NPIMap

Organization Active NPI

State of Wyoming

  • Skilled Nursing Facility
  • Buffalo, WY
National Provider Identifier
1386396935
Registry record updated Mar 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
STATE OF WYOMING
Practice address
700 Veterans LN
Buffalo, WY 82834-9402
Phone
(307) 684-5511
Fax
(307) 684-7636
NPI assigned
Jan 25, 2022
Last updated
Mar 23, 2023By the provider in NPPES
Organization subpart
Yes
Parent organization
STATE OF WYOMINGAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 23, 2023

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

Authorized official

Name
Mr. Bruce Allison
Title
Administrator
Phone
(307) 684-5511

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X Primary

Addresses

Primary practice location

700 Veterans LN
Buffalo, WY 82834-9402

Mailing address

700 Veterans LN
Buffalo, WY 82834-9402
Phone (307) 684-5511

Other names 1

  • Wyoming Veterans Skilled Nursing Facility Former legal business name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250318001829 WY Part A Provider - Skilled Nursing Facility 4587552583 Practice locations: Buffalo, WY

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1386396935. Details of each certification follow.

Skilled nursing facility certification: CCN 535061

Legal name
STATE OF WYOMING
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Aug 30, 2024
Last certification
Jul 26, 2024
Beds
36
Ownership / control type
State
Organization structure
GovernmentNon-profit
Enrollment address
700 Veterans LN
Buffalo, WY 82834-9402
Nursing home name
WYOMING VETERANS' SKILLED NURSING FACILITY

Other NPIs with the same Medicare PAC ID 3

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

Care Compare: Nursing home

Medicare Care Compare
Listed as
Wyoming Veterans' Skilled Nursing FacilityCCN 535061 · All quality measures
Overall star rating
2 of 5
Health inspections
2 of 5
Staffing
4 of 5
Quality measures
3 of 5
Type
Medicare and Medicaid
Ownership
Government - State
Certified
Aug 30, 2024
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
3620.9 residents per day on average
Abuse citation
Cited for abuse (Care Compare abuse icon)
Penalties (3 years)
1Fines totaling $0

Processed by Care Compare on Aug 1, 2026.

National Provider Directory

National Provider Directory
Tax ID family
Wy Public HLTH Lab11 organizations share this tax ID, including this one
Part of
Wy Public HLTH Lab

Other organizations with this tax ID 10

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

Locations

700 Veterans Ln
Buffalo, WY 82834
Phone (307) 684-5511

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
State of Wyoming Organization, Buffalo, WY Corporation 5% Or Greater Security Interest Jan 14, 2025
Operational/Managerial Control Jan 14, 2025
Robert B Allison Individual Operational/Managerial Control Nov 3, 2022
Stefan J Johansson Individual Operational/Managerial Control Jan 14, 2025
Managing Control - Governing BodyDirector Jan 14, 2025
Gregory Meredith Individual Operational/Managerial Control Dec 10, 2024
Managing Control - Governing BodyAdministrator Dec 10, 2024

Owners & managing parties with NPI records 3

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

  • State of Wyoming

    dba Mountain View Skilled Nursing Community at Wyoming Life Resource Cente

    • Skilled Nursing Facility
    • Lander, WY
    • NPI 1093337990

    5% Or Greater Security Interest, Operational/Managerial Control

    CMS ownership
  • State of Wyoming

    dba Wyoming State Hospital

    • Psychiatric Hospital
    • Evanston, WY
    • NPI 1316011562

    5% Or Greater Security Interest, Operational/Managerial Control

    CMS ownership
  • State of Wyoming

    dba Wyoming Retirement Center

    • Skilled Nursing Facility
    • Basin, WY
    • NPI 1659328821

    5% Or Greater Security Interest, Operational/Managerial Control

    CMS ownership

All facility ownership & control disclosures 3

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

FacilityTypeRoleSince
Wyoming State HospitalEvanston, WY, CCN 534001 Hospital Other Jan 1, 1990
Wyoming Retirement CenterBasin, WY, CCN 535021 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%)
Adp of the SNF		 May 23, 1985
May 23, 1984
Mountain View Skilled Nursing Community at Wyoming Life Resource CenteLander, WY, CCN 535058 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control
Adp of the SNF		 Nov 27, 2022
Nov 27, 2022
Nov 27, 2022

Owned or controlled facilities with NPI records 3

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

  • State of Wyoming

    dba Mountain View Skilled Nursing Community at Wyoming Life Resource Cente

    • Skilled Nursing Facility
    • Lander, WY
    • NPI 1093337990

    5% Or Greater Direct Ownership Interest, Adp of the SNF, Operational/Managerial Control

    CMS ownership
  • State of Wyoming

    dba Wyoming State Hospital

    • Psychiatric Hospital
    • Evanston, WY
    • NPI 1316011562

    Other

    CMS ownership
  • State of Wyoming

    dba Wyoming Retirement Center

    • Skilled Nursing Facility
    • Basin, WY
    • NPI 1659328821

    5% Or Greater Direct Ownership Interest, Adp of the SNF

    CMS ownership

Facilities with the same owner 2

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

  • State of Wyoming

    dba Mountain View Skilled Nursing Community at Wyoming Life Resource Cente

    • Skilled Nursing Facility
    • Lander, WY
    • NPI 1093337990

    State of Wyoming

    CMS ownership
  • State of Wyoming

    dba Wyoming Retirement Center

    • Skilled Nursing Facility
    • Basin, WY
    • NPI 1659328821

    State of Wyoming

    CMS ownership

Practitioners & affiliated clinicians

Practitioners 14

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 14

NPI Registry JSON

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

{
    "created_epoch": "1643068800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1679529600000",
    "number": "1386396935",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 VETERANS LN",
            "city": "BUFFALO",
            "state": "WY",
            "postal_code": "828349402",
            "telephone_number": "307-684-5511",
            "fax_number": "307-684-7636"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 VETERANS LN",
            "city": "BUFFALO",
            "state": "WY",
            "postal_code": "828349402",
            "telephone_number": "307-684-5511",
            "fax_number": "307-684-7636"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STATE OF WYOMING",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "STATE OF WYOMING",
        "enumeration_date": "2022-01-25",
        "last_updated": "2023-03-23",
        "certification_date": "2023-03-23",
        "status": "A",
        "authorized_official_last_name": "ALLISON",
        "authorized_official_first_name": "BRUCE",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "307-684-5511",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Wyoming Veterans Skilled Nursing Facility",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Buffalo, WY

Sources for this page

Verify at the official NPI Registry.