Eagle Ridge Rehabilitative Services

Primary specialty

Case Management AgencyTaxonomy code 251B00000X

Legal business name

EAGLE RIDGE REHABILITATIVE SERVICES

Practice address

437 Shadow Ridge Blvd
Sheridan, WY 82801-9350

Phone

(307) 655-8253

NPI assigned

Dec 5, 2012

Last updated

Dec 5, 2012By 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

Mrs. Desree Lynn Smith

Title

Chief Executive Officer

Phone

(307) 751-7588

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1354665600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1354665600000",
    "number": "1841535663",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "437 SHADOW RIDGE BLVD",
            "city": "SHERIDAN",
            "state": "WY",
            "postal_code": "828019350",
            "telephone_number": "307-655-8253"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "437 SHADOW RIDGE BLVD",
            "city": "SHERIDAN",
            "state": "WY",
            "postal_code": "828019350",
            "telephone_number": "307-655-8253"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAGLE RIDGE REHABILITATIVE SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-12-05",
        "last_updated": "2012-12-05",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "DESREE",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "307-751-7588",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Case Management Agency in Sheridan, WY
• Providers in Sheridan, WY by specialty
• Case Management Agency in Wyoming

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2012; 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.