NPIMap

Organization Active NPI

Sage Medical Group LLC

  • Clinic/Center
  • Casper, WY
National Provider Identifier
1700854346
Registry record updated Oct 11, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
SAGE MEDICAL GROUP LLC
Practice address
419 S Washington St
Ste 200
Casper, WY 82601
Phone
(307) 265-8300
Fax
(307) 265-8313
NPI assigned
Mar 9, 2006
Organization subpart
No

Practitioners 12

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

National Provider Directory

National Provider Directory

NPPES NPI Registry

Updated by the provider on Oct 11, 2007

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

Authorized official

Name
Sara Cooper
Title
Administrative Services Manager
Phone
(307) 265-8300

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X Primary

Addresses

Primary practice location

419 S Washington St
Ste 200
Casper, WY 82601

Mailing address

PO Box 50750
Casper, WY 82605
Phone (307) 265-8300

Other identifiers 1

IdentifierTypeStateIssuer
1221190600MedicaidWY

NPI Registry JSON

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

{
    "created_epoch": "1141862400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1192060800000",
    "number": "1700854346",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 50750",
            "city": "CASPER",
            "state": "WY",
            "postal_code": "82605",
            "telephone_number": "307-265-8300",
            "fax_number": "307-265-8313"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "419 S WASHINGTON ST",
            "address_2": "STE 200",
            "city": "CASPER",
            "state": "WY",
            "postal_code": "82601",
            "telephone_number": "307-265-8300",
            "fax_number": "307-265-8313"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAGE MEDICAL GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-09",
        "last_updated": "2007-10-11",
        "status": "A",
        "authorized_official_last_name": "COOPER",
        "authorized_official_first_name": "SARA",
        "authorized_official_title_or_position": "ADMINISTRATIVE SERVICES MANAGER",
        "authorized_official_telephone_number": "307-265-8300"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1221190600",
            "state": "WY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Casper, WY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2007; 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.