NPIMap

Organization Active NPI

Teton County Hospital District

  • Home Health Agency
  • Jackson, WY
National Provider Identifier
1194744235
Registry record updated Feb 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
15092 Issued in WY
Legal business name
TETON COUNTY HOSPITAL DISTRICT
Practice address
555 E Broadway Ave
Ste 115
Jackson, WY 83001-8640
Phone
(307) 739-7465
Fax
(307) 739-7645
NPI assigned
Jul 19, 2006
Organization subpart
Yes
Parent organization
TETON COUNTY HOSPITAL DISTRICTAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 2, 2026

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

Authorized official

Name
Mitchell Watson
Title
Cfo
Phone
(307) 739-7526

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Agency 251B00000X 15092 WY
Home Health Agency 251E00000X 15092 WY Primary

Addresses

Primary practice location

555 E Broadway Ave
Ste 115
Jackson, WY 83001-8640

Mailing address

PO Box 428
Jackson, WY 83001-0428
Phone (307) 739-7465

Other identifiers 2

IdentifierTypeStateIssuer
106299902MedicaidWY
106299908MedicaidWY

Other names 1

  • St John's Home Care Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20071018000355 WY Part A Provider - Home Health Agency 4880582295 Practice locations: Jackson, WY

Home health agency certification: CCN 537063

Legal name
TETON COUNTY HOSPITAL DISTRICT
Doing business as
ST. JOHN'S HOME CARE
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Dec 5, 1990
Last certification
Oct 18, 2018
Ownership / control type
Government Operated
Organization structure
OtherNon-profit
Enrollment address
555 E Broadway Ave
Ste 115
Jackson, WY 83001-8640

Other NPIs with the same Medicare PAC ID 5

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

Care Compare: Home health agency

Medicare Care Compare
Listed as
St John'S Home CareCCN 537063
Overall star rating
3 of 5
Ownership
Government Operated
Certified
Dec 5, 1990
Medicare certification status
ActiveFrom the Provider of Services file
Services
Nursing, Home health aide, Physical therapy, Speech pathology, Occupational therapy

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
53D0903721St John'S Home Care555 E Broadway Ste 115, Jackson, WY 83001Certificate of waiverMay 24, 2028

National Provider Directory

National Provider Directory
Tax ID family
Teton County Hospital Distr9 organizations share this tax ID, including this one
Part of
Teton County Hospital Distr

Other organizations with this tax ID 8

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

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

Ownership & related parties

All disclosed owners & managing parties 9

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

NameRoleSinceShare
Evan Jones Individual Corporate Director May 1, 2022 14.28%
Brent a Blue Individual Corporate Director Nov 6, 2022 14.28%
Pamela V Cutler Individual Corporate OfficerVice Chair Dec 7, 2022
Corporate Director Nov 6, 2022 14.28%
Bruce M Hayse Individual Corporate Director Nov 6, 2008 14.28%
Teton County Hospital District Organization, Jackson, WY Non-profit Operational/Managerial Control Apr 27, 2010 100%
Cynthia Hogan Individual Corporate OfficerSecretary Dec 7, 2022
Corporate Director Apr 1, 2015 14.28%
John J Kren Individual W-2 Managing EmployeeCfo & Coo May 23, 2007
Katharine Conover-Keller Individual Corporate OfficerChair Dec 7, 2022
Corporate Director Jan 1, 2022 14.28%
James K Hunt Individual Corporate OfficerTreasurer Feb 28, 2023
Corporate Director Feb 1, 2023 14.28%

Owners & managing parties with NPI records 7

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

All facility ownership & control disclosures 4

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

FacilityTypeRoleSince
St Johns Med Center/Or St Johns HealthJackson, WY, CCN 530015 Hospital Other May 23, 2007
St Johns Medical CenterJackson, WY, CCN 53U015 Hospital Operational/Managerial Control Jun 13, 2014
St Johns Health Sage LivingJackson, WY, CCN 535046 Skilled nursing facility Adp of the SNF Mar 13, 2025
St. John'S HospiceJackson, WY, CCN 531504 Hospice Operational/Managerial Control (100%) Jan 1, 1970

Owned or controlled facilities with NPI records 3

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

Facilities with the same owner 2

Facilities that share an organizational owner with 5% or greater ownership or operational control.

Practitioners & affiliated clinicians

Affiliated clinicians 8

Clinicians who list this facility as an affiliation in Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1153267200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1769990400000",
    "number": "1194744235",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 428",
            "city": "JACKSON",
            "state": "WY",
            "postal_code": "830010428",
            "telephone_number": "307-739-7465",
            "fax_number": "307-739-7645"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "555 E BROADWAY AVE",
            "address_2": "STE 115",
            "city": "JACKSON",
            "state": "WY",
            "postal_code": "830018640",
            "telephone_number": "307-739-7465",
            "fax_number": "307-739-7645"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TETON COUNTY HOSPITAL DISTRICT",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "TETON COUNTY HOSPITAL DISTRICT",
        "enumeration_date": "2006-07-19",
        "last_updated": "2026-02-02",
        "certification_date": "2026-02-02",
        "status": "A",
        "authorized_official_last_name": "WATSON",
        "authorized_official_first_name": "MITCHELL",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "307-739-7526"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": "WY",
            "license": "15092",
            "primary": false
        },
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "WY",
            "license": "15092",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "106299902",
            "state": "WY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "106299908",
            "state": "WY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "St John's Home Care",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "St John's Home Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Jackson, WY

Sources for this page

Verify at the official NPI Registry.