Ivinson Memorial Hospital
Organization Active NPI Rural Acute Care Hospital · Laramie, WY
NPI 1336289552 · NPPES record last updated Jun 9, 2026
Key facts
- NPI
- 1336289552
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Rural Acute Care Hospital 282NR1301X
- License
- 07108 (WY)
- Legal business name
- IVINSON MEMORIAL HOSPITAL
- Practice address
- 255 N 30TH St
Laramie, WY 82072-5140 - Phone
- (307) 742-2142
- Fax
- (307) 742-0678
- NPI assigned
- Feb 7, 2007
- Organization subpart
- No
Authorized official
- Name
- James Bands
- Title
- Cfo
- Phone
- (307) 755-4603
Owners & managing parties with NPI records 4
Owned or controlled facilities with NPI records 2
Other NPIs with the same Medicare PAC ID 4
Corporate family (same tax ID) 6
Related certifications (CCN) 2
Facilities with the same owner 2
Practitioners 78
-
Molly Adami, DNP, FNP-C
-
Taylor N Baskin, PA-C
-
Candace Mae Burch, FNP
-
Bailey Johnson, M.D.
-
Jaycee Lyn Kline, MD
-
Lauren Carroll Munsell, DNP, FNP-C
-
Harold L. Pierce, MD
-
Philip Lerory Sanders III, FNP-C
-
Amy Diane Smith, NP
-
Ketura Talbot, M.D.
-
Nathan Valencia Still, D.O.
-
Kim Westbrook, M.D.
-
Burk Teal Young, M.D.
-
Sherry Dawn Byl, NP
-
Derek Allen Ewell, D.O.
-
Tyler Gallo, DO
-
Samantha Jo Herriott, D.O.
Affiliated clinicians 308
-
Molly Adami, DNP, FNP-C
-
Nicole N Alexander, PA-C
-
Taylor N Baskin, PA-C
-
Thomas A Bienz, MD
-
Emma Marie Bjore, M.D.
-
John F Bryant, M.D.
-
Candace Mae Burch, FNP
-
Donald Wesley Cain, M.D., M.S.
-
Tracie Caller, M.D.
-
Julie Ann Carlson, M.D.
-
Marten A Carlson, MD
-
Stephanie Chiu, M.D.
-
Chad Joseph Cooper, M.D.
-
Morgan Lee Corrington, FNP-BC
-
Robyn Dawn Curtis-Rice, APRN, FNP-C
-
Alexandru Petre David, M.D.
-
Sara Devine, PA
-
Christine Marie Dipompeo, M.D.
-
Bryan D Dugas, M.D.
-
Tara Dye, FNP-C
Medicare Care Compare: Hospital
- Listed as
- Ivinson Memorial Hospital
- Overall star rating
- ★★★☆☆ 3 of 5
- Type
- Acute Care Hospitals
- Ownership
- Government - Hospital District or Authority
- Medicare certification status
- Active
- Emergency services
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WY
Hospital certification: CCN 530025
- Legal name
- IVINSON MEMORIAL HOSPITAL
- Certification status
- Active
- Provider type (POS)
- Hospital – Short-term
- Participating since
- Jul 1, 1969
- Last certification
- Nov 7, 2011
- Beds
- 99
- Ownership / control type
- Hospital district or authority
- Most recent change of ownership
- Jan 1, 2018 (3 total)
- Organization structure
- Corporation · Non-profit
- Incorporated
- Mar 18, 2017 in WY
- Enrollment address
- 255 N 30TH St
Laramie, WY 82072-5140 - Hospital subgroups
- Acute care
All disclosed owners & managing parties 10
| Name | Role | Since | Share |
|---|---|---|---|
| Catie Ballard |
Corporate Officer | Oct 1, 2024 | 10% |
| James G Bands |
Corporate Officer |
Jan 1, 2018 | 15% |
| Operational/Managerial Control |
Jan 1, 2018 | 20% | |
| Brad Jackson |
Corporate Officer |
Mar 25, 2019 | 10% |
| Andrea Lewis |
W-2 Managing Employee |
Jan 1, 2018 | 5% |
| Doug Faus |
Corporate Officer |
Jan 1, 2018 | 20% |
| Gary Crum |
Corporate Officer |
Mar 24, 2019 | 10% |
| Joseph F Steiner |
Corporate Officer |
Mar 25, 2019 | 10% |
| Ivinson Memorial Hospital |
5% Or Greater Direct Ownership Interest | Jan 1, 2018 | 100% |
| Rick Melone |
Corporate Officer | Oct 1, 2024 | 10% |
| Pamela Dunnuck |
Corporate Officer | Jan 1, 2024 | 10% |
All facility ownership & control disclosures 2
| Facility | Type | Role | Since |
|---|---|---|---|
| Ivinson Memorial Hospital |
Hospital | 5% Or Greater Direct Ownership Interest (100%) | Jan 1, 2018 |
| Ivinson Memorial Hospital |
Hospital | 5% Or Greater Direct Ownership Interest (100%) | Jan 1, 2018 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20171107000723 | WY | Part a Provider - Hospital | 8325304447 | Practice locations: Laramie, WY |
National Provider Directory
- Tax ID family
- Ivinson Memorial Hospital
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Acute Care Hospital | 282N00000X | |||
| Rural Acute Care Hospital | 282NR1301X | 07108 | WY | Yes |
Addresses
Primary practice location
255 N 30TH St
Laramie, WY 82072-5140
Mailing address
255 N 30TH St
Laramie, WY 82072-5140
Phone (307) 742-2142
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00710001 | Other | WY | BCBS PROFESSIONAL |
| 107332001 | Medicaid | WY | |
| 107332008 | Medicaid | WY | |
| 836000188 | Other | WY | CHAMPUS |
| 836000188 | Other | WY | UNITED HEALTHCARE |
| 007153 | Other | WY | BCBS - INSTITUTIONAL |
| 107332002 | Medicaid | WY | |
| 836000188 | Other | WY | GREAT WEST - WYOMING |
| W4251905 | Other | WY | PTAN FOR PART B |
| 107332000 | Medicaid | WY | |
| 107332003 | Medicaid | WY | |
| 95682704 | Medicaid | CO |
Other providers in Laramie, WY
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- Ivinson Memorial Hospital
- Ivinson Memorial Hospital
- Ivinson Memorial Hospital
All providers in Laramie, WY · Rural Acute Care 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 Jun 9, 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.