Active NPI
Community Hospital
- Rural Health Clinic/Center
- Torrington, WY
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Rural Health Clinic/Center
- Legal business name
- COMMUNITY HOSPITAL
- Practice address
- 625 Albany Ave
Torrington, WY 82240-1530 - Phone
- (307) 532-2107
- NPI assigned
- May 3, 2017
- Last updated
- Mar 16, 2023
- Organization subpart
- Yes
- Parent organization
- BANNER HEALTH
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Zachary Miller
- Title
- Ceo
- Phone
- (307) 534-7054
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Rural Health Clinic/Center | 261QR1300X | Primary |
Addresses
Primary practice location
625 Albany Ave
Torrington, WY 82240-1530
Mailing address
2901 N Central Ave Ste 160
Phoenix, AZ 85012-2702
Other names 1
- Banner Medical Clinic Torrington
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WY
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20170608000298 | WY | Part A Provider - Rural Health Clinic | 6608784194 |
1 other NPI on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Torrington, WY |
NPI to CCN mapping 1
The Medicare certification numbers (CCNs) connected to NPI 1174059786. Details of each certification follow.
Rural health clinic certification: CCN 533993
- Legal name
- COMMUNITY HOSPITAL
- Doing business as
- BANNER MEDICAL CLINIC TORRINGTON
- Certification status
- Active
- Provider type (POS)
- Rural health clinic
- Participating since
- Oct 13, 2017
- Last certification
- Jul 2, 2021
- Ownership / control type
- 2B
- Organization structure
- Other
- Enrollment address
- 625 Albany Ave
Torrington, WY 82240-1530 - Related CCNs
- 531307
Related certifications (CCN) 1
Facilities connected through Provider of Services related, parent or unit certification numbers.
Other NPIs on the same Medicare enrollment 1
NPIs listed together on one Medicare enrollment, typically parts of the same organization.
National Provider Directory
National Provider Directory- Part of
- Custer Comm Hosp Rad
Member of 1
Organizations this organization is a member of, according to the National Provider Directory.
-
dba Banner Hospice of Northern Colorado
- Community Based Hospice Care Agency
- Greeley, CO
- NPI 1407409964
Member Of
Locations
2000 Campbell Dr
Ste B
Torrington, WY 82240
Phone (307) 534-7113
Ownership & related parties
All disclosed owners & managing parties 24
As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.
| Name | Role | Since | Share |
|---|---|---|---|
| Julie Ann Alvarado-Dubek | Corporate Officer | Feb 1, 2022 | |
| Ingrid Long | Corporate Director | Jul 21, 2024 | |
| W-2 Managing Employee | Jul 21, 2024 | ||
| Marjorie J Bessel | Corporate Officer | Jan 1, 2018 | |
| Jean Lance | Corporate Officer | Apr 21, 2022 | |
| Staci Dickerson | Corporate Officer | Jul 17, 2023 | |
| Carole Faig | Corporate Director | Mar 1, 2026 | |
| Paris Labruzzo | Corporate Director | Feb 1, 2026 | |
| W-2 Managing Employee | Feb 1, 2026 | ||
| Dean M Harrison | Corporate Director | Sep 1, 2023 | |
| Anne Mariucci | Corporate Director | Mar 1, 2015 | |
| Sujata Gosalia | Corporate Director | Sep 1, 2018 | |
| Brenda a Schaefer | Corporate Officer | Mar 6, 2014 | |
| Quentin P Smith | Corporate Director | Sep 1, 1999 | |
| Vicki Keiser | Corporate Director | Jun 1, 2017 | |
| Holly Gregory | Corporate Director | Feb 1, 2026 | |
| W-2 Managing Employee | Feb 1, 2026 | ||
| Sara Ward | Corporate Director | Sep 1, 2023 | |
| Michael L Butler | Corporate Director | Sep 1, 2025 | |
| Mary Schubert | Corporate Officer | Jan 1, 2024 | |
| Amy Perry | Corporate Officer | Nov 1, 2021 | |
| Rick Myers | Corporate Director | Sep 1, 2023 | |
| John F Koster | Corporate Director | Dec 11, 2015 | |
| Mark Wallace | Corporate Director | Sep 1, 2021 | |
| Christopher H Volk | Corporate Director | Dec 9, 2009 | |
| Michael Garnreiter | Corporate Director | Aug 1, 2012 | |
| Banner Health | 5% Or Greater Direct Ownership Interest | May 1, 2017 | 100% |
| Operational/Managerial Control | May 1, 2017 | 100% |
Owners & managing parties with NPI records 12
Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.
-
- Durable Medical Equipment & Medical Supplies
- Casper, WY
- NPI 1528846912
5% Or Greater Direct Ownership Interest, Operational/Managerial Control
-
dba Banner Casa Grande Medical Center
- General Acute Care Hospital
- Casa Grande, AZ
- NPI 1003232976
5% Or Greater Direct Ownership Interest, Operational/Managerial Control
-
dba Banner Payson Medical Center
- Critical Access Hospital
- Payson, AZ
- NPI 1063923340
5% Or Greater Direct Ownership Interest, Operational/Managerial Control
-
dba Banner Payson Medical Center - Banner Health Clinic Payson
- Rural Health Clinic/Center
- Payson, AZ
- NPI 1073223012
5% Or Greater Direct Ownership Interest, Operational/Managerial Control
-
- Multi-Specialty Clinic/Center
- Susanville, CA
- NPI 1205267549
5% Or Greater Direct Ownership Interest, Operational/Managerial Control
-
dba Banner Payson Medical Center - Banner Health Clinic Pine
- Rural Health Clinic/Center
- Pine, AZ
- NPI 1245940287
5% Or Greater Direct Ownership Interest, Operational/Managerial Control
-
dba Banner Hospice of Northern Colorado
- Community Based Hospice Care Agency
- Greeley, CO
- NPI 1407409964
5% Or Greater Direct Ownership Interest, Operational/Managerial Control
-
- Radiology Clinic/Center
- Susanville, CA
- NPI 1427740570
5% Or Greater Direct Ownership Interest, Operational/Managerial Control
-
dba Banner Fort Collins Medical Center
- General Acute Care Hospital
- Fort Collins, CO
- NPI 1659787554
5% Or Greater Direct Ownership Interest, Operational/Managerial Control
-
dba Banner Payson Medical Center
- Medicare Defined Swing Bed Hospital Unit
- Payson, AZ
- NPI 1861077414
5% Or Greater Direct Ownership Interest, Operational/Managerial Control
-
dba Banner Ocotillo Medical Center
- General Acute Care Hospital
- Chandler, AZ
- NPI 1972139004
5% Or Greater Direct Ownership Interest, Operational/Managerial Control
Parent organization (reported in NPPES) 1
This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.
-
- Durable Medical Equipment & Medical Supplies
- Casper, WY
- NPI 1528846912
Practitioners & affiliated clinicians
Practitioners 70
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- Medical Physician Assistant
- Newcastle, WY
- NPI 1962723130
-
- Emergency Medical Services (Emergency Medicine) Physician
- Wheatland, WY
- NPI 1518987379
-
- Family Nurse Practitioner
- Torrington, WY
- NPI 1912798166
-
- Family Nurse Practitioner
- Torrington, WY
- NPI 1770712507
-
- Family Medicine Physician
- Torrington, WY
- NPI 1427291491
-
- Family Medicine Physician
- Cheyenne, WY
- NPI 1942730080
-
- Family Medicine Physician
- Torrington, WY
- NPI 1841938826
-
- Family Medicine Physician
- Rawlins, WY
- NPI 1023031861
-
- Counselor
- Torrington, WY
- NPI 1043768492
-
- Family Medicine Physician
- Cheyenne, WY
- NPI 1942869177
-
- Obstetrics & Gynecology Physician
- Cheyenne, WY
- NPI 1629095310
-
- Family Medicine Physician
- Torrington, WY
- NPI 1326146846
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1493769600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1678924800000",
"number": "1174059786",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2901 N CENTRAL AVE STE 160",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850122702"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "625 ALBANY AVE",
"city": "TORRINGTON",
"state": "WY",
"postal_code": "822401530",
"telephone_number": "307-532-2107"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "COMMUNITY HOSPITAL",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "BANNER HEALTH",
"enumeration_date": "2017-05-03",
"last_updated": "2023-03-16",
"certification_date": "2023-03-16",
"status": "A",
"authorized_official_last_name": "MILLER",
"authorized_official_first_name": "ZACHARY",
"authorized_official_title_or_position": "CEO",
"authorized_official_telephone_number": "307-534-7054"
},
"taxonomies": [
{
"code": "261QR1300X",
"taxonomy_group": "",
"desc": "Clinic/Center, Rural Health",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Banner Medical Clinic Torrington",
"code": "5",
"type": "Other Name"
}
]
}Other providers in Torrington, WY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.