NPIMap

Organization Active NPI

Crook County Medical Services District

  • Family Medicine Physician
  • Sundance, WY
National Provider Identifier
1245308428
Registry record updated May 6, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
CROOK COUNTY MEDICAL SERVICES DISTRICT
Practice address
713 Oak Street
Sundance, WY 82729
Phone
(307) 283-3501
Fax
(307) 283-2255
NPI assigned
Dec 4, 2006
Organization subpart
Yes
Parent organization
CROOK COUNTY MEDICAL SERVICES DISTRICTAs reported in NPPES

NPPES NPI Registry

Updated by the provider on May 6, 2026

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

Authorized official

Name
Micki Dahne Lyons, DNPNPI 1023445459
Title
Ceo
Phone
(307) 283-3501

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
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary
Rural Health Clinic/Center 261QR1300X

Addresses

Primary practice location

713 Oak Street
Sundance, WY 82729

Mailing address

PO Box 517
713 Oak Street
Sundance, WY 82729-0517
Phone (307) 283-3501

Other identifiers 2

IdentifierTypeStateIssuer
106178006MedicaidWY
106178004MedicaidWY

Other names 1

  • Sundance Clinic Other name

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040127001018 WY Part B Supplier - Clinic/Group Practice 9234032483 Receives reassigned benefits from 13 practitioners
4 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Hulett, WY; Moorcroft, WY; Sundance, WY
O20120229000661 WY Part A Provider - Rural Health Clinic 9234032483 Practice locations: Sundance, WY

Rural health clinic certification: CCN 533976

Legal name
CROOK COUNTY MEDICAL SERVICES DISTRICT
Doing business as
SUNDANCE CLINIC
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Aug 24, 1994
Last certification
Oct 2, 2018
Ownership / control type
2B
Organization structure
CorporationNon-profit
Enrollment address
713 E Oak St
Sundance, WY 82729-5172
Related CCNs
531311

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

Other NPIs with the same Medicare PAC ID 4

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

Other NPIs on the same Medicare enrollment 4

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Crook Co Memorial Hosp6 organizations share this tax ID, including this one
Part of
Crook Co Memorial Hosp

Other organizations with this tax ID 5

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

Locations

165 Cambridge St
Ste 302
Boston, MA 02114
Phone (617) 724-1501

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
Micki D Lyons Individual Corporate Director May 1, 2020
W-2 Managing EmployeeClinic Manager Jun 1, 2016
Alayna Marten Individual Corporate OfficerCfo Jul 1, 2017
Sandra Neiman Individual 5% Or Greater Direct Ownership Interest Nov 1, 2010
Corporate DirectorTrustee Nov 1, 2010
Crook County Medical Services District Organization, Sundance, WY Corporation 5% Or Greater Direct Ownership Interest Jun 26, 1995 100%

Owners & managing parties with NPI records 5

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
Crook County Medical Services DistrictSundance, WY, CCN 531311 Hospital Operational/Managerial Control May 14, 1999
Crook County Medical Services DistrictSundance, WY, CCN 53Z311 Hospital Operational/Managerial Control Nov 23, 2015

Owned or controlled facilities with NPI records 1

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

Facilities with the same owner 1

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

Practitioners & affiliated clinicians

Practitioners 16

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

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1165190400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1778025600000",
    "number": "1245308428",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 517",
            "address_2": "713 OAK STREET",
            "city": "SUNDANCE",
            "state": "WY",
            "postal_code": "827290517",
            "telephone_number": "307-283-3501",
            "fax_number": "307-283-2255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "713 OAK STREET",
            "city": "SUNDANCE",
            "state": "WY",
            "postal_code": "82729",
            "telephone_number": "307-283-3501",
            "fax_number": "307-283-2255"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CROOK COUNTY MEDICAL SERVICES DISTRICT",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CROOK COUNTY MEDICAL SERVICES DISTRICT",
        "enumeration_date": "2006-12-04",
        "last_updated": "2026-05-06",
        "certification_date": "2026-05-06",
        "status": "A",
        "authorized_official_last_name": "LYONS",
        "authorized_official_first_name": "MICKI",
        "authorized_official_middle_name": "DAHNE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "307-283-3501",
        "authorized_official_credential": "DNP"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "106178006",
            "state": "WY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "106178004",
            "state": "WY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sundance Clinic",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Sundance Clinic",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Sundance, WY

Sources for this page

Verify at the official NPI Registry.