Evanston Hospital Corporation

Primary specialty

Rural Health Clinic/CenterTaxonomy code 261QR1300X

License

15107 Issued in WY

Legal business name

EVANSTON HOSPITAL CORPORATION

Doing business as

Bridger Valley Medical Group

Practice address

531 Parkway Drive
Mountain View, WY 82939-0208

Phone

(307) 782-7560

Fax

(307) 782-7024

NPI assigned

Jan 31, 2017

Last updated

Jul 7, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Laura J Fey

Title

Sr. Director Physician Rev Cycle

Phone

(615) 221-3641

Specialties & licenses 1

Addresses

Other names 1

• Bridger Valley Medical Group Doing business as

Medicare fee-for-service enrollment

Enrolled in WY

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1427595271. Details of each certification follow.

• CCN 533992 Rural health clinic · Active · Details

Rural health clinic certification: CCN 533992

Legal name

EVANSTON HOSPITAL CORPORATION

Doing business as

BRIDGER VALLEY MEDICAL GROUP

Certification status

Active

Provider type (POS)

Rural health clinic

Participating since

Jun 23, 2017

Last certification

Jun 23, 2017

Ownership / control type

1B

Organization structure

CorporationProprietary

Incorporated

Sep 7, 1999 in WY

Enrollment address

531 Parkway Dr
Mountain View, WY 82939-0208

Related CCNs

531319

Related certifications (CCN) 1

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

• Evanston Hospital Corporation

  dba Evanston Regional Hospital

  • General Acute Care Hospital
  • Evanston, WY
  • NPI 1639140015

  Parent provider

  Provider of Services

Other NPIs with the same Medicare PAC ID 5

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

• Evanston Hospital Corporation

  • Certified Registered Nurse Anesthetist
  • Evanston, WY
  • NPI 1013288836

  7113900358

  Same PAC ID
• Evanston Hospital Corporation

  dba Bridger Valley Medical Group

  • Rural Health Clinic/Center
  • Lyman, WY
  • NPI 1134666944

  7113900358

  Same PAC ID
• Evanston Hospital Corporation

  dba Evanston Dialysis Center

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Evanston, WY
  • NPI 1255304051

  7113900358

  Same PAC ID
• Evanston Hospital Corporation

  dba Evanston Regional Hospital

  • Medicare Defined Swing Bed Hospital Unit
  • Evanston, WY
  • NPI 1356313506

  7113900358

  Same PAC ID
• Evanston Hospital Corporation

  dba Evanston Regional Hospital

  • General Acute Care Hospital
  • Evanston, WY
  • NPI 1639140015

  7113900358

  Same PAC ID

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

CLIA laboratory certificates

Locations

All disclosed owners & managing parties 19

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

Facilities with the same owner 36

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

• Evanston Hospital Corporation

  dba Bridger Valley Medical Group

  • Rural Health Clinic/Center
  • Lyman, WY
  • NPI 1134666944

  Davidson Kempner Distressed Opportunities Fund LP, Davidson Kempner Distressed Opportunities International Cayman, Davidson Kempner Long-Term Distressed Opportunities Fund IV L, Davidson Kempner Long-Term Distressed Opps Intl IV Aiv LP, DK Distressed

  CMS ownership
• Evanston Hospital Corporation

  dba Evanston Regional Hospital

  • Medicare Defined Swing Bed Hospital Unit
  • Evanston, WY
  • NPI 1356313506

  Goldentree Distressed Master Fund III LTD, Goldentree Distressed Onshore Master Fund III LP, Goldentree Select Offshore Intermediate Fund LP, Quincy Health LLC, Quorum Health Corporation

  CMS ownership
• Evanston Hospital Corporation

  dba Evanston Regional Hospital

  • General Acute Care Hospital
  • Evanston, WY
  • NPI 1639140015

  Davidson Kempner Distressed Opportunities Fund LP, Davidson Kempner Distressed Opportunities International Cayman, Davidson Kempner Long-Term Distressed Opportunities Fund IV L, Davidson Kempner Long-Term Distressed Opps Intl IV Aiv LP, DK Distressed

  CMS ownership
• Big Bend Hospital Corporation

  • Rural Health Clinic/Center
  • Alpine, TX
  • NPI 1275988669

  Goldentree Distressed Master Fund III LTD, Goldentree Distressed Onshore Master Fund III LP, Goldentree Select Offshore Intermediate Fund LP, Quincy Health LLC, Quorum Health Corporation

  CMS ownership
• Big Bend Hospital Corporation

  dba Big Bend Regional Medical Center

  • Critical Access Hospital
  • Alpine, TX
  • NPI 1356312243

  Goldentree Distressed Master Fund III LTD, Goldentree Distressed Onshore Master Fund III LP, Goldentree Select Offshore Intermediate Fund LP, Quincy Health LLC, Quorum Health Corporation

  CMS ownership
• Big Bend Hospital Corporation

  dba Big Bend Regional Medical Center

  • Medicare Defined Swing Bed Hospital Unit
  • Alpine, TX
  • NPI 1689773756

  Goldentree Distressed Master Fund III LTD, Goldentree Distressed Onshore Master Fund III LP, Goldentree Select Offshore Intermediate Fund LP, Quincy Health LLC, Quorum Health Corporation

  CMS ownership
• Big Spring Texas Hospital Company LLC

  dba Scenic Mountain Medical Center

  • General Acute Care Hospital
  • Big Spring, TX
  • NPI 1336976034

  Goldentree Distressed Master Fund III LTD, Goldentree Distressed Onshore Master Fund III LP, Goldentree Select Offshore Intermediate Fund LP, Quincy Health LLC, Quorum Health Corporation

  CMS ownership
• Big Spring Texas Hospital Company LLC

  dba Scenic Mountain Medical Center

  • Psychiatric Hospital Unit
  • Big Spring, TX
  • NPI 1770310476

  Goldentree Distressed Master Fund III LTD, Goldentree Distressed Onshore Master Fund III LP, Goldentree Select Offshore Intermediate Fund LP, Quincy Health LLC, Quorum Health Corporation

  CMS ownership
• CHHP Holdings II, LLC

  dba Community Hospital of Huntington Park

  • General Acute Care Hospital
  • Huntington Park, CA
  • NPI 1891059127

  Davidson Kempner Long-Term Distressed Opportunities Fund IV L, Davidson Kempner Long-Term Distressed Opps Intl IV Aiv LP, DK Ldoi IV Aggregate Holdco LP

  CMS ownership
• CPH Hospital Management LLC

  dba Coast Plaza Hospital

  • General Acute Care Hospital
  • Norwalk, CA
  • NPI 1194016923

  Davidson Kempner Long-Term Distressed Opportunities Fund IV L, Davidson Kempner Long-Term Distressed Opps Intl IV Aiv LP, DK Ldoi IV Aggregate Holdco LP

  CMS ownership
• Deming Hospital Corporation

  dba Mimbres Valley Medical Group

  • Rural Health Clinic/Center
  • Deming, NM
  • NPI 1134526221

  Goldentree Distressed Master Fund III LTD, Goldentree Distressed Onshore Master Fund III LP, Goldentree Select Offshore Intermediate Fund LP, Quincy Health LLC, Quorum Health Corporation

  CMS ownership
• Deming Hospital Corporation

  dba Mimbres Memorial Hospital

  • Medicare Defined Swing Bed Hospital Unit
  • Deming, NM
  • NPI 1710196571

  Goldentree Distressed Master Fund III LTD, Goldentree Distressed Onshore Master Fund III LP, Goldentree Select Offshore Intermediate Fund LP, Quincy Health LLC, Quorum Health Corporation

  CMS ownership

Practitioners 2

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.

• Maria A Cuda, D.O.

  • Hospitalist Physician
  • Huntington, IN
  • NPI 1316946320
  NPD (past)
• Zachary John Pugh, MD

  • Internal Medicine Physician
  • Provo, UT
  • NPI 1215323399
  NPD (past)

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

{
    "created_epoch": "1485820800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1688688000000",
    "number": "1427595271",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "531 PARKWAY DRIVE",
            "city": "MOUNTAIN VIEW",
            "state": "WY",
            "postal_code": "829390208",
            "telephone_number": "307-782-7560",
            "fax_number": "307-782-7024"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "531 PARKWAY DRIVE",
            "city": "MOUNTAIN VIEW",
            "state": "WY",
            "postal_code": "829390208",
            "telephone_number": "307-782-7560",
            "fax_number": "307-782-7024"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVANSTON HOSPITAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-01-31",
        "last_updated": "2023-07-07",
        "certification_date": "2023-07-07",
        "status": "A",
        "authorized_official_last_name": "FEY",
        "authorized_official_first_name": "LAURA",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "SR. DIRECTOR PHYSICIAN REV CYCLE",
        "authorized_official_telephone_number": "615-221-3641"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "WY",
            "license": "15107",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bridger Valley Medical Group",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Bridger Valley Medical Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Lorie Ann Conrad, MA
• Breezy Cooley
• Dallas Cottam, RN
• Kirstin Dennis, SLP-CCC
• Lori Marie Erickson, M.S., CCC-SLP
• Evanston Regional Hospital
• Richard Tad Guild, D.C.
• Sara Hunt, FNP-C
• Keshia Ann Iorg
• Devin Charles Irene, DDS

• Rural Health Clinic/Center in Mountain View, WY
• Providers in Mountain View, WY by specialty
• Rural Health Clinic/Center in Wyoming

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2023; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.