ST JOHN'S SURGICAL GROUP, PC
NPI 1356406557
Surgery in Jackson, WY

Q: What is St John's Surgical Group, PC's NPI number?

The NPI number for St John's Surgical Group, PC is 1356406557. It was assigned to this organization in the NPPES registry on December 27, 2006.

Q: What is St John's Surgical Group, PC's specialty?

The primary specialty registered for this NPI is Surgery with taxonomy code 208600000X.

Active since December 27, 2006

555 E BROADWAY AVE, SUITE 229, JACKSON, WY 83001(307) 733-0422(307) 733-2580 Get Directions Write a Review

NPPES record last updated: September 25, 2014. Verified against the NPPES registry weekly; last sync: August 16, 2026.

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About St John's Surgical Group, Pc NPPES

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

ST JOHN'S SURGICAL GROUP, PC (NPI 1356406557) is a healthcare organization registered as a surgery in Jackson, Wyoming and active in the NPI registry since December 2006. The organization lists Michael Rosenberg, President, as its authorized official.

NPPES Registry Identity

NPI1356406557

Entity TypeOrganization

Primary Taxonomy208600000X

Legal Business NameST JOHN'S SURGICAL GROUP, PC

Location Address555 E BROADWAY AVE, SUITE 229Jackson, WY 83001-8640

Mailing AddressPo Box 4197Jackson, WY 83001-4197 · (307) 733-0422 · Fax (307) 733-2580

Phone(307) 733-0422

Fax(307) 733-2580

Organization SubpartNo

Authorized OfficialMichael RosenbergPresident · (307) 733-0422

Enumeration DateDecember 27, 2006

Last NPPES UpdateSeptember 25, 2014

✔ NPI 1356406557 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySurgeryAllopathic & Osteopathic Physicians

Taxonomy Code208600000X

License✔ Licensed in WY · 5051A

Definition

A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery.

555 E BROADWAY AVE, Jackson, WY 83001

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Other Identifiers 4

Medicare ID-Type Unspecified020034960ID · Individual #

Medicare ID-Type UnspecifiedW305966WY · Individual#

Medicaid101117100WY

Medicaid004294400ID

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 20

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

DEVYN PARNES VORE PA

Physician Assistant

555 E BROADWAY AVE
JACKSON, WY 83001

Teton County (307) 733-3900

FAMILY FIRST HEALTH PC

Nurse Practitioner (Family)

555 E BROADWAY AVE, STE 218
JACKSON, WY 83001

Teton County (307) 201-1696

LAURA A COLLEBRUSCO PT

Physical Therapist

555 E BROADWAY AVE
JACKSON, WY 83001

Teton County (307) 739-7491

SARAH J PETERSON RD

Dietitian, Registered

555 E BROADWAY AVE, STE 201
JACKSON, WY 83001

Teton County (307) 739-7634

TETON COUNTY HOSPITAL DISTRICT

Home Health

555 E BROADWAY AVE, STE 115
JACKSON, WY 83001

Teton County (307) 739-7465

MEGAN ROSE AVERY PA-C

Physician Assistant (Medical)

555 E BROADWAY AVE
JACKSON, WY 83001

Teton County (307) 733-3900

MOUNTAIN THERAPY PLLC

Counselor (Professional)

555 E BROADWAY AVE, SUITE 216
JACKSON, WY 83001

Teton County (404) 483-2555

KAYLA WARD DPT

Physical Therapist

555 E BROADWAY AVE
JACKSON, WY 83001

Teton County (307) 733-3900

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 St John's Surgical Group, PC's NPI number?

The NPI number for St John's Surgical Group, PC is 1356406557. It was assigned to this organization in the NPPES registry on December 27, 2006.

Where is St John's Surgical Group, PC located?

St John's Surgical Group, PC is located at 555 E Broadway Ave Suite 229, Jackson, WY 83001. The listed phone number is (307) 733-0422.

What is St John's Surgical Group, PC's specialty?

The primary specialty registered for this NPI is Surgery with taxonomy code 208600000X.

When was this NPI record last updated?

The NPPES record for St John's Surgical Group, PC was last updated on September 25, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 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.