Active NPI
Washakie Medical Center
- Critical Access Hospital
- Worland, WY
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Critical Access Hospital
- License
- 06196
- Legal business name
- WASHAKIE MEDICAL CENTER
- Practice address
- 400 S 15TH St
Worland, WY 82401-3531 - Phone
- (307) 347-3221
- NPI assigned
- Jun 26, 2006
- Last updated
- Apr 3, 2026
- 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
- Lisa Van Brunt
- Title
- Ceo
- Phone
- (307) 347-3221
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Critical Access Hospital | 282NC0060X | 06196 | WY | Primary |
Addresses
Primary practice location
400 S 15TH St
Worland, WY 82401-3531
Mailing address
2901 N Central Ave Ste 160
Phoenix, AZ 85012-2702
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | https://esmd.officeally.io:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service | Other | Bluemark LLC / Office Ally |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WY
Enrollment records 2
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040312000646 | WY | Part B Supplier - Clinic/Group Practice | 2466369301 |
Receives reassigned benefits from 38 practitioners Practice locations: Worland, WY |
| O20061104000309 | WY | Part A Provider - Critical Access Hospital | 2466369301 |
Receives reassigned benefits from 45 practitioners Practice locations: Worland, WY |
NPI to CCN mapping 1
The Medicare certification numbers (CCNs) connected to NPI 1255368593. Details of each certification follow.
Hospital certification: CCN 531306
- Legal name
- WASHAKIE MEDICAL CENTER
- Certification status
- Active
- Provider type (POS)
- Hospital – Critical access hospital
- Participating since
- Jan 1, 2003
- Last certification
- Aug 24, 2023
- Beds
- 25
- Ownership / control type
- Local
- Organization structure
- Corporation
- Enrollment address
- 400 S 15TH St
Worland, WY 82401-3531
Related certifications (CCN) 1
Facilities connected through Provider of Services related, parent or unit certification numbers.
-
- Medicare Defined Swing Bed Hospital Unit
- Worland, WY
- NPI 1366594988
Other NPIs with the same Medicare PAC ID 1
NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).
-
- Medicare Defined Swing Bed Hospital Unit
- Worland, WY
- NPI 1366594988
2466369301
Care Compare: Hospital
Medicare Care Compare- Listed as
- Washakie Medical Center
- Overall star rating
- Type
- Critical Access Hospitals
- Ownership
- Government - Local
- Medicare certification status
- Active
- Emergency services
- Yes
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
401 S 15th St
Worland, WY 82401
Phone (307) 347-2525
Ownership & related parties
All disclosed owners & managing parties 23
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 | |
| Lisa Van Brunt | Corporate Director | Jan 21, 2024 | |
| W-2 Managing Employee | Jan 21, 2024 | ||
| Marjorie J Bessel | Corporate Officer | Jan 1, 2018 | |
| Jean Lance | Corporate Officer | Jun 30, 2022 | |
| 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 | Jun 1, 2017 | |
| 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, 2003 | 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
-
dba Banner Casa Grande Medical Center
- General Acute Care Hospital
- Casa Grande, AZ
- NPI 1003232976
5% Or Greater Direct Ownership Interest
-
dba Banner Payson Medical Center
- Critical Access Hospital
- Payson, AZ
- NPI 1063923340
5% Or Greater Direct Ownership Interest
-
dba Banner Payson Medical Center - Banner Health Clinic Payson
- Rural Health Clinic/Center
- Payson, AZ
- NPI 1073223012
5% Or Greater Direct Ownership Interest
-
- Multi-Specialty Clinic/Center
- Susanville, CA
- NPI 1205267549
5% Or Greater Direct Ownership Interest
-
dba Banner Payson Medical Center - Banner Health Clinic Pine
- Rural Health Clinic/Center
- Pine, AZ
- NPI 1245940287
5% Or Greater Direct Ownership Interest
-
dba Banner Hospice of Northern Colorado
- Community Based Hospice Care Agency
- Greeley, CO
- NPI 1407409964
5% Or Greater Direct Ownership Interest
-
- Radiology Clinic/Center
- Susanville, CA
- NPI 1427740570
5% Or Greater Direct Ownership Interest
-
dba Banner Fort Collins Medical Center
- General Acute Care Hospital
- Fort Collins, CO
- NPI 1659787554
5% Or Greater Direct Ownership Interest
-
dba Banner Payson Medical Center
- Medicare Defined Swing Bed Hospital Unit
- Payson, AZ
- NPI 1861077414
5% Or Greater Direct Ownership Interest
-
dba Banner Ocotillo Medical Center
- General Acute Care Hospital
- Chandler, AZ
- NPI 1972139004
5% Or Greater Direct Ownership Interest
Facilities with the same owner 59
Facilities that share an organizational owner with 5% or greater ownership or operational control.
-
- Medicare Defined Swing Bed Hospital Unit
- Torrington, WY
- NPI 1356493068
Banner Health
-
- Medicare Defined Swing Bed Hospital Unit
- Wheatland, WY
- NPI 1457403073
Banner Health
-
- Medicare Defined Swing Bed Hospital Unit
- Worland, WY
- NPI 1366594988
Banner Health
-
- Psychiatric Hospital Unit
- Phoenix, AZ
- NPI 1629122171
Banner Health
-
- General Acute Care Hospital
- Phoenix, AZ
- NPI 1841224870
Banner Health
-
- General Acute Care Hospital
- Tucson, AZ
- NPI 1558759498
Banner Health
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 64
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.
-
- Diagnostic Radiology Physician
- Worland, WY
- NPI 1588662951
-
- Emergency Medicine Physician
- Worland, WY
- NPI 1689963597
-
- Certified Registered Nurse Anesthetist
- Worland, WY
- NPI 1649610205
-
- Certified Registered Nurse Anesthetist
- Thermopolis, WY
- NPI 1225146327
-
- Emergency Medicine Physician
- Worland, WY
- NPI 1184935041
-
- Certified Registered Nurse Anesthetist
- Thermopolis, WY
- NPI 1134227200
-
- Family Medicine Physician
- Thermopolis, WY
- NPI 1336637529
-
- Certified Registered Nurse Anesthetist
- Powell, WY
- NPI 1396734687
-
- Emergency Medicine Physician
- Basin, WY
- NPI 1497775100
-
- Surgery Physician
- Worland, WY
- NPI 1033174198
-
- Family Medicine Physician
- Cheyenne, WY
- NPI 1942730080
-
- Personal Emergency Response Attendant
- Worland, WY
- NPI 1295773505
Affiliated clinicians 95
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": "1151280000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1775174400000",
"number": "1255368593",
"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": "400 S 15TH ST",
"city": "WORLAND",
"state": "WY",
"postal_code": "824013531",
"telephone_number": "307-347-3221"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "WASHAKIE MEDICAL CENTER",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "BANNER HEALTH",
"enumeration_date": "2006-06-26",
"last_updated": "2026-04-03",
"certification_date": "2026-04-03",
"status": "A",
"authorized_official_last_name": "VAN BRUNT",
"authorized_official_first_name": "LISA",
"authorized_official_title_or_position": "CEO",
"authorized_official_telephone_number": "307-347-3221"
},
"taxonomies": [
{
"code": "282NC0060X",
"taxonomy_group": "",
"desc": "General Acute Care Hospital, Critical Access",
"state": "WY",
"license": "06196",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "https://esmd.officeally.io:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
"affiliation": "Y",
"endpointDescription": "2.16.840.1.113883.3.2019.3",
"affiliationName": "Bluemark LLC / Office Ally",
"use": "OTHER",
"useDescription": "Other",
"useOtherDescription": "CMS esMD eMDR",
"address_1": "1300 SE Cardinal Ct Ste 190",
"city": "Vancouver",
"state": "WA",
"country_code": "US",
"postal_code": "986839683",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Worland, WY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2026; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.