EVERGREEN PEDIATRICS
NPI 1417257155
Pediatrics in Riverton, WY

NPI Status: Active since October 28, 2010

Contact Information

1005 COLLEGE VIEW DR
RIVERTON, WY
ZIP 82501
Phone: (307) 857-3488
Fax: (307) 857-5215

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  • Organization
  • Pediatrics
  • CLIA Number: 53D0519897
  • CLIA Cert. Type: Physician Office
  • CLIA Exp. Date: 04-07-2027

About EVERGREEN PEDIATRICS

This page provides the complete NPI Profile along with additional information for Evergreen Pediatrics, a pediatrician established in Riverton, Wyoming operating as a Pediatrics. The healthcare provider is registered in the NPI registry with number 1417257155 assigned on October 2010. The practitioner's primary taxonomy code is 208000000X. The provider is registered as an organization and their NPI record was last updated 16 years ago. The organization operates as a Single Specialty Group with one or more individual practitioners, all of who practice with the same area of specialization. The provider's is doing business as Evergreen Pediatrics. The authorized official of this NPI record is Jess N Judy (President)

NPI
1417257155
Provider Legal Name
RIVERTON PHYSICIAN PRACTICES, LLC
Other Organization Name
EVERGREEN PEDIATRICS
Other Name Type
Doing Business As (3)
Entity Type
Organization
Location Address
1005 COLLEGE VIEW DR RIVERTON, WY 82501
Location Phone
(307) 857-3488
Location Fax
(307) 857-5215
Mailing Address
1005 COLLEGE VIEW DR RIVERTON, WY 82501
Mailing Phone
(307) 857-3488
Mailing Fax
(307) 857-5215
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
10-28-2010
Last Update Date
10-28-2010
Code Navigator

A pediatrician like Evergreen Pediatrics is a physician who has completed a pediatric residency and is board-certified or board-eligible in a pediatric specialty. Pediatric care providers are trained to care for newborns, infants, children and adolescents. A pediatrician could perform physical exams, manage vaccinations, monitor development milestones, diagnose illnesses, infections, injuries or other health problems, etc.

Location Map

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Pediatrics

Taxonomy Code
208000000X
Type
Allopathic & Osteopathic Physicians
Taxonomy Description
A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.

Group Taxonomy 193400000X SINGLE SPECIALTY GROUP

This provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

JESS N JUDY

Authorized Official Title
PRESIDENT
Authorized Official Phone
(615) 372-8500

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:

CLIA Number
53D0519897
Facility Type
Physician Office
Certificate Effective Date
April 08, 2025
Certificate Expiration Date
April 07, 2027
Laboratory Director
JOSEPH P. TURNER
Certificate Type
Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description
This CLIA certificate is issued to Evergreen Pediatrics in which a physician, midlevel practitioner or dentist that performs specific microscopy procedures during the course of a patient's visit. A limited list of provider-performed microscopy procedures is included under this certificate type, which are categorized as moderate complexity testing.

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1417257155, we treat the final digit (5) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 55. The final step is to find the difference between that total and the next multiple of ten (60 - 55 = 5).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
4
Unchanged
Pos 3
1
Doubled → 2
Pos 4
7
Unchanged
Pos 5
2
Doubled → 4
Pos 6
5
Unchanged
Pos 7
7
Doubled → 14 → 1 + 4
Pos 8
1
Unchanged
Pos 9
5
Doubled → 10 → 1 + 0
Check
5
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 1 → 2 2 → 4 7 → 14 → 5 5 → 10 → 1

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 4 + 2 + 7 + 4 + 5 + 1 + 4 + 1 + 1 + 0 + 24 = 55

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 55 is 60. The difference is the calculated check digit.

60 - 55 = 5
This NPI is valid
The calculated check digit is 5, which matches the last digit of 1417257155.

Other Providers at the Same Location


The following 20 providers are registered at the same or a nearby location.

Specialist
1005 COLLEGE VIEW DR
RIVERTON, WY 82501
Obstetrics & Gynecology
1005 COLLEGE VIEW DR
RIVERTON, WY 82501
Internal Medicine
1005 COLLEGE VIEW DR
RIVERTON, WY 82501
Internal Medicine
1005 COLLEGE VIEW DR
RIVERTON, WY 82501
Internal Medicine
1005 COLLEGE VIEW DR
RIVERTON, WY 82501
Internal Medicine
1005 COLLEGE VIEW DR
RIVERTON, WY 82501
Podiatrist (Foot & Ankle Surgery)
1005 COLLEGE VIEW DR
RIVERTON, WY 82501
Ophthalmology
1005 COLLEGE VIEW DR
RIVERTON, WY 82501
Internal Medicine
1005 COLLEGE VIEW DR
RIVERTON, WY 82501
Podiatrist
1005 COLLEGE VIEW DR, SUITE 4
RIVERTON, WY 82501
Orthopaedic Surgery
1005 COLLEGE VIEW DR, SUITE 9
RIVERTON, WY 82501
Pediatrics
1005 COLLEGE VIEW DR
RIVERTON, WY 82501
Pediatrics
1005 COLLEGE VIEW DR
RIVERTON, WY 82501
Surgery
1005 COLLEGE VIEW DR
RIVERTON, WY 82501
Pediatrics
1005 COLLEGE VIEW DR
RIVERTON, WY 82501
Internal Medicine
1005 COLLEGE VIEW DR
RIVERTON, WY 82501
Family Medicine
1005 COLLEGE VIEW DR
RIVERTON, WY 82501
Emergency Medicine
1005 COLLEGE VIEW DR
RIVERTON, WY 82501
Pediatrics
1005 COLLEGE VIEW DR
RIVERTON, WY 82501
Obstetrics & Gynecology
1005 COLLEGE VIEW DR
RIVERTON, WY 82501

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1417257155, enumerated as an "organization" on October 28, 2010.

The provider is located at 1005 COLLEGE VIEW DR RIVERTON, WY 82501 and the phone number is (307) 857-3488.

Pediatrics with taxonomy code 208000000X.