Jackson Hole OBGYN PC

Primary specialty

MidwifeTaxonomy code 176B00000X

Legal business name

JACKSON HOLE OBGYN PC

Practice address

555 E Broadway
Ste 201
Jackson, WY 83001

Phone

(307) 733-8537

NPI assigned

Nov 20, 2006

Organization subpart

No

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

Authorized official

Name

Roger Malcom Brecheen, MD FACOGNPI 1720039357

Title

Owner

Phone

(307) 733-8537

Specialties & licenses 2

Addresses

Practitioners 2

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

• Roger Malcom Brecheen, MD FACOG

  • Obstetrics & Gynecology Physician
  • Jackson, WY
  • NPI 1720039357
  NPD (past) Authorized official
• Maura J. Lofaro, MD, FACOG

  • Gynecology Physician
  • Jackson, WY
  • NPI 1669423273

  Obstetrics & Gynecology

  NPD (past)

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

{
    "created_epoch": "1163980800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757548800000",
    "number": "1841364882",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 15570",
            "city": "JACKSON",
            "state": "WY",
            "postal_code": "83002",
            "telephone_number": "307-733-8537",
            "fax_number": "307-733-0141"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "555 E BROADWAY",
            "address_2": "STE 201",
            "city": "JACKSON",
            "state": "WY",
            "postal_code": "83001",
            "telephone_number": "307-733-8537"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JACKSON HOLE OBGYN PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-20",
        "last_updated": "2025-09-11",
        "status": "A",
        "authorized_official_last_name": "BRECHEEN",
        "authorized_official_first_name": "ROGER",
        "authorized_official_middle_name": "MALCOM",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "307-733-8537",
        "authorized_official_credential": "MD FACOG"
    },
    "taxonomies": [
        {
            "code": "176B00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Midwife",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Jackson Hole Medical Imaging, PC (JH Medical Imaging PC)
• Jackson Hole Mental Health LLC
• Jackson Hole Physical Therapy, PC
• Jackson Hole Sports Recovery LLC
• Jackson Hole Surgery
• Jackson Pediatric Associates, LLC (Jackson Pediatrics)
• Jackson Pediatrics P.C.

• Midwife in Jackson, WY
• Providers in Jackson, WY by specialty
• Midwife in Wyoming

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; 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.