NPIMap

Organization Active NPI

Southwest Wyoming Rehabilitation Center

  • Case Management Agency
  • Rock Springs, WY
National Provider Identifier
1801125430
Registry record updated Dec 10, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Management AgencyTaxonomy code 251B00000X
Legal business name
SOUTHWEST WYOMING REHABILITATION CENTER
Practice address
4509 Foothill Blvd
Rock Springs, WY 82901-4367
Phone
(307) 382-3842
Fax
(307) 362-4615
NPI assigned
Dec 10, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 10, 2009

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

Authorized official

Name
Mr. Jackson Bruce Waters, BSN, RN, CLNC
Title
Ceo
Phone
(307) 382-3842

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Agency 251B00000X Primary

Addresses

Primary practice location

4509 Foothill Blvd
Rock Springs, WY 82901-4367

Mailing address

PO Box 519
Rock Springs, WY 82902-0519
Phone (307) 382-3842

Other names 1

  • SWRC Other name

National Provider Directory

National Provider Directory
Tax ID family
Southwest Wyoming Rehabilitation Center3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1260403200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1260403200000",
    "number": "1801125430",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 519",
            "city": "ROCK SPRINGS",
            "state": "WY",
            "postal_code": "829020519",
            "telephone_number": "307-382-3842",
            "fax_number": "307-362-4615"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4509 FOOTHILL BLVD",
            "city": "ROCK SPRINGS",
            "state": "WY",
            "postal_code": "829014367",
            "telephone_number": "307-382-3842",
            "fax_number": "307-362-4615"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHWEST WYOMING REHABILITATION CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-12-10",
        "last_updated": "2009-12-10",
        "status": "A",
        "authorized_official_last_name": "WATERS",
        "authorized_official_first_name": "JACKSON",
        "authorized_official_middle_name": "BRUCE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "307-382-3842",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "BSN, RN, CLNC"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SWRC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Rock Springs, WY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2009; 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.