NPIMap

Organization Active NPI

Evanston Hospital Corporation

  • Rural Health Clinic/Center
  • Mountain View, WY
National Provider Identifier
1427595271
Registry record updated Jul 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
License
15107 Issued in WY
Legal business name
EVANSTON HOSPITAL CORPORATION
Practice address
531 Parkway Drive
Mountain View, WY 82939-0208
Phone
(307) 782-7560
Fax
(307) 782-7024
NPI assigned
Jan 31, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 7, 2023

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

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X 15107 WY Primary

Addresses

Primary practice location

531 Parkway Drive
Mountain View, WY 82939-0208

Mailing address

531 Parkway Drive
Mountain View, WY 82939-0208
Phone (307) 782-7560

Other names 1

  • Bridger Valley Medical Group Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20171229001328 WY Part A Provider - Rural Health Clinic 7113900358 Practice locations: Mountain View, WY

Other NPIs with the same Medicare PAC ID 5

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

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

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

National Provider Directory

National Provider Directory

Ownership & related parties

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.

NameRoleSinceShare
Davidson Kempner Distressed Opportunities International Cayman Organization, New York, NY Investment firm 5% Or Greater Indirect Ownership Interest Jul 7, 2020 11.6%
Henry Kunath Individual Corporate OfficerSr Vice President/Treasurer/Cfo Sep 6, 2023
Corporate DirectorSr Vice President/Treasurer/Cfo Sep 6, 2023
Cheri L Willard Individual W-2 Managing EmployeeCeo/Cno Dec 1, 2018
DK Distressed Opportunities Int LTD Organization, New York, NY Investment firm 5% Or Greater Indirect Ownership Interest Jul 7, 2020 13.2%
DK Ldoi IV Aggregate Holdco LP Organization, New York, NY Investment firm 5% Or Greater Indirect Ownership Interest Jul 7, 2020 11.8%
Davidson Kempner Long-Term Distressed Opportunities Fund IV L Organization, New York, NY Investment firm 5% Or Greater Indirect Ownership Interest Jul 7, 2020 6.1%
Quorum Health Corporation Organization, Brentwood, TN 5% Or Greater Direct Ownership Interest Apr 29, 2016 100%
DK Quincy Investor BT I LLC Organization, New York, NY LLC, Investment firm 5% Or Greater Indirect Ownership Interest Jul 7, 2020 7.9%
Davidson Kempner Long-Term Distressed Opps Intl IV Aiv LP Organization, New York, NY Investment firm 5% Or Greater Indirect Ownership Interest Jul 7, 2020 11.8%
Goldentree Distressed Onshore Master Fund III LP Organization, New York, NY Investment firm 5% Or Greater Indirect Ownership Interest Aug 5, 2020 6.8%
DK Quincy Investor BT II LLC Organization, New York, NY LLC, Investment firm 5% Or Greater Indirect Ownership Interest Jul 7, 2020 7.9%
Laura Fey Individual Corporate DirectorVP of Revenue Cycle Aug 27, 2018
Goldentree Select Offshore Intermediate Fund LP Organization, New York, NY Investment firm 5% Or Greater Indirect Ownership Interest Jul 7, 2020 5.44%
Goldentree Distressed Master Fund III LTD Organization, New York, NY Investment firm 5% Or Greater Indirect Ownership Interest Jul 7, 2020 11%
Quincy Health LLC Organization, New York, NY Created for acquisition, LLC 5% Or Greater Indirect Ownership Interest Jul 7, 2020 100%
Steven W Frantz Individual Corporate OfficerVice President Aug 10, 2022
Corporate DirectorVice President Aug 10, 2022
Julie Manas Individual Corporate OfficerPresident Aug 10, 2022
Corporate DirectorPresident Aug 10, 2022
Davidson Kempner Distressed Opportunities Fund LP Organization, New York, NY Investment firm 5% Or Greater Indirect Ownership Interest Jul 7, 2020 7.8%
Donald Esposito Individual Corporate OfficerSVP & Secretary Sep 16, 2021
Corporate DirectorSVP & Secretary Sep 16, 2021

Facilities with the same owner 36

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

  • Evanston Hospital Corporation
    • 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
    • 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
    • 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
    • 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
    • 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
    • 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
    • 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
    • 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
    • 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
    • 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
    • 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
View all 36

Practitioners 16

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 16

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
53D1080144Bridger Valley Medical Group - MTN View531 Parkway Drive, Mountain View, WY 82939Certificate of waiverFeb 13, 2028

NPI Registry JSON

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"
        }
    ]
}

Other providers in Mountain View, WY

Sources for this page

Verify at the official NPI Registry.