Jacob V Johnson, DO
Individual provider Active NPI Family Medicine Physician · Rock Springs, WY
NPI 1851673008 · NPPES record last updated Jan 22, 2020
Key facts
- NPI
- 1851673008
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 9086A (WY)
- Practice address
- 3000 College Dr
Rock Springs, WY 82901-4202 - Phone
- (307) 212-7708
- Fax
- (307) 352-8148
- NPI assigned
- Sep 14, 2011
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Hospital & facility affiliations 5
Medicare Care Compare profile
- Specialty
- Osteopathic Manipulative Medicine
- Education
- Other, 2013
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Memorial Hospital of Sweetwater County
Practice addresses (Care Compare)
1180 College Dr
Rock Springs, WY 82901-5863
Phone (307) 352-8125
Hospital & facility affiliations
- Rocky Mountain Home Care-Green River
- Symbii Home Health
- Cowboy Cares Home Health
- Hospice of Sweetwater County
- Memorial Hospital Sweetwater County
Merit-based Incentive Payment System (MIPS)
- Final score
- 81.04 of 100
- Quality
- 64.43
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 72.37
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Melanoma (skin cancer) excision | 1-10 |
| Skin biopsy | 1-10 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WY
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20130725000372 | WY | Practitioner - Osteopathic Manipulative Medicine |
0446491914 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Osteopathy
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Memorial Hospital of Sweetwater County | Current |
Accepting new patients | |
| Memorial Hospital of Sweetwater County | Current |
Accepting new patients |
Locations
3000 College Dr
Rock Springs, WY 82901
Phone (307) 212-7708
1180 College Dr
Rock Springs, WY 82901
Phone (307) 352-8125
1200 College Dr
Rock Springs, WY 82901
Phone (307) 352-8352
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 9086A | WY | Yes |
Addresses
Primary practice location
3000 College Dr
Rock Springs, WY 82901-4202
Mailing address
PO Box 1359
Rock Springs, WY 82902-1359
Phone (307) 212-7708
Other providers in Rock Springs, WY
- Peter Merrill Jensen
- Melissa M Jewell
- John W. Aaron III, DPM
- Colton Johnson
- Frederick Johnson
- Jaime K Johnson
- Jill Ann Johnson
- Joel Johnson
- Kasia Marie Johnson
- Rhiannon Renee Johnson
All providers in Rock Springs, WY · Family Medicine Physician in Wyoming
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 22, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.