Eric G Roman, NP

Primary specialty

Psychiatric/Mental Health Clinical Nurse SpecialistTaxonomy code 364SP0808X

License

25318.1148 Issued in WY

Practice address

831 Highway 150 S
Evanston, WY 82930-5340

Phone

(307) 789-3464

Fax

(307) 789-7373

NPI assigned

Jan 19, 2012

Last updated

Mar 13, 2013By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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.

• State of Wyoming

  dba Wyoming State Hospital

  • Psychiatric Hospital
  • Evanston, WY
  • NPI 1316011562
  Medicare reassignment

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

{
    "created_epoch": "1326931200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1363132800000",
    "number": "1700157948",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "831 HIGHWAY 150 S",
            "address_2": "P.O. BOX 177",
            "city": "EVANSTON",
            "state": "WY",
            "postal_code": "829305340",
            "telephone_number": "307-789-3464",
            "fax_number": "307-789-7373"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "831 HIGHWAY 150 S",
            "city": "EVANSTON",
            "state": "WY",
            "postal_code": "829305340",
            "telephone_number": "307-789-3464",
            "fax_number": "307-789-7373"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROMAN",
        "first_name": "ERIC",
        "middle_name": "G",
        "name_prefix": "Mr.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-01-19",
        "last_updated": "2013-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364SP0808X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Psychiatric/Mental Health",
            "state": "WY",
            "license": "25318.1148",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "25318.1148",
            "state": "WY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Katrina Roberts
• Patricia Ann Roberts, LCSW
• Auburn Amanda Robertson, LMFT
• Michelle A Robertson, M.A.
• Shontay Marie Roe, LCSW
• Pennie Roussin
• David Ray Russell, O.D.
• Linda Gail Sandness, BA. NCACII LAT LAT-1
• Roger Nelson Scarborough, MS
• Nathan C Schafer, M.D.

• Psychiatric/Mental Health Clinical Nurse Specialist in Evanston, WY
• Providers in Evanston, WY by specialty
• Psychiatric/Mental Health Clinical Nurse Specialist in Wyoming

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 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.