Hole Ortho LLC

Primary specialty

Orthopaedic Surgery PhysicianTaxonomy code 207X00000X

Legal business name

HOLE ORTHO LLC

Practice address

555 E Broadway Ave Ste 211
Jackson, WY 83001-8640

Phone

(307) 699-6801

Fax

(307) 733-6912

NPI assigned

Aug 4, 2023

Last updated

Apr 29, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Rebecca Ashley Sjostrom, MDNPI 1760654651

Title

Owner

Phone

(307) 699-6801

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WY2 enrollments

Enrollment records 2

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Rebecca Ashley Sjostrom, MD

  • Orthopaedic Surgery Physician
  • Jackson, WY
  • NPI 1760654651
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1691107200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1714348800000",
    "number": "1831871250",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "970 W BROADWAY STE E121",
            "city": "JACKSON",
            "state": "WY",
            "postal_code": "830016402",
            "telephone_number": "307-699-6801",
            "fax_number": "307-733-6912"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "555 E BROADWAY AVE STE 211",
            "city": "JACKSON",
            "state": "WY",
            "postal_code": "830018640",
            "telephone_number": "307-699-6801",
            "fax_number": "307-733-6912"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOLE ORTHO LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-08-04",
        "last_updated": "2024-04-29",
        "certification_date": "2024-04-29",
        "status": "A",
        "authorized_official_last_name": "SJOSTROM",
        "authorized_official_first_name": "REBECCA",
        "authorized_official_middle_name": "ASHLEY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "307-699-6801",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mark Lawrence Hibbard
• Riley Jared Hicks, D.D.S.
• Christopher Clayton Hills, D.O.
• Rose Margaret Hochheiser, PSYD
• Christine Holding, LMFT
• Catherine Holland, RD, CDE, LD
• Gale D Holtby, LPC
• Therese Hooft, DNP, MHS, PMHNP-BC
• Christine Houlton
• Mark Houser

• Orthopaedic Surgery Physician in Jackson, WY
• Providers in Jackson, WY by specialty
• Orthopaedic Surgery Physician in Wyoming

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.