Sweetwater Urology

Primary specialty

Urology PhysicianTaxonomy code 208800000X

License

3547A Issued in WY

Legal business name

SWEETWATER UROLOGY

Practice address

1208 Hilltop Dr
Suite 204
Rock Springs, WY 82901-5859

Phone

(307) 362-4200

Fax

(307) 362-5406

NPI assigned

Sep 9, 2010

Organization subpart

No

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

Authorized official

Name

Dr. Michael Sutphin, MD

Title

Owner

Phone

(307) 362-4200

Specialties & licenses 4

Addresses

Other identifiers 3

Locations

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

{
    "created_epoch": "1283990400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1283990400000",
    "number": "1629385786",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1208 HILLTOP DR",
            "address_2": "SUITE 204",
            "city": "ROCK SPRINGS",
            "state": "WY",
            "postal_code": "829015859",
            "telephone_number": "307-362-4200",
            "fax_number": "307-362-5406"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1208 HILLTOP DR",
            "address_2": "SUITE 204",
            "city": "ROCK SPRINGS",
            "state": "WY",
            "postal_code": "829015859",
            "telephone_number": "307-362-4200",
            "fax_number": "307-362-5406"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SWEETWATER UROLOGY",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-09-09",
        "last_updated": "2010-09-09",
        "status": "A",
        "authorized_official_last_name": "SUTPHIN",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "307-362-4200",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Urology",
            "state": "WY",
            "license": "3547A",
            "primary": true
        },
        {
            "code": "208800000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Urology",
            "state": "UT",
            "license": "166834-1025",
            "primary": false
        },
        {
            "code": "208800000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Urology",
            "state": "CA",
            "license": "G42452",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": "WY",
            "license": "WY192",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "104849000",
            "state": "WY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "340001047",
            "state": "WY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS OF WYOMING",
            "identifier": "2266",
            "state": "WY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Urology Physician in Rock Springs, WY
• Providers in Rock Springs, WY by specialty
• Urology Physician in Wyoming

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2010; 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.