Active NPI
West Park Hospital District
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- Cody, WY
National Provider Identifier
1295815744
On this page
Key facts
NPPES NPI Registry- Primary specialty
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- License
- 06-003
- Legal business name
- WEST PARK HOSPITAL DISTRICT
- Practice address
- 707 Sheridan Ave
Cody, WY 82414-3409 - Phone
- (307) 527-7501
- Fax
- (307) 578-2485
- NPI assigned
- Oct 17, 2006
- Organization subpart
- Yes
- Parent organization
- WEST PARK HOSPITAL DISTRICT
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dougals Alan McMillan
- Title
- Ceo
- Phone
- (307) 578-2489
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| End-Stage Renal Disease (ESRD) Treatment Clinic/Center | 261QE0700X | 06-003 | WY | Primary |
Addresses
Primary practice location
707 Sheridan Ave
Cody, WY 82414-3409
Mailing address
707 Sheridan Ave
Cody, WY 82414-3409
Phone (307) 527-7501
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 007062 | Other | WY | BLUE CROSS |
| 106133005 | Medicaid | WY | |
| 041794 | Other | WY | BLUE CROSS |
Other names 1
- Dialysis
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WY
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040127000865 | WY | Part B Supplier - Clinic/Group Practice | 7315855624 |
Receives reassigned benefits from 197 practitioners 4 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Powell, WY; Worland, WY; Thermopolis, WY; Meeteetse, WY; Cody, WY; Lovell, WY; Basin, WY |
Other NPIs on the same Medicare enrollment 4
NPIs listed together on one Medicare enrollment, typically parts of the same organization.
National Provider Directory
National Provider Directory- Part of
- John L Noyes MD
Member of 1
Organizations this organization is a member of, according to the National Provider Directory.
Networks
- Freedom Health HMO Network
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161043200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1613606400000",
"number": "1295815744",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "707 SHERIDAN AVE",
"city": "CODY",
"state": "WY",
"postal_code": "824143409",
"telephone_number": "307-527-7501",
"fax_number": "307-578-2485"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "707 SHERIDAN AVE",
"city": "CODY",
"state": "WY",
"postal_code": "824143409",
"telephone_number": "307-527-7501",
"fax_number": "307-578-2485"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "WEST PARK HOSPITAL DISTRICT",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "WEST PARK HOSPITAL DISTRICT",
"enumeration_date": "2006-10-17",
"last_updated": "2021-02-18",
"certification_date": "2021-02-18",
"status": "A",
"authorized_official_last_name": "MCMILLAN",
"authorized_official_first_name": "DOUGALS",
"authorized_official_middle_name": "ALAN",
"authorized_official_title_or_position": "CEO",
"authorized_official_telephone_number": "307-578-2489"
},
"taxonomies": [
{
"code": "261QE0700X",
"taxonomy_group": "",
"desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
"state": "WY",
"license": "06-003",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS",
"identifier": "007062",
"state": "WY"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "106133005",
"state": "WY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS",
"identifier": "041794",
"state": "WY"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Dialysis",
"code": "5",
"type": "Other Name"
},
{
"organization_name": "Dialysis",
"code": "5",
"type": "Other Name"
}
]
}Other providers in Cody, WY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.