OUTPATIENT RADIOLOGY LLC NPI 1396704474

NPI Information

  • NPI: 1396704474
  • Provider Name: OUTPATIENT RADIOLOGY LLC
  • Classification: Radiology - 2085R0202X
  • Specialization: Diagnostic Radiology
  • Entity Type: Organization
  • CLIA Number: 53D2281744
  • Address: 419 SOUTH WASHINGTON STREET
    SUITE 101
    CASPER, WY
    ZIP 82601
  • Phone: (307) 234-6963

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NPI Details

OUTPATIENT RADIOLOGY LLC is a diagnostic radiology radiology in Casper, WY. The provider is a radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. OUTPATIENT RADIOLOGY LLC NPI is 1396704474. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

419 SOUTH WASHINGTON STREET
SUITE 101
CASPER, WY
ZIP 82601
Phone: (307) 234-6963
Fax: (307) 237-1074

The provider's authorized official is Jeffrey Rhea .
The authorized official title is President and has the following contact phone number (307) 265-1620.

The CLIA number assigned to this NPI record is 53D2281744 - other - outpatient radiology imag with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 3/20/2006 and was last updated on 6/17/2024.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
12085R0202XRadiologyDiagnostic RadiologyYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
110025260001MEDICAIDNEBRASKA
2116358200MEDICAIDWYOMING

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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