Rock Springs, WY 82901-6727
Phone (307) 352-3626

Other identifiers 1

IdentifierTypeStateIssuer
118547100MedicaidWY

National Provider Directory

National Provider Directory

Locations

418 Broadway St
Rock Springs, WY 82901
Phone (307) 352-3626

Practitioners & affiliated clinicians

Practitioners 7

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": "1155686400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1309910400000",
    "number": "1508979535",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1401 GATEWAY BLVD UNIT 2",
            "city": "ROCK SPRINGS",
            "state": "WY",
            "postal_code": "829016727",
            "telephone_number": "307-352-3626",
            "fax_number": "307-352-3628"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 GATEWAY BLVD STE 2",
            "city": "ROCK SPRINGS",
            "state": "WY",
            "postal_code": "829016786",
            "telephone_number": "307-352-3626",
            "fax_number": "307-352-3628"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROCKY MOUNTAIN SPORTS MEDICINE AND REHABILITATION LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-16",
        "last_updated": "2011-07-06",
        "status": "A",
        "authorized_official_last_name": "KNUDSON",
        "authorized_official_first_name": "JAELYN",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "OFFICE ADMINISTRATOR",
        "authorized_official_telephone_number": "307-352-3626",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "118547100",
            "state": "WY"
        }
    ],
    "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 Jul 6, 2011; 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.