NPIMap

Organization Active NPI

Wray Community District Hospital

  • Rural Health Clinic/Center
  • Wray, CO
National Provider Identifier
1184414542
Registry record updated May 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
WRAY COMMUNITY DISTRICT HOSPITAL
Practice address
1017 W 7TH St
Wray, CO 80758-1420
Phone
(970) 332-4811
NPI assigned
May 8, 2025
Last updated
May 8, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 8, 2025

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

Authorized official

Name
John H Everett
Title
Cfo
Phone
(325) 207-6584

Specialties & licenses 1

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

Addresses

Primary practice location

1017 W 7TH St
Wray, CO 80758-1420

Mailing address

1017 W 7TH St
Wray, CO 80758-1420
Phone (970) 332-4811

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250904003533 CO Part A Provider - Rural Health Clinic 3274425038 Practice locations: Wray, CO

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1184414542. Details of each certification follow.

Rural health clinic certification: CCN 068530

Legal name
WRAY COMMUNITY DISTRICT HOSPITAL
Doing business as
THE WRAY CLINIC
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Dec 26, 2025
Last certification
Dec 26, 2025
Ownership / control type
2B
Organization structure
CorporationNon-profit
Enrollment address
1017 W 7TH St
Wray, CO 80758-1420
Related CCNs
061309

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs with the same Medicare PAC ID 3

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

National Provider Directory

National Provider Directory
Tax ID family
Wray Community3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

All disclosed owners & managing parties 4

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

NameRoleSinceShare
John H Everett Individual Corporate OfficerChief Financial Officer Nov 1, 2024
W-2 Managing EmployeeCfo Nov 1, 2024
John S Hart Individual Corporate OfficerChief Executive Officer Jan 6, 2019
Samuel Herbert Individual Operational/Managerial ControlCompliance Officer & Program Dir. Oct 15, 2018
David Glen Reed Individual OtherMedical Director Jan 1, 2000

Owners & managing parties with NPI records 1

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

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Wray Community District HospitalWray, CO, CCN 06Z309 Hospital 5% Or Greater Direct Ownership Interest
Operational/Managerial Control		 Jan 1, 1994
Jan 1, 1994
Wray Community District HospitalWray, CO, CCN 061309 Hospital Operational/Managerial Control Jan 4, 2016

Owned or controlled facilities with NPI records 3

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

NPI Registry JSON

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

{
    "created_epoch": "1746662400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1746662400000",
    "number": "1184414542",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1017 W 7TH ST",
            "city": "WRAY",
            "state": "CO",
            "postal_code": "807581420",
            "telephone_number": "970-332-4811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1017 W 7TH ST",
            "city": "WRAY",
            "state": "CO",
            "postal_code": "807581420",
            "telephone_number": "970-332-4811"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WRAY COMMUNITY DISTRICT HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-05-08",
        "last_updated": "2025-05-08",
        "certification_date": "2025-05-08",
        "status": "A",
        "authorized_official_last_name": "EVERETT",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "325-207-6584"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wray, CO

Sources for this page

Verify at the official NPI Registry.