NPIMap

Organization Active NPI

South Lyon Health Center, Inc.

Doing business as South Lyon Medical Center

  • Medicare Defined Swing Bed Hospital Unit
  • Yerington, NV
National Provider Identifier
1285008219
Registry record updated Jan 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medicare Defined Swing Bed Hospital UnitTaxonomy code 275N00000X
Legal business name
SOUTH LYON HEALTH CENTER, INC.
Doing business as
South Lyon Medical Center
Practice address
213 S Whitacre St
Yerington, NV 89447-2561
Phone
(775) 463-2301
NPI assigned
Nov 13, 2015
Last updated
Jan 17, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 17, 2020

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

Authorized official

Name
Toni A Inserra, CEO
Title
Administrator
Phone
(775) 463-6404

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medicare Defined Swing Bed Hospital Unit 275N00000X Primary

Addresses

Primary practice location

213 S Whitacre St
Yerington, NV 89447-2561

Mailing address

213 S Whitacre St
Yerington, NV 89447-2561
Phone (775) 463-2301

Other names 1

  • South Lyon Medical Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160113003066 NV Part A Provider - Critical Access Hospital 0648178533 Receives reassigned benefits from 1 practitioner
Practice locations: Yerington, NV

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1285008219. Details of each certification follow.

Hospital certification: CCN 29Z314

Legal name
SOUTH LYON HEALTH CENTER INC
Doing business as
SOUTH LYON MEDICAL CENTER
Organization structure
CorporationNon-profit
Incorporated
Jan 5, 1991 in NV
Enrollment address
213 S Whitacre St
Yerington, NV 89447-2561
Hospital Swing-Bed Unit

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

Other NPIs with the same Medicare PAC ID 5

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

National Provider Directory

National Provider Directory
Tax ID family
South Lyon Medical Cent12 organizations share this tax ID, including this one

Other organizations with this tax ID 11

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

Ownership & related parties

All disclosed owners & managing parties 7

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

NameRoleSinceShare
John Diekmann Individual Corporate DirectorBoard Member May 1, 2009
Robert Rowley Individual Corporate DirectorBoard President Aug 1, 2015
Alyce Reese Individual Corporate DirectorBoard Member Jun 1, 2018
Dale Theiss Individual Corporate DirectorBoard Member Dec 1, 2017
Toni a Inserra Individual Corporate Officer Jul 31, 2013 100%
W-2 Managing EmployeeCeo Jul 31, 2013 100%
Kylee Fowler Individual W-2 Managing EmployeeMedical Staff Coordinator Mar 14, 2022
Emily Christensen Individual Corporate DirectorBoard Member Aug 1, 2022

All facility ownership & control disclosures 1

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

FacilityTypeRoleSince
South Lyon Medical CenterYerington, NV, CCN 295011 Skilled nursing facility Operational/Managerial Control (100%) Jan 5, 1990

Owned or controlled facilities with NPI records 1

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

Practitioners & affiliated clinicians

Practitioners 53

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.

View all 53

Affiliated clinicians 1

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": "1447372800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1579219200000",
    "number": "1285008219",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "213 S WHITACRE ST",
            "city": "YERINGTON",
            "state": "NV",
            "postal_code": "894472561",
            "telephone_number": "775-463-2301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "213 S WHITACRE ST",
            "city": "YERINGTON",
            "state": "NV",
            "postal_code": "894472561",
            "telephone_number": "775-463-2301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH LYON HEALTH CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-11-13",
        "last_updated": "2020-01-17",
        "certification_date": "2020-01-17",
        "status": "A",
        "authorized_official_last_name": "INSERRA",
        "authorized_official_first_name": "TONI",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "775-463-6404",
        "authorized_official_credential": "CEO"
    },
    "taxonomies": [
        {
            "code": "275N00000X",
            "taxonomy_group": "",
            "desc": "Medicare Defined Swing Bed Unit",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "South Lyon Medical Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "South Lyon Medical Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Yerington, NV

Sources for this page

Verify at the official NPI Registry.