NPIMap

Organization Active NPI

West Park Hospital District

  • Multi-Specialty Clinic/Center
  • Cody, WY
National Provider Identifier
1477192243
Registry record updated Oct 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
Legal business name
WEST PARK HOSPITAL DISTRICT
Practice address
424 Yellowstone Ave
Cody, WY 82414-9309
Phone
(307) 578-2904
NPI assigned
Dec 27, 2019
Organization subpart
Yes
Parent organization
WEST PARK HOSPITAL DISTRICTAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 7, 2025

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

Authorized official

Name
Shannon M Salters
Title
Credentialing Specialist
Phone
(307) 578-2486

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X
Multi-Specialty Clinic/Center 261QM1300X Primary
Rural Health Clinic/Center 261QR1300X

Addresses

Primary practice location

424 Yellowstone Ave
Cody, WY 82414-9309

Mailing address

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

Other names 1

  • CODY REGIONAL RURAL HEALTH CLINIC Other name

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040127000865 WY Part B Supplier - Clinic/Group Practice 7315855624 Receives reassigned benefits from 197 practitioners
4 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Powell, WY; Worland, WY; Thermopolis, WY; Meeteetse, WY; Cody, WY; Lovell, WY; Basin, WY
O20200130001212 WY Part A Provider - Rural Health Clinic 7315855624 Practice locations: Cody, WY

Rural health clinic certification: CCN 533401

Legal name
WEST PARK HOSPITAL DISTRICT
Doing business as
CODY REGIONAL HEALTH
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Nov 25, 2020
Last certification
Nov 25, 2020
Ownership / control type
Non-profit – corporation
Organization structure
OtherNon-profit
Enrollment address
424 Yellowstone Ave
Ste 120, 140, 220, 230, 250, 330
Cody, WY 82414
Related CCNs
531312

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 4

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

Care Compare: Dialysis facility

Medicare Care Compare
Listed as
532505 Big Horn Basin Regional Dialysis (Dci)CCN 532505
Overall star rating
3.0 of 5
Ownership
Non-profit
Certified
May 24, 1995
Medicare certification status
ActiveFrom the Provider of Services file
Chain
Dialysis Clinic, Inc.
Dialysis stations
10

Name & address match This facility record has no NPI; it was connected to this NPI by matching name and address.

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
53D2069608Cody Regional Health-Behavioral Health424 Yellowstone Ave, Suite 220, Cody, WY 82414Certificate of waiverNov 26, 2027
53D2080154Cody Regional Health Internal Medicine424 Yellowstone Ave, Suite 230, Cody, WY 82414Certificate of waiverJun 30, 2028
53D2104358Cody Regional Health OB/GYN Clinic424 Yellowstone Ave, Suite 330, Cody, WY 82414Provider-performed microscopyNov 2, 2027

National Provider Directory

National Provider Directory
Part of
John L Noyes MD

Locations

709 Sheridan Ave
Cody, WY 82414

424 Yellowstone Ave
Ste 140
Cody, WY 82414
Phone (307) 527-7100

424 Yellowstone Ave
Ste 120
Cody, WY 82414
Phone (307) 578-2903

708 Sheridan Ave
Cody, WY 82414

Ownership & related parties

All disclosed owners & managing parties 8

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

NameRoleSinceShare
Peter D Sidor Individual Corporate DirectorBoard Secretary Nov 13, 2024
Angela Johnson Individual Corporate DirectorBoard Vice-Chairman Nov 13, 2024
Richard Tyler Nelson Individual Corporate DirectorBoard Chairman Jan 1, 2013
Stephanie Kearney Individual Corporate OfficerChief Ambulatory Officer Nov 1, 2022
Operational/Managerial ControlCao Nov 1, 2022
Jennifer M Talich Individual Corporate DirectorBoard Treasurer Nov 13, 2024
Coby Lablue Individual Corporate OfficerChief Financial Officer May 19, 2025
West Park Hospital District Organization, Cody, WY Non-profit 5% Or Greater Direct Ownership Interest Nov 25, 2021 100%
Operational/Managerial Control Nov 25, 2021
Mary Hannah McRae Individual Corporate OfficerChief Executive Officer Oct 1, 2021
Operational/Managerial ControlCeo Oct 1, 2021

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 Long Term Care CenterCody, WY, CCN 535027 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control
Adp of the SNF		 Feb 23, 2009
Feb 23, 2009
Feb 3, 2009
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 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 70

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

View all 70

Affiliated clinicians 3

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": "1577404800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1759795200000",
    "number": "1477192243",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "424 YELLOWSTONE AVE",
            "city": "CODY",
            "state": "WY",
            "postal_code": "824149309",
            "telephone_number": "307-578-2904"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WEST PARK HOSPITAL DISTRICT",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "WEST PARK HOSPITAL DISTRICT",
        "enumeration_date": "2019-12-27",
        "last_updated": "2025-10-07",
        "certification_date": "2025-10-07",
        "status": "A",
        "authorized_official_last_name": "SALTERS",
        "authorized_official_first_name": "SHANNON",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "307-578-2486"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CODY REGIONAL RURAL HEALTH CLINIC",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "CODY REGIONAL RURAL HEALTH CLINIC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Cody, WY

Sources for this page

Verify at the official NPI Registry.