OrganizationActive
Snake River Plastic Surgery LLC
NPI 1104137074 · Specialist · Jackson, WY
Snake River Plastic Surgery LLC is a Specialist organization in Jackson, WY (NPI 1104137074).
Provider details
- NPI number
- 1104137074
- Entity type
- Organization
- Primary specialty
- SpecialistOther Service Providers
- Organization subpart
- No
- Authorized official
- Michael Gellis, Member(307) 733-6077
- License
- 2735A (WY)
Specialties & taxonomies
Other Service Providers
Profile Score
Detailed profile(84/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
16 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
555 E. Broadway
Suite 212
Jackson, WY 83001
Phone: (307) 733-6077
Street-level locationGet directions
Mailing address
Po Box 2862
Jackson, WY 83001-2862
Registry dates
- Enumerated
- 2010-06-25
- Last updated
- 2010-06-25
Frequently asked questions
- What is Snake River Plastic Surgery LLC's NPI number?
- Snake River Plastic Surgery LLC's National Provider Identifier (NPI) is 1104137074, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Snake River Plastic Surgery LLC?
- Snake River Plastic Surgery LLC is classified in the NPPES registry as Specialist (Other Service Providers).
- Where is Snake River Plastic Surgery LLC located?
- Snake River Plastic Surgery LLC's practice location on file with NPPES is 555 E. Broadway, Jackson, WY 83001.
- What is Snake River Plastic Surgery LLC's phone number?
- The practice phone number listed in the NPPES registry for Snake River Plastic Surgery LLC is (307) 733-6077.
- Who is the authorized official for Snake River Plastic Surgery LLC?
- The authorized official listed on Snake River Plastic Surgery LLC's NPPES record is Michael Gellis, Member. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Snake River Plastic Surgery LLC's NPI active?
- Yes — Snake River Plastic Surgery LLC's NPI (1104137074) is active in the NPPES registry as of the last update on 2010-06-25.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.