NPIMap

Organization Active NPI

Hot Springs County Hospital District

Doing business as Hot Springs Health Shoshoni

  • Rural Health Clinic/Center
  • Shoshoni, WY
National Provider Identifier
1407447766
Registry record updated Sep 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
HOT SPRINGS COUNTY HOSPITAL DISTRICT
Doing business as
Hot Springs Health Shoshoni
Practice address
702 E 2ND St
Shoshoni, WY 82649
Phone
(307) 876-0221
Fax
(307) 876-0931
NPI assigned
Jan 29, 2021
Last updated
Sep 4, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 4, 2024

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

Authorized official

Name
Natalya Keller
Title
Cfo
Phone
(307) 864-5065

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X Primary
Family Medicine Physician 207Q00000X

Addresses

Primary practice location

702 E 2ND St
Shoshoni, WY 82649

Mailing address

120 N C Ave
Thermopolis, WY 82443-2410
Phone (307) 864-5534

Other names 1

  • Hot Springs Health Shoshoni Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WY2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040324001069 WY Part B Supplier - Clinic/Group Practice 9234020439 Receives reassigned benefits from 44 practitioners
7 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Riverton, WY; Shoshoni, WY; Thermopolis, WY; Worland, WY
O20220614000126 WY Part A Provider - Rural Health Clinic 9234020439 Practice locations: Shoshoni, WY

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1407447766. Details of each certification follow.

Rural health clinic certification: CCN 533402

Legal name
HOT SPRINGS COUNTY HOSPITAL DISTRICT
Doing business as
HOT SPRINGS HEALTH SHOSHONI
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Sep 29, 2022
Last certification
Sep 29, 2022
Ownership / control type
2B
Organization structure
GovernmentNon-profit
Incorporated
Jun 4, 1946 in WY
Enrollment address
702 E 2ND St
Shoshoni, WY 82649
Related CCNs
531304

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).

Other NPIs on the same Medicare enrollment 7

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
53D2209477Hot Springs Health Shoshoni702 E 2ND Street, Shoshoni, WY 82649Provider-performed microscopyAug 20, 2026

National Provider Directory

National Provider Directory
Tax ID family
Hot Springs Mem Hospita8 organizations share this tax ID, including this one

Other organizations with this tax ID 7

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

Locations

120 N C Ave
Thermopolis, WY 82443
Phone (307) 864-5534

Ownership & related parties

All disclosed owners & managing parties 7

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

NameRoleSinceShare
Aimee Kay Individual Corporate DirectorBoard Member Jan 1, 2024
Melissa Johnson Individual Corporate DirectorBoard Member Jan 1, 2022
Scott Alwin Individual Corporate OfficerCeo Dec 1, 2023
Corporate DirectorCeo Dec 1, 2023
W-2 Managing EmployeeCeo Dec 1, 2023
William Willliams Individual Corporate DirectorBoard Member Jan 1, 2022
Jessica Benefiel Individual Corporate DirectorBoard Member Jan 1, 2022
Hot Springs County Hospital District Organization, Thermopolis, WY Corporation, Non-profit 5% Or Greater Direct Ownership Interest Jan 1, 2022 100%
David Koerwitz Individual Corporate DirectorBoard Member Jan 1, 2022

Owners & managing parties with NPI records 5

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

All facility ownership & control disclosures 4

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

FacilityTypeRoleSince
Hot Springs County Hospital DistrictThermopolis, WY, CCN 53Z304 Hospital Operational/Managerial Control Jan 25, 2008
Hot Springs Health ThermopolisThermopolis, WY, CCN 533996 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Dec 7, 2017
Hot Springs Health WorlandWorland, WY, CCN 533999 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Apr 1, 2020
Hot Springs Health RivertonRiverton, WY, CCN 533403 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Jan 1, 2022

Owned or controlled facilities with NPI records 4

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

Facilities with the same owner 4

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

Practitioners & affiliated clinicians

Practitioners 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1611878400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1725408000000",
    "number": "1407447766",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 N C AVE",
            "city": "THERMOPOLIS",
            "state": "WY",
            "postal_code": "824432410",
            "telephone_number": "307-864-5534",
            "fax_number": "307-864-5226"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "702 E 2ND ST",
            "city": "SHOSHONI",
            "state": "WY",
            "postal_code": "82649",
            "telephone_number": "307-876-0221",
            "fax_number": "307-876-0931"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOT SPRINGS COUNTY HOSPITAL DISTRICT",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-01-29",
        "last_updated": "2024-09-04",
        "certification_date": "2024-09-04",
        "status": "A",
        "authorized_official_last_name": "KELLER",
        "authorized_official_first_name": "NATALYA",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "307-864-5065"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Hot Springs Health Shoshoni",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Shoshoni, WY

Sources for this page

Verify at the official NPI Registry.