Dane St. John, M.D.

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

9197A Issued in WY

Practice address

707 Sheridan Ave
Cody, WY 82414

Phone

(307) 578-2500

Fax

(307) 578-2492

NPI assigned

May 21, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in LA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Louisiana State University School of Medicine in New Orleans Faculty G

  dba LSU Healthcare Network

  • Multi-Specialty Clinic/Center
  • New Orleans, LA
  • NPI 1477582526
  Medicare reassignment NPD
• Louisiana State University School of Medicine in New Orleans Faculty G

  dba Lsu Healthcare Network

  • Durable Medical Equipment & Medical Supplies
  • Kenner, LA
  • NPI 1316417629
  NPD
• Louisiana State University School of Medicine in New Orleans Faculty G

  dba LSU Healthcare Network

  • Dentist
  • New Orleans, LA
  • NPI 1740534064
  NPD

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

{
    "created_epoch": "1179705600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1365724800000",
    "number": "1689883589",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "707 SHERIDAN AVE",
            "city": "CODY",
            "state": "WY",
            "postal_code": "82414",
            "telephone_number": "307-578-2500",
            "fax_number": "307-578-2492"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "707 SHERIDAN AVE",
            "city": "CODY",
            "state": "WY",
            "postal_code": "82414",
            "telephone_number": "307-578-2500",
            "fax_number": "307-578-2492"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ST. JOHN",
        "first_name": "DANE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-21",
        "last_updated": "2013-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "AL",
            "license": "27461",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "WY",
            "license": "9197A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Debra Raye Spence
• Joshua B. Spinney, LPC
• Spirit Mountain Hospice
• Jocelyn Marie Sporer
• Adam M Sproat, PA-C
• St. Vincent Healthcare (Cody Radiation Oncology)
• St. Vincent Healthcare (St. Vincent Physician Network Cody Medical Oncology)
• Kyle Starostka, PHARM D
• R Scott Staudt
• Tara Stebleton

• Oral and Maxillofacial Surgery (Dentist) in Cody, WY
• Providers in Cody, WY by specialty
• Oral and Maxillofacial Surgery (Dentist) in Wyoming

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.