Active NPI
Community Hospital
- Rural Health Clinic/Center
- Torrington, WY
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Rural Health Clinic/Center
- Legal business name
- COMMUNITY HOSPITAL
- Practice address
- 625 Albany Ave
Torrington, WY 82240-1530 - Phone
- (307) 532-2107
- NPI assigned
- Jan 22, 2024
- Last updated
- Aug 30, 2024
- Organization subpart
- Yes
- Parent organization
- BANNER HEALTH
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Ingrid T Long
- Title
- Ceo
- Phone
- (307) 532-2107
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Rural Health Clinic/Center | 261QR1300X | NU | Primary | |
| Family Medicine Physician | 207Q00000X | NU |
Addresses
Primary practice location
625 Albany Ave
Torrington, WY 82240-1530
Mailing address
2901 N Central Ave Ste 160
Phoenix, AZ 85012-2702
Phone (602) 747-4000
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WY
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20170608000298 | WY | Part A Provider - Rural Health Clinic | 6608784194 |
1 other NPI on this enrollment Practice locations: Torrington, WY |
NPI to CCN mapping 1
The Medicare certification numbers (CCNs) connected to NPI 1407617871. Details of each certification follow.
Rural health clinic certification: CCN 533993
- Legal name
- COMMUNITY HOSPITAL
- Doing business as
- BANNER MEDICAL CLINIC TORRINGTON
- Certification status
- Active
- Provider type (POS)
- Rural health clinic
- Participating since
- Oct 13, 2017
- Last certification
- Jul 2, 2021
- Ownership / control type
- 2B
- Organization structure
- Other
- Enrollment address
- 625 Albany Ave
Torrington, WY 82240-1530 - Related CCNs
- 531307
Related certifications (CCN) 1
Facilities connected through Provider of Services related, parent or unit certification numbers.
Other NPIs with the same Medicare PAC ID 2
NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).
-
- Medicare Defined Swing Bed Hospital Unit
- Torrington, WY
- NPI 1356493068
6608784194
Other NPIs on the same Medicare enrollment 1
NPIs listed together on one Medicare enrollment, typically parts of the same organization.
National Provider Directory
National Provider Directory- Tax ID family
- Community Hospital
- Part of
- Big Horn Family Med
Other organizations with this tax ID 3
Organizations that report the same tax identification number in the National Provider Directory.
-
- Multi-Specialty Clinic/Center
- Torrington, WY
- NPI 1083143895
-
- Medicare Defined Swing Bed Hospital Unit
- Torrington, WY
- NPI 1356493068
-
- Critical Access Hospital
- Torrington, WY
- NPI 1740665983
Ownership & related parties
All disclosed owners & managing parties 24
As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.
| Name | Role | Since | Share |
|---|---|---|---|
| Julie Ann Alvarado-Dubek | Corporate Officer | Feb 1, 2022 | |
| Ingrid Long | Corporate Director | Jul 21, 2024 | |
| W-2 Managing Employee | Jul 21, 2024 | ||
| Marjorie J Bessel | Corporate Officer | Jan 1, 2018 | |
| Jean Lance | Corporate Officer | Apr 21, 2022 | |
| Staci Dickerson | Corporate Officer | Jul 17, 2023 | |
| Carole Faig | Corporate Director | Mar 1, 2026 | |
| Paris Labruzzo | Corporate Director | Feb 1, 2026 | |
| W-2 Managing Employee | Feb 1, 2026 | ||
| Dean M Harrison | Corporate Director | Sep 1, 2023 | |
| Anne Mariucci | Corporate Director | Mar 1, 2015 | |
| Sujata Gosalia | Corporate Director | Sep 1, 2018 | |
| Brenda a Schaefer | Corporate Officer | Mar 6, 2014 | |
| Quentin P Smith | Corporate Director | Sep 1, 1999 | |
| Vicki Keiser | Corporate Director | Jun 1, 2017 | |
| Holly Gregory | Corporate Director | Feb 1, 2026 | |
| W-2 Managing Employee | Feb 1, 2026 | ||
| Sara Ward | Corporate Director | Sep 1, 2023 | |
| Michael L Butler | Corporate Director | Sep 1, 2025 | |
| Mary Schubert | Corporate Officer | Jan 1, 2024 | |
| Amy Perry | Corporate Officer | Nov 1, 2021 | |
| Rick Myers | Corporate Director | Sep 1, 2023 | |
| John F Koster | Corporate Director | Dec 11, 2015 | |
| Mark Wallace | Corporate Director | Sep 1, 2021 | |
| Christopher H Volk | Corporate Director | Dec 9, 2009 | |
| Michael Garnreiter | Corporate Director | Aug 1, 2012 | |
| Banner Health | 5% Or Greater Direct Ownership Interest | May 1, 2017 | 100% |
| Operational/Managerial Control | May 1, 2017 | 100% |
Owners & managing parties with NPI records 12
Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.
-
- Durable Medical Equipment & Medical Supplies
- Casper, WY
- NPI 1528846912
5% Or Greater Direct Ownership Interest, Operational/Managerial Control
-
dba Banner Casa Grande Medical Center
- General Acute Care Hospital
- Casa Grande, AZ
- NPI 1003232976
5% Or Greater Direct Ownership Interest, Operational/Managerial Control
-
dba Banner Payson Medical Center
- Critical Access Hospital
- Payson, AZ
- NPI 1063923340
5% Or Greater Direct Ownership Interest, Operational/Managerial Control
-
dba Banner Payson Medical Center - Banner Health Clinic Payson
- Rural Health Clinic/Center
- Payson, AZ
- NPI 1073223012
5% Or Greater Direct Ownership Interest, Operational/Managerial Control
-
- Multi-Specialty Clinic/Center
- Susanville, CA
- NPI 1205267549
5% Or Greater Direct Ownership Interest, Operational/Managerial Control
-
dba Banner Payson Medical Center - Banner Health Clinic Pine
- Rural Health Clinic/Center
- Pine, AZ
- NPI 1245940287
5% Or Greater Direct Ownership Interest, Operational/Managerial Control
-
dba Banner Hospice of Northern Colorado
- Community Based Hospice Care Agency
- Greeley, CO
- NPI 1407409964
5% Or Greater Direct Ownership Interest, Operational/Managerial Control
-
- Radiology Clinic/Center
- Susanville, CA
- NPI 1427740570
5% Or Greater Direct Ownership Interest, Operational/Managerial Control
-
dba Banner Fort Collins Medical Center
- General Acute Care Hospital
- Fort Collins, CO
- NPI 1659787554
5% Or Greater Direct Ownership Interest, Operational/Managerial Control
-
dba Banner Payson Medical Center
- Medicare Defined Swing Bed Hospital Unit
- Payson, AZ
- NPI 1861077414
5% Or Greater Direct Ownership Interest, Operational/Managerial Control
-
dba Banner Ocotillo Medical Center
- General Acute Care Hospital
- Chandler, AZ
- NPI 1972139004
5% Or Greater Direct Ownership Interest, Operational/Managerial Control
Facilities with the same owner 59
Facilities that share an organizational owner with 5% or greater ownership or operational control.
-
- Medicare Defined Swing Bed Hospital Unit
- Torrington, WY
- NPI 1356493068
Banner Health
-
- Medicare Defined Swing Bed Hospital Unit
- Wheatland, WY
- NPI 1457403073
Banner Health
-
- Medicare Defined Swing Bed Hospital Unit
- Worland, WY
- NPI 1366594988
Banner Health
-
- Psychiatric Hospital Unit
- Phoenix, AZ
- NPI 1629122171
Banner Health
-
- General Acute Care Hospital
- Phoenix, AZ
- NPI 1841224870
Banner Health
-
- General Acute Care Hospital
- Tucson, AZ
- NPI 1558759498
Banner Health
Parent organization (reported in NPPES) 1
This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.
-
- Durable Medical Equipment & Medical Supplies
- Casper, WY
- NPI 1528846912
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1705881600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1724976000000",
"number": "1407617871",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2901 N CENTRAL AVE STE 160",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850122702",
"telephone_number": "602-747-4000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "625 ALBANY AVE",
"city": "TORRINGTON",
"state": "WY",
"postal_code": "822401530",
"telephone_number": "307-532-2107"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "COMMUNITY HOSPITAL",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "BANNER HEALTH",
"enumeration_date": "2024-01-22",
"last_updated": "2024-08-30",
"certification_date": "2024-08-30",
"status": "A",
"authorized_official_last_name": "LONG",
"authorized_official_first_name": "INGRID",
"authorized_official_middle_name": "T",
"authorized_official_title_or_position": "CEO",
"authorized_official_telephone_number": "307-532-2107"
},
"taxonomies": [
{
"code": "261QR1300X",
"taxonomy_group": "",
"desc": "Clinic/Center, Rural Health",
"state": "NU",
"license": null,
"primary": true
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "NU",
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Torrington, WY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.