Individual provider Active NPI

Jason W Lloyd

  • Family Medicine Physician
  • Casper, WY
National Provider Identifier
1841298536
Registry record updated Dec 28, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
6674A Issued in WY
Practice address
1020 S. Conwell Street
Casper, WY 82601
Phone
(307) 265-8300
Fax
(307) 233-8230
NPI assigned
Jul 7, 2005
Last updated
Dec 28, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 28, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 6674A WY Primary

Addresses

Primary practice location

1020 S. Conwell Street
Casper, WY 82601

Mailing address

1020 S. Conwell Street
Casper, WY 82601
Phone (307) 265-8300

Other identifiers 1

IdentifierTypeStateIssuer
117384700MedicaidWY

Medicare participation

Medicare enrollment files
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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240410003828 WY Order and Referring Only - Family PracticePractitioner - Family Practice 4880502103

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
3663WYMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Sage Medical Group LLC Past Accepting new patients
Sage Medical Group LLC Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1120694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1356652800000",
    "number": "1841298536",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1020 S. CONWELL STREET",
            "city": "CASPER",
            "state": "WY",
            "postal_code": "82601",
            "telephone_number": "307-265-8300",
            "fax_number": "307-233-8230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1020 S. CONWELL STREET",
            "city": "CASPER",
            "state": "WY",
            "postal_code": "82601",
            "telephone_number": "307-265-8300",
            "fax_number": "307-233-8230"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LLOYD",
        "first_name": "JASON",
        "middle_name": "W",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-07",
        "last_updated": "2012-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WY",
            "license": "6674A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "117384700",
            "state": "WY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Casper, WY

Sources for this page

Verify at the official NPI Registry.