SNAKE RIVER PLASTIC SURGERY LLC
NPI 1104137074
Specialist in Jackson, WY

Q: What is Snake River Plastic Surgery LLC's NPI number?

The NPI number for Snake River Plastic Surgery LLC is 1104137074. It was assigned to this organization in the NPPES registry on June 25, 2010.

Q: What is Snake River Plastic Surgery LLC's specialty?

The primary specialty registered for this NPI is Specialist with taxonomy code 174400000X.

Active since June 25, 2010

555 E. BROADWAY, SUITE 212, JACKSON, WY 83001(307) 733-6077 Get Directions Write a Review

NPPES record last updated: June 25, 2010. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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About Snake River Plastic Surgery Llc NPPES

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

SNAKE RIVER PLASTIC SURGERY LLC (NPI 1104137074) is a healthcare organization registered as a specialist in Jackson, Wyoming and active in the NPI registry since June 2010. The organization lists Michael Barry Gellis, Member, as its authorized official.

NPPES Registry Identity

NPI1104137074

Entity TypeOrganization

Primary Taxonomy174400000X

Legal Business NameSNAKE RIVER PLASTIC SURGERY LLC

Location Address555 E. BROADWAY, SUITE 212Jackson, WY 83001

Mailing AddressPo Box 2862Jackson, WY 83001-2862 · (307) 733-6077

Phone(307) 733-6077

Organization SubpartNo

Authorized OfficialMichael Barry GellisMember · (307) 733-6077

Enumeration DateJune 25, 2010

✔ NPI 1104137074 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySpecialistOther Service Providers

Taxonomy Code174400000X

License✔ Licensed in WY · 2735A

Definition

An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

555 E. BROADWAY, Jackson, WY 83001

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Other Identifiers 1

Other1508997032WY · Npi Type 1

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES 8

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

DR. ROBERT D. LANGER M.D., M.P.H.

Preventive Medicine (Public Health & General Preventive Medicine)

555 E. BROADWAY, SUITE 108
JACKSON, WY 83001

Teton County (307) 733-4452

DOUBLE RAINBOW SCIENCES, LLC

Clinic/Center (Medical Specialty)

555 E. BROADWAY, SUITE 108
JACKSON, WY 83001

Teton County (307) 733-4452

BIOHEALTH INC

Clinic/Center (Health Service)

555 E. BROADWAY, STE 210
JACKSON, WY 83001

Teton County (307) 739-7532

HOLLY GAIL PAYNE D.O.

Pediatrics

555 E. BROADWAY, SUITE 211
JACKSON, WY 83001

Teton County (307) 733-8070

JACKSON HOLE SURGERY

Surgery

555 E. BROADWAY, SUITE 212
JACKSON, WY 83001

Teton County (307) 734-1600

DR. JOY LEWIS MD

Internal Medicine

555 E. BROADWAY, SUITE 216
JACKSON, WY 83001

Teton County (307) 739-7528

KARIN L KLEE MD

Pediatrics

555 E. BROADWAY, SUITE 216
JACKSON, WY 83001

Teton County (307) 734-0242

DR. WILLIAM JOHN RAMSAY III M.D.

Ophthalmology

555 E. BROADWAY, SUITE 214
JACKSON, WY 83001

Teton County (307) 733-1051

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 Snake River Plastic Surgery LLC's NPI number?

The NPI number for Snake River Plastic Surgery LLC is 1104137074. It was assigned to this organization in the NPPES registry on June 25, 2010.

Where is Snake River Plastic Surgery LLC located?

Snake River Plastic Surgery LLC is located at 555 E. Broadway Suite 212, Jackson, WY 83001. The listed phone number is (307) 733-6077.

What is Snake River Plastic Surgery LLC's specialty?

The primary specialty registered for this NPI is Specialist with taxonomy code 174400000X.

When was this NPI record last updated?

The NPPES record for Snake River Plastic Surgery LLC was last updated on June 25, 2010. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 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.