NPIMap

Organization Active NPI

South Lyon Health Center, Inc.

Doing business as South Lyon Medical Center

  • Critical Access Hospital
  • Yerington, NV
National Provider Identifier
1376917302
Registry record updated Jan 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Access HospitalTaxonomy code 282NC0060X
Legal business name
SOUTH LYON HEALTH CENTER, INC.
Doing business as
South Lyon Medical Center
Practice address
213 S Whitacre St
Yerington, NV 89447-2561
Phone
(775) 463-2301
Fax
(775) 463-7864
NPI assigned
Nov 13, 2015
Last updated
Jan 17, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 17, 2020

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

Authorized official

Name
Toni A Inserra, CEO
Title
Administrator
Phone
(775) 463-6404

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Access Hospital 282NC0060X Primary

Addresses

Primary practice location

213 S Whitacre St
Yerington, NV 89447-2561

Mailing address

213 S Whitacre St
Yerington, NV 89447-2561
Phone (775) 463-2301

Other names 1

  • South Lyon Medical Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160113002811 NV Part A Provider - Critical Access Hospital 0648178533 Receives reassigned benefits from 48 practitioners
Practice locations: Yerington, NV

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1376917302. Details of each certification follow.

Hospital certification: CCN 291314

Legal name
SOUTH LYON HEALTH CENTER INC
Doing business as
SOUTH LYON MEDICAL CENTER
Certification status
Active
Provider type (POS)
Hospital – Critical access hospital
Participating since
May 19, 2016
Last certification
Dec 3, 2021
Beds
14
Ownership / control type
Private (not for profit)
Organization structure
CorporationNon-profit
Incorporated
Jan 2, 1991 in NV
Enrollment address
213 S Whitacre St
Yerington, NV 89447-2561
Other Hospital Practice Location

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

Other NPIs with the same Medicare PAC ID 5

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

Care Compare: Hospital

Medicare Care Compare
Listed as
South Lyon Medical CenterCCN 291314 · All quality measures
Type
Critical Access Hospitals
Ownership
Voluntary non-profit - Private
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory
Tax ID family
South Lyon Medical Center12 organizations share this tax ID, including this one

Other organizations with this tax ID 11

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

Ownership & related parties

All disclosed owners & managing parties 4

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

NameRoleSinceShare
John Diekmann Individual Corporate DirectorBoard Member May 1, 2009
Robert Rowley Individual Corporate DirectorBoard Member Aug 1, 2015
Toni a Inserra Individual Corporate Officer100 Jul 31, 2013
W-2 Managing EmployeeCeo Jul 31, 2013 100%
Kylee Fowler Individual W-2 Managing EmployeeMedical Staff Coordinator Mar 14, 2022

All facility ownership & control disclosures 1

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

FacilityTypeRoleSince
South Lyon Medical CenterYerington, NV, CCN 295011 Skilled nursing facility Operational/Managerial Control (100%) Jan 5, 1990

Owned or controlled facilities with NPI records 1

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

Practitioners & affiliated clinicians

Practitioners 48

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 48

Affiliated clinicians 50

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

View all 50

NPI Registry JSON

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

{
    "created_epoch": "1447372800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1579219200000",
    "number": "1376917302",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "213 S WHITACRE ST",
            "city": "YERINGTON",
            "state": "NV",
            "postal_code": "894472561",
            "telephone_number": "775-463-2301",
            "fax_number": "775-463-7864"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "213 S WHITACRE ST",
            "city": "YERINGTON",
            "state": "NV",
            "postal_code": "894472561",
            "telephone_number": "775-463-2301",
            "fax_number": "775-463-7864"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH LYON HEALTH CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-11-13",
        "last_updated": "2020-01-17",
        "certification_date": "2020-01-17",
        "status": "A",
        "authorized_official_last_name": "INSERRA",
        "authorized_official_first_name": "TONI",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "775-463-6404",
        "authorized_official_credential": "CEO"
    },
    "taxonomies": [
        {
            "code": "282NC0060X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Critical Access",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "South Lyon Medical Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "South Lyon Medical Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Yerington, NV

Sources for this page

Verify at the official NPI Registry.