NPIMap

Organization Active NPI

Teton County Hospital District

  • Skilled Nursing Facility
  • Jackson, WY
National Provider Identifier
1215064985
Registry record updated Nov 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
TETON COUNTY HOSPITAL DISTRICT
Practice address
625 E Broadway Ave BLDG B
Jackson, WY 83001-8642
Phone
(307) 739-7450
Fax
(307) 739-7344
NPI assigned
Feb 28, 2007
Organization subpart
Yes
Parent organization
TETON COUNTY HOSPITAL DISTRICTAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 25, 2025

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

Authorized official

Name
Jeffrey Sollis
Title
Chief Executive Officer
Phone
(307) 739-7525

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X Primary

Addresses

Primary practice location

625 E Broadway Ave BLDG B
Jackson, WY 83001-8642

Mailing address

PO Box 428
Jackson, WY 83001-0428
Phone (307) 739-7450

Other identifiers 1

IdentifierTypeStateIssuer
106299901MedicaidWY

Other names 1

  • St John's Health Sage Living Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090603000462 WY Part A Provider - Skilled Nursing Facility 4880582295 Practice locations: Jackson, WY

Skilled nursing facility certification: CCN 535046

Legal name
TETON COUNTY HOSPITAL DISTRICT
Doing business as
ST JOHNS HEALTH SAGE LIVING
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Dec 7, 1991
Last certification
May 8, 2025
Beds
60
Ownership / control type
Hospital District
Organization structure
GovernmentNon-profit
Enrollment address
625 E Broadway Ave
BLDG B
Jackson, WY 83001-8642
Nursing home name
ST JOHN'S HEALTH SAGE LIVING

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: Nursing home

Medicare Care Compare
Listed as
St John's Health Sage LivingCCN 535046
Overall star rating
5 of 5
Health inspections
5 of 5
Staffing
5 of 5
Quality measures
5 of 5
Type
Medicare and Medicaid
Ownership
Government - Hospital district
Certified
Dec 7, 1991
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
6049.5 residents per day on average

Processed by Care Compare on Aug 1, 2026.

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.

Ownership & related parties

All disclosed owners & managing parties 12

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

NameRoleSinceShare
Kathleen a Vanier Individual Operational/Managerial Control Jan 17, 2022
Adp of the SNF Feb 18, 2025
Brent a Blue Individual Operational/Managerial Control Nov 5, 2022
Trustee of the SNF Nov 5, 2022
Adp of the SNF Nov 5, 2022
Pamela V Cutler Individual Operational/Managerial Control Jan 1, 2022
Trustee of the SNF Nov 5, 2022
Adp of the SNF Nov 5, 2022
Bruce M Hayse Individual Operational/Managerial Control Nov 5, 2008
Trustee of the SNF Nov 5, 2008
Adp of the SNF Nov 5, 2008
Shannon Brennan Individual Operational/Managerial Control Nov 5, 2024
Trustee of the SNF Jan 1, 2022
Adp of the SNF Nov 5, 2024
Jeffrey W Sollis Individual Operational/Managerial Control Jan 3, 2023
Adp of the SNF Jan 3, 2023
Seth Robertson Individual Operational/Managerial Control Oct 22, 2021
Adp of the SNF Feb 18, 2025
Teton County Hospital District Organization Adp of the SNF Mar 13, 2025
John J Kren Individual Operational/Managerial Control Jan 1, 2009
Adp of the SNF Jan 1, 2009
Katharine Conover-Keller Individual Operational/Managerial Control Jan 1, 2022
Trustee of the SNF Jan 1, 2022
Adp of the SNF Jan 1, 2022
William Hogland Individual Operational/Managerial Control Nov 5, 2024
Trustee of the SNF Jan 1, 2022
Adp of the SNF Nov 5, 2022
James K Hunt Individual Operational/Managerial Control Feb 1, 2023
Trustee of the SNF Feb 1, 2023
Adp of the SNF Feb 1, 2023

Owners & managing parties with NPI records 8

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. John'S Home CareJackson, WY, CCN 537063 Home health agency Operational/Managerial Control (100%) Apr 27, 2010
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.

Practitioners & affiliated clinicians

Practitioners 107

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

View all 107

NPI Registry JSON

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

{
    "created_epoch": "1172620800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1764028800000",
    "number": "1215064985",
    "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": "307-739-7450",
            "fax_number": "307-739-7344"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "625 E BROADWAY AVE BLDG B",
            "city": "JACKSON",
            "state": "WY",
            "postal_code": "830018642",
            "telephone_number": "307-739-7450",
            "fax_number": "307-739-7344"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TETON COUNTY HOSPITAL DISTRICT",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "TETON COUNTY HOSPITAL DISTRICT",
        "enumeration_date": "2007-02-28",
        "last_updated": "2025-11-25",
        "certification_date": "2025-11-25",
        "status": "A",
        "authorized_official_last_name": "SOLLIS",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "307-739-7525"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "106299901",
            "state": "WY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "St John's Health Sage Living",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Jackson, WY

Sources for this page

Verify at the official NPI Registry.