ANESTHESIA SERVICES OF JACKSONHOLE, P.C. — NPI 1831383264 (Board-Certified Anesthesiologist & Interventional Pain Specialist in JACKSON, WY)

CMS-1500 Box 24J / 33a • NPI

1831383264

Type 2 Organization (Box 32a/33a)

HIPAA NUCC Taxonomy • CMS Code

207L00000X (CMS 05)

Board-Certified Anesthesiologist & Interventional Pain Specialist

Box 32 Service Location & ZIP+4

970 W BROADWAY # 378, JACKSON, WY, 83001-9475

✓ 9-Digit EDI 837 ZIP+4 (83001-9475)

Practice Phone & Referral Fax

(307) 734-6956

Direct NPPES Verification Line

✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR: NPI 1831383264 (ANESTHESIA SERVICES OF JACKSONHOLE, P.C.) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).

CMS Medicare Order & Referring PECOS Eligibility

Institutional Type-2 NPI facilities enroll via CMS-855A institutional provider agreements rather than individual Order & Referring PECOS.

Official CMS NPPES Credential & Practice Profile

10-Digit NPI Number	`1831383264` (NPI-2 Organization / Facility)
Provider / Legal Name	ANESTHESIA SERVICES OF JACKSONHOLE, P.C.
Plain-English Specialty	Board-Certified Anesthesiologist & Interventional Pain Specialist NUCC Code: `207L00000X` (Anesthesiology)
Certifying / Licensing Body	American Board of Anesthesiology (ABA)
Practice Location Address	970 W BROADWAY # 378, JACKSON, WY, 83001-9475
Practice Telephone / Fax	Tel: (307) 734-6956
Administrative Mailing Address	970 W BROADWAY # 378, JACKSON, WY, 83001-9475
Enumeration & Last Sync	Enumerated: 2007-08-29 \| CMS Record Updated: 2007-08-29
Authorized Official	CHARLES PAYNE (President)

Clinic Location, Accessibility & Directions

📍 Practice Location & Patient Access

970 W BROADWAY # 378, JACKSON, WY, 83001-9475

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Plain-English Taxonomy & CMS Crosswalk (207L00000X)

What Does Taxonomy Code 207L00000X Mean?

In the HIPAA National Uniform Claim Committee (NUCC) classification, code 207L00000X translates to:
"Board-Certified Anesthesiologist & Interventional Pain Specialist"

CMS-1500 Medicare Specialty Crosswalk: CMS Code 05 (Physician/Anesthesiology) • CMS Code 79 (Physician/Addiction Medicine)
Certifying / Accrediting Authority: American Board of Anesthesiology (ABA)
Clinical Scope: Pre-surgical anesthesia evaluation, obstetric labor epidural care, or interventional spine and nerve block procedures for chronic pain.

Specialty Clinical Procedures & Therapeutic Classes

Standard Scope of Care (ANESTHESIA SERVICES OF JACKSONHOLE, P.C.)

Typical CPT / Diagnostic Procedures:

General Endotracheal Anesthesia & Total Intravenous Anesthesia (TIVA)
Ultrasound-Guided Peripheral Nerve Blocks & Labor Epidural Analgesia
Fluoroscopic Epidural Steroid Injections & Facet Joint Blocks

Common Therapeutic Classes:

Propofol, Sevoflurane, Rocuronium & Sugammadex
Bupivacaine, Lidocaine & Ropivacaine Regional Anesthetics

All Registered NUCC Taxonomies & State Licenses

Taxonomy Code & Plain-English Description	State License & Primary Status
`207L00000X` — Anesthesiology Plain English: Board-Certified Anesthesiologist & Interventional Pain Specialist	State: WY \| License: `6301A` \| Primary: Yes (Primary)

Medical Billing, RCM & Hospital Credentialing Teams:

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ANESTHESIA SERVICES OF JACKSONHOLE, P.C. (NPI #1831383264)