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SPORTS AND REHABILITATION CENTER OF WYOMING LLC
NPI 1063009272
Rehabilitation Practitioner in Jackson, WY

Active since December 22, 2020
625 E BROADWAY AVE, JACKSON, WY 83001(307) 920-1688 Get Directions Write a Review

NPPES record last updated: May 23, 2021. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: May 23, 2021, Dec 22, 2020 (2 updates tracked since 2020).

About Sports And Rehabilitation Center Of Wyoming Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SPORTS AND REHABILITATION CENTER OF WYOMING LLC (NPI 1063009272) is a healthcare organization registered as a rehabilitation practitioner in Jackson, Wyoming and active in the NPI registry since December 2020. The organization lists Austin Hammesfahr, Manager, as its authorized official.

NPPES Registry Identity

NPI1063009272
Entity TypeOrganization
Primary Taxonomy225400000X
Legal Business NameSPORTS AND REHABILITATION CENTER OF WYOMING LLC
Location Address625 E BROADWAY AVEJackson, WY 83001-8642
Mailing Address522 N Sweetzer Ave Apt 5Los Angeles, CA 90048-2659 · (310) 307-9670
Phone(307) 920-1688
Organization SubpartNo
Authorized OfficialAustin HammesfahrManager · (310) 307-9670
Enumeration DateDecember 22, 2020
Last NPPES UpdateMay 23, 20212 updates tracked since enumeration
NPPES CertifiedMay 23, 2021
✔ NPI 1063009272 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyRehabilitation PractitionerRespiratory, Developmental, Rehabilitative and Restorative Service Providers
Taxonomy Code225400000X
Definition
A health care practitioner who trains or retrains individuals disabled by disease or injury to help them attain their maximum functional capacity.
625 E BROADWAY AVE, Jackson, WY 83001
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Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

SHAWN BRICE WRIGHT CRNA
Nurse Anesthetist, Certified Registered
625 E BROADWAY AVE
JACKSON, WY 83001
Teton County (307) 733-3636
MR. HENRY MICHAEL MCELROY CRNA
Nurse Anesthetist, Certified Registered
625 E BROADWAY AVE
JACKSON, WY 83001
Teton County (307) 739-7218
DR. EDWARD CALLAGHAN M.D.
Pathology (Anatomic Pathology & Clinical Pathology)
625 E BROADWAY AVE
JACKSON, WY 83001
Teton County (307) 733-6418
LEAH NYDAM IBCLC
Registered Nurse (Lactation Consultant)
625 E BROADWAY AVE
JACKSON, WY 83001
Teton County (307) 739-7572
DR. ADAM JOHNSON M.D.
Emergency Medicine
625 E BROADWAY AVE
JACKSON, WY 83001
Teton County (307) 739-7250
SCHROEDER SURGICAL ASSISTING LLC
Specialist/Technologist, Other
625 E BROADWAY AVE
JACKSON, WY 83001
Teton County (208) 525-2090
LISA LAURITZEN SMITH RDN
Dietitian, Registered
625 E BROADWAY AVE
JACKSON, WY 83001
Teton County (307) 739-7357
MEAGHAN MAKALA PAUL DPT
Physical Therapist
625 E BROADWAY AVE
JACKSON, WY 83001
Teton County (307) 733-3636

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Sports And Rehabilitation Center Of Wyoming LLC's NPI number?

The NPI number for Sports And Rehabilitation Center Of Wyoming LLC is 1063009272. It was assigned to this organization in the NPPES registry on December 22, 2020.

Where is Sports And Rehabilitation Center Of Wyoming LLC located?

Sports And Rehabilitation Center Of Wyoming LLC is located at 625 E Broadway Ave, Jackson, WY 83001. The listed phone number is (307) 920-1688.

What is Sports And Rehabilitation Center Of Wyoming LLC's specialty?

The primary specialty registered for this NPI is Rehabilitation Practitioner with taxonomy code 225400000X.

When was this NPI record last updated?

The NPPES record for Sports And Rehabilitation Center Of Wyoming LLC was last updated on May 23, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.