TETON OUTPATIENT SERVICES LLC (NPI# 1689651481) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1689651481 |
Entity Type | Organization |
Organization Name | TETON OUTPATIENT SERVICES LLC |
Practice Address |
150 Buffalo Way Jackson WY 83001-2530 |
Mailing Address |
150 Buffalo Way Po Box 12530 Jackson WY 83001-2530 |
Practice Telephone | 3077338677 |
Practice Fax Number | 3077347365 |
Mailing Telephone | 3077338677 |
Mailing Fax Number | 3077347365 |
Enumeration Date | 2005-12-22 |
Last Update Date | 2020-06-24 |
Authorized Official Name | ERIC BOON (OFFICER/AUTHORIZED OFFICIAL) |
Authorized Official Telephone | 4805670269 |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 261QA1903X |
Clinic/Center Specialization: Ambulatory Surgical |
0713016 | WY | Ambulatory Health Care Facilities |
State | Issuer | Identifier | Type Code |
---|---|---|---|
WY | 113599600 | 05 | |
WY | RAILROAD MEDICARE | 490004244 | 01 |
Street Address |
150 BUFFALO WAY |
City | JACKSON |
State | WY |
Zip Code | 83001-2530 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1528417938 | Grand Teton Anesthesia, LLC | Anesthesiology | 150 Buffalo Way, Jackson, WY 83001 | 2016-06-07 |
1477916856 | Uap of Wyoming, Inc. | Anesthesiology | 150 Buffalo Way, Jackson, WY 83001 | 2016-04-01 |
1477974608 | Richard Gomez Md PC | Anesthesiology | 150 Buffalo Way, Jackson, WY 83002-2530 | 2013-12-13 |
1952420853 | Chris Schroeder | Specialist/Technologist, Other | 150 Buffalo Way, Jackson, WY 83002 | 2007-03-29 |
1942364567 | Jackson Hole Anesthesia Services | Nurse Anesthetist, Certified Registered | 150 Buffalo Way, Jackson, WY 83002 | 2006-12-20 |
1871657486 | Molly Breslin | Nurse Anesthetist, Certified Registered | 150 Buffalo Way, Jackson, WY 83002 | 2006-12-20 |
1578627246 | Glacier Anesthesia Services | Anesthesiology | 150 Buffalo Way, Jackson, WY 83002 | 2006-12-20 |
1598829228 | Philip C Blum | Anesthesiology | 150 Buffalo Way, Jackson, WY 83002 | 2006-12-20 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1861006108 | Anne Kathleen Milburn | Physical Therapist | 3620 S Park Drive, Jackson, WY 83001 | 2020-09-03 |
1568009637 | Katherine Pringle Ford | Case Manager/Care Coordinator | 2065 E. Limber Pine Road, Jackson, WY 83001 | 2019-12-07 |
1043878408 | Cossette Burnham | Physical Therapist | Four Pines Physical Therapy, 1090 S Hwy 89, Jackson, WY 83001 | 2019-05-31 |
1982169371 | Cynthia Buck Huyffer | Social Worker | 755a Cache Creek Drive, Jackson, WY 83001 | 2019-02-10 |
1093281594 | Lara Cilo | Speech-Language Pathologist | 1300 W. Valley Springs Road, Jackson, WY 83001 | 2018-10-23 |
1740776202 | Teton Oral and Maxillofacial Surgery | Dentist | 1160 Alpine Ln Ste 1d, Jackson, WY 83001 | 2018-07-09 |
1437642055 | Anna Yanchek | Physical Therapist | 1090 Us- 89, Jackson Hole, WY 83001 | 2018-06-08 |
1891200762 | Tyler Ross Wright | Chiropractor | 1325 Us-89, Suite 108, Jackson, WY 83001 | 2017-12-13 |
1073027280 | Root To Rise Counseling and Consulting, Pllc | Social Worker | 2033 Dandelion Court, Jackson, WY 83001 | 2017-11-27 |
1962923912 | Piper Worthington | Social Worker | 1910 High School Rd, Jackson, WY 83001 | 2017-06-29 |
Find all providers in zip 83001 |
Taxonomy Code | 261QA1903X |
Grouping | Ambulatory Health Care Facilities |
Classification | Clinic/Center |
Specialization | Ambulatory Surgical |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1821336371 | Eyecare Surgery Center, LLC | Clinic/Center | 1501 Lakeland Dr Ste 101, Jackson, MS 39216-4839 | 2013-01-17 |
1265618904 | Jackson Gastroenterology Center, LLC | Clinic/Center | 4400 Ann Arbor Road, Jackson, MI 49202 | 2008-01-11 |
1912099805 | Sapheneia Medical Minimally Invasive Therapy Institute | Clinic/Center | 932 N State St, Jackson, MS 39202-2613 | 2006-09-28 |
1588764989 | W. A. Foote Memorial Hospital, Inc. | Clinic/Center | 1125 E Michigan Ave, Jackson, MI 49201-1801 | 2006-09-25 |
1225096498 | Amador Surgery Center | Clinic/Center | 223 Clinton Road, Suite 204, Jackson, CA 95642-2680 | 2006-05-03 |
1558327213 | Surgicare of Jackson Ltd | Clinic/Center | 760 Lakeland Dr, Jackson, MS 39216-4610 | 2006-04-21 |
1588631832 | Surgical Services of Michigan, LLC | Clinic/Center | 2775 Blake Road, Jackson, MI 49201-8838 | 2006-03-07 |
1255303517 | St Dominic Ambulatory Surgery Center L L C | Clinic/Center | 970 Lakeland Dr, Suite 15, Jackson, MS 39216-4601 | 2006-02-02 |
1710591060 | Midsouth Interventional Pain Institute LLC | Clinic/Center | 2016 Greystone Sq, Jackson, TN 38305-3575 | 2020-09-03 |
1386149979 | W. A. Foote Memorial Hospital, Inc | Clinic/Center | 205 S East Ave, Jackson, MI 49201-2413 | 2018-03-27 |
Find all providers in JACKSON |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.