Individual provider Active NPI

Jason Lee Sondgeroth

  • Family Nurse Practitioner
  • Laramie, WY
National Provider Identifier
1639698608
Registry record updated Sep 11, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
34334.1654 Issued in WY
Practice address
255 N 30TH St
Laramie, WY 82072-5140
Phone
(307) 742-2141
NPI assigned
Sep 11, 2017
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 11, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 34334.1654 WY Primary

Addresses

Primary practice location

255 N 30TH St
Laramie, WY 82072-5140

Mailing address

5418 Summit Dr
Laramie, WY 82070-5737

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171114002838 WY Practitioner - Nurse Practitioner 9931465572 Reassigns benefits to 4 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Summit Medical Group, LLC CurrentSince May 1, 2020 Accepting new patients
Ivinson Memorial Hospital CurrentSince Jan 1, 2018 Accepting new patients
Ivinson Memorial Hospital CurrentSince Jan 1, 2018 Accepting new patients
Laramie Reproductive Health CurrentSince Apr 13, 2024 Accepting new patients

Locations

214 E 23rd St
Cheyenne, WY 82001
Phone (307) 324-2221

3116 Willett Dr
Laramie, WY 82072
Phone (307) 742-6319

255 N 30th St
Laramie, WY 82072
Phone (307) 742-2141

3236 E Grand Ave
Ste D
Laramie, WY 82070
Phone (307) 760-8602

605 Skyline Rd
Ste 201
Laramie, WY 82070
Phone (307) 745-5364

Organizations & group practices 5

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": "1505088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1505088000000",
    "number": "1639698608",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5418 SUMMIT DR",
            "city": "LARAMIE",
            "state": "WY",
            "postal_code": "820705737"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "255 N 30TH ST",
            "city": "LARAMIE",
            "state": "WY",
            "postal_code": "820725140",
            "telephone_number": "307-742-2141"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SONDGEROTH",
        "first_name": "JASON",
        "middle_name": "LEE",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-09-11",
        "last_updated": "2017-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WY",
            "license": "34334.1654",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Laramie, WY

Sources for this page

Verify at the official NPI Registry.