NPIMap

Organization Active NPI

Southwest Wyoming Rehabilitation Center

  • Developmentally Disabled Services Day Training Agency
  • Rock Springs, WY
National Provider Identifier
1558699835
Registry record updated Nov 25, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Developmentally Disabled Services Day Training AgencyTaxonomy code 251C00000X
Legal business name
SOUTHWEST WYOMING REHABILITATION CENTER
Practice address
4509 Foothill Blvd
Rock Springs, WY 82901-4367
Phone
(307) 371-1241
Fax
(307) 362-4615
NPI assigned
Nov 25, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 25, 2009

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

Authorized official

Name
Mr. Jackson Bruce Waters, RN
Title
Chief Executive Officer
Phone
(307) 371-1241

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Developmentally Disabled Services Day Training Agency 251C00000X Primary

Addresses

Primary practice location

4509 Foothill Blvd
Rock Springs, WY 82901-4367

Mailing address

PO Box 519
Rock Springs, WY 82902-0519
Phone (307) 371-1241

Other names 1

  • SWRC Other name

National Provider Directory

National Provider Directory
Tax ID family
Southwest Wyoming Rehabilitation Center3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1259107200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1259107200000",
    "number": "1558699835",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 519",
            "city": "ROCK SPRINGS",
            "state": "WY",
            "postal_code": "829020519",
            "telephone_number": "307-371-1241",
            "fax_number": "307-362-4615"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4509 FOOTHILL BLVD",
            "city": "ROCK SPRINGS",
            "state": "WY",
            "postal_code": "829014367",
            "telephone_number": "307-371-1241",
            "fax_number": "307-362-4615"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHWEST WYOMING REHABILITATION CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-11-25",
        "last_updated": "2009-11-25",
        "status": "A",
        "authorized_official_last_name": "WATERS",
        "authorized_official_first_name": "JACKSON",
        "authorized_official_middle_name": "BRUCE",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "307-371-1241",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SWRC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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 Nov 25, 2009; 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.