NPIMap

Organization Active NPI

North Lincoln County Hospital District

  • Ambulance
  • Afton, WY
National Provider Identifier
1285657007
Registry record updated Jan 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
AmbulanceTaxonomy code 341600000X
License
01 Issued in WY
Legal business name
NORTH LINCOLN COUNTY HOSPITAL DISTRICT
Practice address
901 Adams
Afton, WY 83110-0579
Phone
(307) 885-5800
Fax
(307) 885-5865
NPI assigned
Jul 25, 2006
Last updated
Jan 12, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 12, 2021

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

Authorized official

Name
Deirdre Hebdon
Title
Credentialing Specialist
Phone
(307) 885-5811

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulance 341600000X 01 WY Primary

Addresses

Primary practice location

901 Adams
Afton, WY 83110-0579

Mailing address

PO Box 579
Afton, WY 83110-0579
Phone (307) 885-5800

Other identifiers 3

IdentifierTypeStateIssuer
1285657007MedicaidWY
1255376406MedicaidWY
1285657007OtherWYMEDICARE

Other names 2

  • Star Valley Health-EMS Other name
  • Star Valley Medical Center EMTs Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090702000373 WY Part B Supplier - Ambulance Service Supplier 4789580218 Practice locations: Afton, WY

Other NPIs with the same Medicare PAC ID 3

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

National Provider Directory

National Provider Directory
Tax ID family
North Lincoln Cty Hosp Dist3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

Ownership & related parties

All facility ownership & control disclosures 3

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

FacilityTypeRoleSince
Star Valley HealthAfton, WY, CCN 531313 Hospital 5% Or Greater Direct Ownership Interest Oct 15, 1999
Star Valley HealthAfton, WY, CCN 53Z313 Hospital Other (100%) Dec 15, 2011
Star Valley Care CenterAfton, WY, CCN 535059 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Oct 13, 2006

Owned or controlled facilities with NPI records 2

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

Practitioners & affiliated clinicians

Practitioners 9

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.

NPI Registry JSON

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

{
    "created_epoch": "1153785600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1610409600000",
    "number": "1285657007",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 579",
            "city": "AFTON",
            "state": "WY",
            "postal_code": "831100579",
            "telephone_number": "307-885-5800",
            "fax_number": "307-885-5865"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 ADAMS",
            "city": "AFTON",
            "state": "WY",
            "postal_code": "831100579",
            "telephone_number": "307-885-5800",
            "fax_number": "307-885-5865"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH LINCOLN COUNTY HOSPITAL DISTRICT",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-25",
        "last_updated": "2021-01-12",
        "certification_date": "2021-01-12",
        "status": "A",
        "authorized_official_last_name": "HEBDON",
        "authorized_official_first_name": "DEIRDRE",
        "authorized_official_title_or_position": "CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "307-885-5811"
    },
    "taxonomies": [
        {
            "code": "341600000X",
            "taxonomy_group": "",
            "desc": "Ambulance",
            "state": "WY",
            "license": "01",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1285657007",
            "state": "WY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1255376406",
            "state": "WY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "1285657007",
            "state": "WY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Star Valley Health-EMS",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Star Valley Medical Center EMTs",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Afton, WY

Sources for this page

Verify at the official NPI Registry.