NPIMap

Organization Active NPI

Glenrock Hospital District

  • Rural Health Clinic/Center
  • Glenrock, WY
National Provider Identifier
1093758161
Registry record updated Jan 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
GLENROCK HOSPITAL DISTRICT
Practice address
925 W Birch St
Glenrock, WY 82637-0786
Phone
(307) 436-9206
Fax
(307) 436-9730
NPI assigned
Jun 14, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 29, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Ashley Marie Oviedo-Lopez, FNPCNPI 1841797461
Title
Administrator
Phone
(307) 436-9206

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X
Rural Health Clinic/Center 261QR1300X Primary

Addresses

Primary practice location

925 W Birch St
Glenrock, WY 82637-0786

Mailing address

PO Box 786
Glenrock, WY 82637-0786
Phone (307) 436-9206

Other names 1

  • glenrock health center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WY2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040604000855 WY Part B Supplier - Clinic/Group Practice 8527976828 Receives reassigned benefits from 8 practitioners
Practice locations: Glenrock, WY
O20071119000058 WY Part A Provider - Rural Health Clinic 8527976828 Practice locations: Glenrock, WY

Rural health clinic certification: CCN 533819

Legal name
GLENROCK HOSPITAL DISTRICT
Doing business as
GLENROCK HEALTH CENTER
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Sep 9, 2008
Last certification
Sep 30, 2021
Ownership / control type
Non-profit – church related
Organization structure
OtherNon-profit
Enrollment address
925 W Birch
Glenrock, WY 82637-0786

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 7

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Melody Dugan Individual Corporate OfficerElected Member Nov 1, 2018 25%
John Moulton Individual Corporate OfficerPresident Nov 1, 2016 25%
Melanie Cielinski Individual Corporate DirectorAdministor Mar 10, 2003 100%
W-2 Managing Employee Mar 10, 2003 100%
Sharon Burns Individual Corporate OfficerVice President Nov 1, 2018 25%
Glenrock Hospital District Organization, Glenrock, WY Non-profit Operational/Managerial Control Mar 24, 2003 100%
Terri Saul Individual W-2 Managing EmployeeOffice Manager Jun 21, 2011
Kate Anfinson Individual Corporate OfficerSecretary Nov 1, 2016 25%

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1150243200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1738108800000",
    "number": "1093758161",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 786",
            "city": "GLENROCK",
            "state": "WY",
            "postal_code": "826370786",
            "telephone_number": "307-436-9206",
            "fax_number": "307-436-9730"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "925 W BIRCH ST",
            "city": "GLENROCK",
            "state": "WY",
            "postal_code": "826370786",
            "telephone_number": "307-436-9206",
            "fax_number": "307-436-9730"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GLENROCK HOSPITAL DISTRICT",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-14",
        "last_updated": "2025-01-29",
        "status": "A",
        "authorized_official_last_name": "OVIEDO-LOPEZ",
        "authorized_official_first_name": "ASHLEY",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "307-436-9206",
        "authorized_official_credential": "FNPC"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "glenrock health center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "glenrock health center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Glenrock, WY

Sources for this page

Verify at the official NPI Registry.