NPIMap

Organization Active NPI

West Park Hospital District Long Term Care Center

  • Skilled Nursing Facility
  • Cody, WY
National Provider Identifier
1467534081
Registry record updated Sep 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
06-003 Issued in WY
Legal business name
WEST PARK HOSPITAL DISTRICT LONG TERM CARE CENTER
Practice address
707 Sheridan Ave
Cody, WY 82414-3409
Phone
(307) 527-7501
Fax
(307) 578-2485
NPI assigned
Oct 20, 2006
Last updated
Sep 12, 2025By the provider in NPPES
Organization subpart
Yes
Parent organization
WEST PARK HOSPITAL DISTRICTAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 12, 2025

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

Authorized official

Name
Coby L La Blue
Title
Cfo
Phone
(307) 578-2490

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 06-003 WY Primary

Addresses

Primary practice location

707 Sheridan Ave
Cody, WY 82414-3409

Mailing address

707 Sheridan Ave
Cody, WY 82414-3409
Phone (307) 527-7501

Other identifiers 4

IdentifierTypeStateIssuer
106133004MedicaidWY
007062OtherWYBLUE CROSS
041793OtherWYBLUE CROSS
106133005MedicaidWY

Other names 2

  • Long Term Care Other name
  • Long Term Care Center Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090603000575 WY Part A Provider - Skilled Nursing Facility 7315855624 Practice locations: Cody, WY

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1467534081. Details of each certification follow.

Skilled nursing facility certification: CCN 535027

Legal name
WEST PARK HOSPITAL DISTRICT
Doing business as
CODY REGIONAL HEALTH LONG TERM CARE CENTER
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Jan 22, 1985
Last certification
Aug 22, 2024
Beds
94
Ownership / control type
Hospital District
Organization structure
GovernmentNon-profit
Enrollment address
707 Sheridan Ave
Cody, WY 82414-3409
Nursing home name
CODY REGIONAL HEALTH LONG TERM CARE CENTER

Other NPIs with the same Medicare PAC ID 5

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

Care Compare: Nursing home

Medicare Care Compare
Listed as
Cody Regional Health Long Term Care CenterCCN 535027 · All quality measures
Overall star rating
4 of 5
Health inspections
4 of 5
Staffing
3 of 5
Quality measures
2 of 5
Type
Medicare and Medicaid
Ownership
Government - Hospital district
Certified
Jan 22, 1985
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
9450.1 residents per day on average

Processed by Care Compare on Aug 1, 2026.

National Provider Directory

National Provider Directory
Tax ID family
Lake Hospital13 organizations share this tax ID, including this one
Part of
Lake Hospital

Other organizations with this tax ID 12

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

Member organizations 6

Organizations listed as members of this organization in the National Provider Directory.

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
Laura Moore Individual Operational/Managerial Control Aug 2, 2021
Adp of the SNF Aug 2, 2021
Tarra L Deiter Enright Individual Operational/Managerial Control Apr 27, 2022
Adp of the SNF Apr 27, 2022
Angela Johnson Individual Managing Control - Governing BodyBoard Vice-Chair Nov 13, 2024
Trustee of the SNF Nov 13, 2024
Adp of the SNF Nov 13, 2024
Indirect Ownership Interest Nov 13, 2024
Richard Tyler Nelson Individual Corporate DirectorBoard Chairman Jun 25, 2021
Trustee of the SNF Jan 1, 2024
Jennifer M Talich Individual Operational/Managerial Control Nov 4, 2024
Trustee of the SNF Nov 13, 2024
Adp of the SNF Nov 13, 2024
West Park Hospital District Organization, Cody, WY Medical provider/supplier 5% Or Greater Direct Ownership Interest Feb 23, 2009 100%
Operational/Managerial Control Feb 23, 2009
Adp of the SNF Feb 3, 2009
Mary Hannah McRae Individual Corporate OfficerCeo Oct 1, 2020
Operational/Managerial Control Oct 1, 2020
Adp of the SNF Oct 1, 2020

Owners & managing parties with NPI records 6

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

All facility ownership & control disclosures 6

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

FacilityTypeRoleSince
Cody Regional HealthCody, WY, CCN 531312 Hospital Operational/Managerial Control Jan 22, 2009
Cody Regional HealthCody, WY, CCN 53Z312 Hospital 5% Or Greater Direct Ownership Interest (100%) Jan 1, 1986
Cody Regional Health Home HealthCody, WY, CCN 537031 Home health agency 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Aug 9, 2012
Aug 9, 2012
Cody Regional Health Home Health and Spirit Mountain HospiceCody, WY, CCN 531505 Hospice Other (100%) Jul 1, 1995
Cody Regional HealthCody, WY, CCN 533401 Rural health clinic 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control		 Nov 25, 2021
Nov 25, 2021
Cody Regional Basin Rural Health ClinicBasin, WY, CCN 538500 Rural health clinic Operational/Managerial Control Jan 1, 2023

Owned or controlled facilities with NPI records 7

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

Facilities with the same owner 5

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

Practitioners & affiliated clinicians

Practitioners 6

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.

Affiliated clinicians 1

Clinicians who list this facility as an affiliation in Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1161302400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757635200000",
    "number": "1467534081",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "707 SHERIDAN AVE",
            "city": "CODY",
            "state": "WY",
            "postal_code": "824143409",
            "telephone_number": "307-527-7501",
            "fax_number": "307-578-2485"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "707 SHERIDAN AVE",
            "city": "CODY",
            "state": "WY",
            "postal_code": "824143409",
            "telephone_number": "307-527-7501",
            "fax_number": "307-578-2485"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WEST PARK HOSPITAL DISTRICT LONG TERM CARE CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "WEST PARK HOSPITAL DISTRICT",
        "enumeration_date": "2006-10-20",
        "last_updated": "2025-09-12",
        "certification_date": "2025-09-12",
        "status": "A",
        "authorized_official_last_name": "LA BLUE",
        "authorized_official_first_name": "COBY",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "307-578-2490"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "WY",
            "license": "06-003",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "106133004",
            "state": "WY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "007062",
            "state": "WY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "041793",
            "state": "WY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "106133005",
            "state": "WY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Long Term Care",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Long Term Care Center",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Cody, WY

Sources for this page

Verify at the official NPI Registry.