NPIMap

Organization Active NPI

Ivinson Memorial Hospital

  • Rural Acute Care Hospital
  • Laramie, WY
National Provider Identifier
1336289552
Registry record updated Jun 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Acute Care HospitalTaxonomy code 282NR1301X
License
07108 Issued in 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
Last updated
Jun 9, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2026

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

Authorized official

Name
James Bands
Title
Cfo
Phone
(307) 755-4603

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Acute Care Hospital 282N00000X
Rural Acute Care Hospital 282NR1301X 07108 WY Primary

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

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20171107000723 WY Part A Provider - Hospital 8325304447 Practice locations: Laramie, WY

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1336289552. Details of each certification follow.

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
CorporationNon-profit
Incorporated
Mar 18, 2017 in WY
Enrollment address
255 N 30TH St
Laramie, WY 82072-5140
Other Hospital Practice Location
Hospital subgroups
Acute care

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

Other NPIs with the same Medicare PAC ID 4

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

Care Compare: Hospital

Medicare Care Compare
Listed as
Ivinson Memorial HospitalCCN 530025 · All quality measures
Overall star rating
3 of 5
Type
Acute Care Hospitals
Ownership
Government - Hospital District or Authority
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory
Tax ID family
Ivinson Memorial Hospital7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

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

Ownership & related parties

All disclosed owners & managing parties 10

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

NameRoleSinceShare
Catie Ballard Individual Corporate Officer Oct 1, 2024 10%
James G Bands Individual Corporate OfficerCfo Jan 1, 2018 15%
Operational/Managerial ControlCfo Jan 1, 2018 20%
Brad Jackson Individual Corporate OfficerTreasurer Mar 25, 2019 10%
Andrea Lewis Individual W-2 Managing EmployeeRevenue Cycle Director Jan 1, 2018 5%
Doug Faus Individual Corporate OfficerCeo Jan 1, 2018 20%
Gary Crum Individual Corporate OfficerVice Chair Mar 24, 2019 10%
Joseph F Steiner Individual Corporate OfficerChair Mar 25, 2019 10%
Ivinson Memorial Hospital Organization, Laramie, WY Corporation, Non-profit 5% Or Greater Direct Ownership Interest Jan 1, 2018 100%
Rick Melone Individual Corporate Officer Oct 1, 2024 10%
Pamela Dunnuck Individual Corporate Officer Jan 1, 2024 10%

Owners & managing parties with NPI records 4

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

All facility ownership & control disclosures 2

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

FacilityTypeRoleSince
Ivinson Memorial HospitalLaramie, WY, CCN 53S025 Hospital 5% Or Greater Direct Ownership Interest (100%) Jan 1, 2018
Ivinson Memorial HospitalLaramie, WY, CCN 53U025 Hospital 5% Or Greater Direct Ownership Interest (100%) Jan 1, 2018

Owned or controlled facilities with NPI records 2

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

Facilities with the same owner 2

Facilities that share an organizational owner with 5% or greater ownership or operational control.

Practitioners & affiliated clinicians

Practitioners 43

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 43

Affiliated clinicians 308

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

View all 308

NPI Registry JSON

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

{
    "created_epoch": "1170806400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1780963200000",
    "number": "1336289552",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "255 N 30TH ST",
            "city": "LARAMIE",
            "state": "WY",
            "postal_code": "820725140",
            "telephone_number": "307-742-2142",
            "fax_number": "307-742-0678"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "255 N 30TH ST",
            "city": "LARAMIE",
            "state": "WY",
            "postal_code": "820725140",
            "telephone_number": "307-742-2142",
            "fax_number": "307-742-0678"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IVINSON MEMORIAL HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-07",
        "last_updated": "2026-06-09",
        "certification_date": "2026-06-09",
        "status": "A",
        "authorized_official_last_name": "BANDS",
        "authorized_official_first_name": "JAMES",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "307-755-4603"
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "282NR1301X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Rural",
            "state": "WY",
            "license": "07108",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Laramie, WY

Sources for this page

Verify at the official NPI Registry.