Active NPI
Michael Sutphin, M.D.
- Urology Physician
- Rock Springs, WY
National Provider Identifier
1871693838
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Urology Physician
- License
- 3547A
- Practice address
- 1180 College Drive
Rock Springs, WY 82901 - Phone
- (307) 362-4200
- Fax
- (307) 362-5406
- NPI assigned
- Sep 22, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Urology Physician | 208800000X | 3547A | WY | Primary |
| Urology Physician | 208800000X | 166834-1205 | UT | |
| Urology Physician | 208800000X | G42452 | CA |
Addresses
Primary practice location
1180 College Drive
Rock Springs, WY 82901
Mailing address
1180 College Drive
Rock Springs, WY 82901
Phone (307) 362-4200
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 104849000 | Medicaid | WY | |
| 2266 | Other | WY | BCBS-WY |
| 340001047 | Other | WY | UPREHA |
| 1312335 | Other | WY | UMWA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| G42452 | CA | MD | Urology Physician |
| 166834-1205 | UT | MD | Urology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ihc Health Services, Inc. | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
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NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158883200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1416355200000",
"number": "1871693838",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1180 COLLEGE DRIVE",
"city": "ROCK SPRINGS",
"state": "WY",
"postal_code": "82901",
"telephone_number": "307-362-4200",
"fax_number": "307-362-5406"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1180 COLLEGE DRIVE",
"city": "ROCK SPRINGS",
"state": "WY",
"postal_code": "82901",
"telephone_number": "307-362-4200",
"fax_number": "307-362-5406"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SUTPHIN",
"first_name": "MICHAEL",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-09-22",
"last_updated": "2014-11-19",
"status": "A"
},
"taxonomies": [
{
"code": "208800000X",
"taxonomy_group": "",
"desc": "Urology",
"state": "WY",
"license": "3547A",
"primary": true
},
{
"code": "208800000X",
"taxonomy_group": "",
"desc": "Urology",
"state": "UT",
"license": "166834-1205",
"primary": false
},
{
"code": "208800000X",
"taxonomy_group": "",
"desc": "Urology",
"state": "CA",
"license": "G42452",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "104849000",
"state": "WY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS-WY",
"identifier": "2266",
"state": "WY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UPREHA",
"identifier": "340001047",
"state": "WY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UMWA",
"identifier": "1312335",
"state": "WY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Rock Springs, WY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.