NPIMap

Organization Active NPI

Central Wyoming Hospice Program

  • Community Based Hospice Care Agency
  • Casper, WY
National Provider Identifier
1295725976
Registry record updated Jan 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
License
06 160 Issued in WY
Legal business name
CENTRAL WYOMING HOSPICE PROGRAM
Practice address
319 S Wilson St
Casper, WY 82601-2943
Phone
(307) 577-4832
Fax
(307) 577-4841
NPI assigned
Oct 25, 2005
Last updated
Jan 28, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2020

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

Authorized official

Name
Kilty Brown
Title
Executive Director
Phone
(307) 577-4832

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Based Hospice Care Agency 251G00000X 06 160 WY Primary

Addresses

Primary practice location

319 S Wilson St
Casper, WY 82601-2943

Mailing address

319 S Wilson St
Casper, WY 82601-2943
Phone (307) 577-4832

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20030804000024 WY Part A Provider - Hospice 8123939832 Practice locations: Casper, WY

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1295725976. Details of each certification follow.

Hospice certification: CCN 531501

Legal name
CENTRAL WYOMING HOSPICE PROGRAM
Doing business as
CENTRAL WYOMING HOSPICE & TRANSITIONS
Certification status
Active
Provider type (POS)
Hospice
Participating since
Jan 6, 1992
Last certification
Feb 13, 2020
Ownership / control type
Non-Profit - Private
Organization structure
CorporationNon-profit
Incorporated
Sep 20, 1980 in WY
Enrollment address
319S Wilson St
Casper, WY 82601-2943

Care Compare: Hospice

Medicare Care Compare
Listed as
Central Wyoming Hospice ProgramCCN 531501 · All quality measures
Ownership
Non-Profit
Certified
Jan 6, 1992
Medicare certification status
ActiveFrom the Provider of Services file

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
53D2230824Central Wyoming Hospice Program319 S Wilson St, Casper, WY 82601Certificate of waiverJul 27, 2027

National Provider Directory

National Provider Directory

Member organizations 2

Organizations listed as members of this organization in the National Provider Directory.

Locations

319 S Wilson St
Casper, WY 82601
Phone (307) 258-6672

Ownership & related parties

All disclosed owners & managing parties 6

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

NameRoleSinceShare
Lisa Mathiowetz Individual W-2 Managing EmployeeController Jul 1, 2015
Larry a Kloster Individual Corporate OfficerPresident Jan 1, 2022
Joan Means Individual Other Jan 1, 2022
Joseph K Schoeber Individual Contracted Managing EmployeeMD; Jun 1, 2003
Stuart Atnip Individual Other Jan 1, 2018
Kilty Brown Individual W-2 Managing EmployeeAd; Jun 18, 2017

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Practitioners & affiliated clinicians

Practitioners 2

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.

Affiliated clinicians 15

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1130198400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1580169600000",
    "number": "1295725976",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "319 S WILSON ST",
            "city": "CASPER",
            "state": "WY",
            "postal_code": "826012943",
            "telephone_number": "307-577-4832",
            "fax_number": "307-577-4841"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "319 S WILSON ST",
            "city": "CASPER",
            "state": "WY",
            "postal_code": "826012943",
            "telephone_number": "307-577-4832",
            "fax_number": "307-577-4841"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTRAL WYOMING HOSPICE PROGRAM",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-25",
        "last_updated": "2020-01-28",
        "certification_date": "2020-01-28",
        "status": "A",
        "authorized_official_last_name": "BROWN",
        "authorized_official_first_name": "KILTY",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "307-577-4832"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "WY",
            "license": "06 160",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Casper, WY

Sources for this page

Verify at the official NPI Registry.