DR. RANDY J KJORSTAD


Address: 555 E Broadway Ave, Suite 229, Jackson, WY 83001-8640
Phone: 3077397690

DR. RANDY J KJORSTAD (NPI# 1043283336) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1043283336
Entity Type Individual
Full Name DR. RANDY J KJORSTAD
Credential M.D.
Practice Address 555 E Broadway Ave
Suite 229
Jackson
WY 83001-8640
Mailing Address Po Box 428
Jackson
WY 83001-0428
Practice Telephone 3077397690
Practice Fax Number 3077397644
Mailing Telephone 3077397690
Mailing Fax Number 3077397644
Enumeration Date 2006-02-08
Last Update Date 2014-08-22
Gender Code M
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 208600000X Surgery 9756A WY Allopathic & Osteopathic Physicians
N 208600000X Surgery 12855 MT Allopathic & Osteopathic Physicians
N 208600000X Surgery M-9325 ID Allopathic & Osteopathic Physicians

Other Provider Identifier

State Issuer Identifier Type Code
WY SJMC PTAN W26189 01

Office Location

Street Address 555 E BROADWAY AVE
SUITE 229
City JACKSON
State WY
Zip Code 83001-8640

Providers in the same location

NPI Name Taxonomy Address Enumeration
1336124890 Angus G Goetz IIi Orthopaedic Surgery 555 E Broadway Ave, Jackson, WY 83001-8640 2005-12-07
1013403013 Devyn K Parnes Physician Assistant 555 E Broadway Ave, Jackson, WY 83001-8640 2018-07-03
1447785829 Nola Peacock Physical Therapist 555 E Broadway Ave, Suite 113, Jackson, WY 83001-8640 2017-04-24
1609323302 Calvin P Schenk Physician Assistant 555 E Broadway Ave, Suite 201, Jackson, WY 83001-8640 2016-09-09
1194196667 Sarah J Peterson Dietitian, Registered 555 E Broadway Ave, Ste 201, Jackson, WY 83001-8640 2015-10-09
1679994933 Lindsay Katherine Love Physical Therapist 555 E Broadway Ave, Jackson, WY 83001-8640 2014-01-03
1588005193 Cara Anne Sengebush Physical Therapist 555 E Broadway Ave, Jackson, WY 83001-8640 2013-07-11
1336588672 Mountain Therapy Pllc Counselor 555 E Broadway Ave, Suite 216, Jackson, WY 83001-8640 2013-06-20
1376895169 Patricia Drui Speech-Language Pathologist 555 E Broadway Ave, Suite 100, Jackson, WY 83001-8640 2012-10-04
1982955001 Carol Bocker Speech-Language Pathologist 555 E Broadway Ave, Suite 100, Jackson, WY 83001-8640 2012-09-28
Find all providers in the same location

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1861006108 Anne Kathleen Milburn Physical Therapist 3620 S Park Drive, Jackson, WY 83001 2020-09-03
1568009637 Katherine Pringle Ford Case Manager/Care Coordinator 2065 E. Limber Pine Road, Jackson, WY 83001 2019-12-07
1043878408 Cossette Burnham Physical Therapist Four Pines Physical Therapy, 1090 S Hwy 89, Jackson, WY 83001 2019-05-31
1982169371 Cynthia Buck Huyffer Social Worker 755a Cache Creek Drive, Jackson, WY 83001 2019-02-10
1093281594 Lara Cilo Speech-Language Pathologist 1300 W. Valley Springs Road, Jackson, WY 83001 2018-10-23
1740776202 Teton Oral and Maxillofacial Surgery Dentist 1160 Alpine Ln Ste 1d, Jackson, WY 83001 2018-07-09
1437642055 Anna Yanchek Physical Therapist 1090 Us- 89, Jackson Hole, WY 83001 2018-06-08
1891200762 Tyler Ross Wright Chiropractor 1325 Us-89, Suite 108, Jackson, WY 83001 2017-12-13
1073027280 Root To Rise Counseling and Consulting, Pllc Social Worker 2033 Dandelion Court, Jackson, WY 83001 2017-11-27
1962923912 Piper Worthington Social Worker 1910 High School Rd, Jackson, WY 83001 2017-06-29
Find all providers in zip 83001

Taxonomy Information

Taxonomy Code 208600000X
Grouping Allopathic & Osteopathic Physicians
Classification Surgery

Taxonomy 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.
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source]
- Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification
- Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1851731103 Zachary James Virgin Surgery 300 W Washington Ave Ste 300, Jackson, MI 49201-2160 2013-07-01
1407290372 Derek S. Palmer Surgery 120 District Blvd Apt 433, Jackson, MS 39211-6389 2013-04-23
1881037703 Kara Spinks Logan Surgery 1190 N State St Ste 502, Jackson, MS 39202 2013-04-10
1639419997 Fred Silvestri Md, LLC Surgery 4 Long Bay Rd, Jackson, NJ 08527-2662 2013-02-25
1528356482 James P. Spell Surgery 21 Lamplighter Rd., Jackson, MS 39208 2011-07-13
1629371018 Richard L Yelverton Md Pa Surgery 1040 River Oaks Dr Ste 102, Jackson, MS 39232-9539 2010-12-07
1619125952 Otha Edward Williams Jr. Surgery 1736 Lake Trace Dr, Jackson, MS 39211-3353 2008-08-28
1770604803 Rajesh Kuruba Surgery 1500 E Woodrow Wilson Ave., Jackson, MS 39216-5199 2007-04-03
1679692396 Reginald Willis Martin Surgery 971 Lakeland Dr Ste 211, Jackson, MS 39216-4607 2007-03-28
1295878783 P George Poore Surgery 555 East Broadway Ste 212, Jackson, WY 83001-4777 2007-02-14
Find all providers in JACKSON

Competitor

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City JACKSON
Zip Code 83001

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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