ROLAND FLECK (NPI# 1528162120) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1528162120 |
| Entity Type | Individual |
| Full Name | ROLAND FLECK |
| Credential | MD |
| Practice Address |
555 E Broadway Suite 212 Jackson WY 83001 |
| Mailing Address |
Po Box 1766 555 E Broadway Suite 212 Jackson WY 83001 |
| Practice Telephone | 3077337677 |
| Practice Fax Number | 3077337679 |
| Mailing Telephone | 3077337677 |
| Mailing Fax Number | 3077337679 |
| Enumeration Date | 2006-09-12 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 208600000X | Surgery | 7844 | MT | Allopathic & Osteopathic Physicians |
| N | 208600000X | Surgery | M4186 | ID | Allopathic & Osteopathic Physicians |
| Y | 208600000X | Surgery | 2822A | WY | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WY | BCBS | 301378 | 01 |
| ID | BC OF IDA | 37747 | 01 |
| Street Address |
555 E BROADWAY SUITE 212 |
| City | JACKSON |
| State | WY |
| Zip Code | 83001 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104825025 | Blane A Woodfin | Orthopaedic Surgery | 555 E Broadway, Jackson, WY 83001-9496 | 2005-07-21 |
| 1568632586 | P George Poore Md PC | Surgery | 555 E Broadway, Ste 212, Jackson, WY 83001-4777 | 2008-03-05 |
| 1316071145 | John C Payne | Surgery | 555 E Broadway, Suite 211, Jackson, WY 83001 | 2007-03-15 |
| 1356406599 | Phillip Lowe | Urology | 555 E Broadway, Suite 207, Jackson, WY 83001 | 2006-12-27 |
| 1003974262 | Blythe Elizabeth Cox | Internal Medicine | 555 E Broadway, Suite 229, Jackson, WY 83001 | 2006-12-04 |
| 1841364882 | Jackson Hole Obgyn PC | Midwife | 555 E Broadway, Ste 201, Jackson, WY 83001 | 2006-11-20 |
| 1407926835 | Stuart Ronald Sugarman | Specialist | 555 E Broadway, Suite 220, Jackson, WY 83001 | 2006-11-09 |
| 1255359626 | James R Champa | Orthopaedic Surgery | 555 E Broadway, Jackson, WY 83001 | 2006-07-17 |
| 1336167667 | Peter E Rork | Orthopaedic Surgery | 555 E Broadway, Jackson, WY 83001 | 2006-07-17 |
| 1528014768 | Laura Lee Simmons | Physical Therapist | 555 E Broadway, Jackson, WY 83001-9496 | 2006-05-26 |
| Find all providers in the same location | ||||
| 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 Code | 208600000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| 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. |
| 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 | ||||
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| 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.