Washakie Medical Center
Organization Active NPI Critical Access Hospital · Worland, WY
NPI 1255368593 · NPPES record last updated Apr 3, 2026
Key facts
- NPI
- 1255368593
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Critical Access Hospital 282NC0060X
- License
- 06196 (WY)
- 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
- Organization subpart
- Yes
- Parent organization (as reported)
- BANNER HEALTH
Authorized official
- Name
- Lisa Van Brunt
- Title
- Ceo
- Phone
- (307) 347-3221
Parent organization (reported in NPPES) 1
Owners & managing parties with NPI records 12
-
Marjorie Bessel, MD
Other NPIs with the same Medicare PAC ID 1
Member of 1
Related certifications (CCN) 1
Facilities with the same owner 59
Practitioners 64
-
John M. Bramble, MD
-
Megan Kirch, M.D.
-
Kevin James Ryan, CRNA
-
Andrew B Baker, CRNA
-
Ronald Lee Burinsky, D.O.
-
Ryan T Clifford, M.D.
-
Marvin Wayne Couch II, M.D.
-
Adam C Crawford, RN
-
Tyler Lee Dickey, M.D.
-
Adam Lee Fieber, CRNA
-
Mark A Flinner, MD
-
Whitney Elizabeth Hine, M.D.
-
Craig Lauer, MD
-
Matthew Mullinix, CRNA
-
Kari Sack, CRNA
-
Jan K. Siebersma, M.D.
Affiliated clinicians 95
-
Brett J Argeris, PAC
-
Andrew B Baker, CRNA
-
Nina Beach, FNP
-
Jimmie G Biles Jr., M.D.
-
Hallie Yvonne Bischoff, D.O.
-
Wade Travis Bomengen, M.D.
-
Adair M. Bowlby, MD
-
John M. Bramble, MD
-
Linsey Kaye Brooks, WHNP-BC, FNP-C
-
Jeremiah Cannon, FNP
-
Andrea Chisholm, MD
-
Adam C Crawford, RN
-
Shawn William Ficken, PA-C
-
Mark A Flinner, MD
-
Whitney Elizabeth Hine, M.D.
-
Nicole C Jamieson, D.O
Medicare Care Compare: Hospital
- Listed as
- Washakie Medical Center
- Overall star rating
- ★★★★☆ 4 of 5
- Type
- Critical Access Hospitals
- Ownership
- Government - Local
- Medicare certification status
- Active
- Emergency services
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in WY
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 · Non-profit
- Enrollment address
- 400 S 15TH St
Worland, WY 82401-3531
All disclosed owners & managing parties 23
| 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% |
Medicare enrollment records
| 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 |
National Provider Directory
- Part of
- M E Lee MD
Locations
400 S 15th St
Worland, WY 82401
Phone (307) 347-3221
403 S 15th St
Worland, WY 82401
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Critical Access Hospital | 282NC0060X | 06196 | WY | Yes |
Addresses
Primary practice location
400 S 15TH St
Worland, WY 82401-3531
Mailing address
2901 N Central Ave Ste 160
Phoenix, AZ 85012-2702
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 106535100 | Medicaid | WY | |
| 106535101 | Medicaid | WY |
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | https://esmd.officeally.io:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service | Other | Bluemark LLC / Office Ally |
Other providers in Worland, WY
- Danielle Warren
- Timothy Warren
- Washakie County Senior Citizens Center
- Washakie Family Planning
- Washakie Medical Center
- Washakie Medical Center
- Washakie Medical Center
- Charles Wassum
- Dale Adam Weber
- Kenzi L Weddle
All providers in Worland, WY · Critical Access Hospital in Wyoming
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 3, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.