Black Rock Surgery Center LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

BLACK ROCK SURGERY CENTER LLC

Practice address

2901 Powder Basin Ave
Gillette, WY 82718-6406

Phone

(307) 682-6222

Fax

(307) 682-6999

NPI assigned

May 24, 2019

Organization subpart

No

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

Authorized official

Name

Mr. Mark G Murphy

Title

Owner

Phone

(307) 358-6200

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1558656000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1558656000000",
    "number": "1669039640",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 688",
            "city": "DOUGLAS",
            "state": "WY",
            "postal_code": "826330688",
            "telephone_number": "307-358-6200",
            "fax_number": "307-358-3748"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2901 POWDER BASIN AVE",
            "city": "GILLETTE",
            "state": "WY",
            "postal_code": "827186406",
            "telephone_number": "307-682-6222",
            "fax_number": "307-682-6999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLACK ROCK SURGERY CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-05-24",
        "last_updated": "2019-05-24",
        "status": "A",
        "authorized_official_last_name": "MURPHY",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "307-358-6200",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Black Hills Orthopedic & Spine Center of Wyoming PC
• Black Hills Orthopedic & Spine Center of Wyoming PC
• Black Hills Regional Eye Institute, LLP
• Black Hills Surgical Hospital, LLC
• Black Rock Advanced Medical Imaging
• Ryan Duane Black, D.O.
• Katelynn Donna Blakeman
• BNC Dougal Anesthesia PLLC
• Lyndi Marie Boe, FNP-C
• Timothy Dean Bohlender, M.D.

• All providers in Gillette, WY
• Ambulatory Surgical Clinic/Center in Wyoming

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2019; 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.