EVERGREEN PEDIATRICS
NPI 1417257155
Pediatrics in Riverton, WY
About Evergreen Pediatrics NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
EVERGREEN PEDIATRICS (NPI 1417257155) is a healthcare organization registered as a pediatrics in Riverton, Wyoming and active in the NPI registry since October 2010. The organization holds a CLIA Microscopy certificate valid through April 7, 2027 and lists Jess N Judy, President, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Names 1
Group Practice 1
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Evergreen Pediatrics is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
54Medicare enrollment records show 54 clinicians reassign Medicare billing to Evergreen Pediatrics, which bills Medicare for the services they deliver. Of these, 4 practice at this address and 5 within 10 miles. Listed here are the 20 practicing nearest to this location.
Clinicians by Medicare Specialty 15
Nearest to this location (20)
See all 54Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
CLIA Laboratory Certificates CMS CLIA
Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.
Certificate for Provider-Performed Microscopy Procedures (PPMP) 53D0519897
Riverton Physicians Practice LLC · Riverton, WYFrequently 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 Riverton Physician Practices, LLC's NPI number?
The NPI number for Riverton Physician Practices, LLC is 1417257155. It was assigned to this organization in the NPPES registry on October 28, 2010. The provider is doing business as Evergreen Pediatrics.
Where is Riverton Physician Practices, LLC located?
Riverton Physician Practices, LLC is located at 1005 College View Dr, Riverton, WY 82501. The listed phone number is (307) 857-3488.
What is Riverton Physician Practices, LLC's specialty?
The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.
Is Riverton Physician Practices, LLC enrolled in Medicare?
Yes. Riverton Physician Practices, LLC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Riverton Physician Practices, LLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 54 clinicians in 15 Medicare specialties reassign their Medicare billing to Riverton Physician Practices, LLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are General Surgery (12), Internal Medicine (12) and Family Practice (9). Of these, 4 practice at this address and 5 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does Riverton Physician Practices, LLC hold a CLIA laboratory certificate?
Yes. A Certificate for Provider-Performed Microscopy Procedures (PPMP) (number 53D0519897) is associated with this NPI, valid through April 7, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
When was this NPI record last updated?
The NPPES record for Riverton Physician Practices, LLC was last updated on October 28, 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.
# Evergreen Pediatrics · NPI 1417257155
Pediatrics organization in Riverton, Wyoming. Organization record, active in the CMS NPPES registry since October 28, 2010.
## Identity
- **NPI:** 1417257155 (Entity type: Organization)
- **Enumerated:** October 28, 2010
- **Primary specialty:** Pediatrics · taxonomy 208000000X
- **Legal business name:** Riverton Physician Practices, Llc
- **Organization subpart:** No
- **Authorized official:** Jess Judy, PRESIDENT
## Practice location
- **Address:** 1005 COLLEGE VIEW DR, Riverton, WY 82501-2289
- **Phone:** (307) 857-3488 · **Fax:** (307) 857-5215
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 54 clinicians in 15 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: General Surgery (12), Internal Medicine (12), Family Practice (9); 4 practice at this address and 5 within 10 miles; [full list](https://npiprofile.com/npi/1417257155/clinicians) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** October 28, 2010
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1417257155) · Data from the CMS NPPES public registry.