NPIMap

Organization Active NPI

Western Wyoming Pathology, Inc

  • Clinical Medical Laboratory
  • Jackson, WY
National Provider Identifier
1578633988
Registry record updated Mar 9, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
License
6461A Issued in WY
Legal business name
WESTERN WYOMING PATHOLOGY, INC
Practice address
625 E Broadway
Jackson, WY 83001
Phone
(307) 733-6418
NPI assigned
Nov 9, 2006
Last updated
Mar 9, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 9, 2011

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

Authorized official

Name
A Franci Tryka
Title
MD
Phone
(307) 733-6418

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X 6461A WY Primary

Addresses

Primary practice location

625 E Broadway
Jackson, WY 83001

Mailing address

PO Box 3789
Jackson, WY 83001-3789
Phone (307) 733-6418

Other identifiers 2

IdentifierTypeStateIssuer
115921600MedicaidWY
805888600MedicaidID

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 10

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.

NPI Registry JSON

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

{
    "created_epoch": "1163030400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1299628800000",
    "number": "1578633988",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3789",
            "city": "JACKSON",
            "state": "WY",
            "postal_code": "830013789",
            "telephone_number": "307-733-6418"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "625 E BROADWAY",
            "city": "JACKSON",
            "state": "WY",
            "postal_code": "83001",
            "telephone_number": "307-733-6418"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WESTERN WYOMING PATHOLOGY, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-09",
        "last_updated": "2011-03-09",
        "status": "A",
        "authorized_official_last_name": "TRYKA",
        "authorized_official_first_name": "A FRANCI",
        "authorized_official_title_or_position": "MD",
        "authorized_official_telephone_number": "307-733-6418"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "WY",
            "license": "6461A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "115921600",
            "state": "WY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "805888600",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, WY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 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.