Powell Valley Health Care Inc
Organization Active NPI Critical Access Hospital · Powell, WY
NPI 1497753115 · NPPES record last updated Feb 7, 2022
Key facts
- NPI
- 1497753115
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Critical Access Hospital 282NC0060X
- License
- 07084 (WY)
- Legal business name
- POWELL VALLEY HEALTH CARE INC
- Practice address
- 777 Avenue H
Powell, WY 82435 - Phone
- (307) 754-1101
- Fax
- (307) 754-3176
- NPI assigned
- Jul 8, 2005
- Organization subpart
- No
Authorized official
- Name
- Mrs. Terry Odom
- Title
- Ceo
- Phone
- (307) 754-1107
Owners & managing parties with NPI records 1
-
Nathaniel Rieb, M.D.
Other NPIs with the same Medicare PAC ID 4
Corporate family (same tax ID) 5
Related certifications (CCN) 1
Practitioners 108
-
Andrew B Baker, CRNA
-
Michael Allen Bellamy, D.O.
-
Jimmie G Biles Jr., M.D.
-
Michael K Bohlman, M.D.
-
Lindsay Nicole Carlson, M.D.
-
Adam W Childers, MD
-
Kelly E Christensen, M.D.
-
Nicole Marie Comer, M.D.
-
Adam C Crawford, RN
-
Ashley Dee Engesser, CNM, IBCLC
-
Stephen R Katz, CRNA
-
Jana Keeler, PA-C
-
Shawna Martin, CRNA
-
Bradley J North, DO
-
Aida R Polson, MD
-
Stephen Rogers, PA-C
-
Bryan Kenneth Tipton, PA-C, MPAS
-
Andrew Cox, MD
-
Paul F Hunt, M.D.
Affiliated clinicians 191
-
Julie Agee, FNP
-
Andrew B Baker, CRNA
-
Valerie J Baldes, MD
-
Nina Beach, FNP
-
Lael J. Beachler, DPM
-
Michael Allen Bellamy, D.O.
-
Sean E Beyer, MD
-
Jimmie G Biles Jr., M.D.
-
Amanda Bisby, FNP-BC
-
Michael K Bohlman, M.D.
-
Adair M. Bowlby, MD
-
Amanda Kay Buffkin, FNP-C
-
Troy J Caldwell, M.D.
-
Lindsay Nicole Carlson, M.D.
-
Adam W Childers, MD
-
Lisa Renee Christen, DNP, APRN-AGNP-C
-
Kelly E Christensen, M.D.
-
Gregory P Clark, P.A.
-
Carletta Collins, MD
-
Nicole Marie Comer, M.D.
Medicare Care Compare: Hospital
- Listed as
- Powell Valley Hospital
- Overall star rating
- ★★★★☆ 4 of 5
- Type
- Critical Access Hospitals
- Ownership
- Government - Hospital District or Authority
- Medicare certification status
- Active
- Emergency services
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in WY
Hospital certification: CCN 531310
- Legal name
- POWELL VALLEY HEALTH CARE INC
- Doing business as
- POWELL VALLEY CLINIC
- Certification status
- Active
- Provider type (POS)
- Hospital – Critical access hospital
- Participating since
- Nov 1, 2003
- Last certification
- Apr 7, 2022
- Beds
- 25
- Ownership / control type
- Hospital district or authority
- Organization structure
- Corporation · Non-profit
- Incorporated
- Jun 4, 1992 in WY
- Enrollment address
- 777 Avenue H
Powell, WY 82435-2260
All disclosed owners & managing parties 11
| Name | Role | Since | Share |
|---|---|---|---|
| Reynolds Kost |
Corporate Director | Jan 3, 2011 | |
| Larry Parker |
Corporate Director | Jan 3, 2011 | |
| Arleen Campeau |
Corporate Director |
Jan 1, 2017 | |
| Bonita Katz |
Corporate Director |
Jan 1, 2017 | |
| Elizabeth M Gilb |
Other |
Jan 1, 2017 | |
| James Carlson |
Corporate Director | Jan 3, 2011 | |
| Deborah Kleinfeldt |
Corporate Director | Apr 26, 2009 | |
| Stephen Miller |
Corporate Officer |
May 1, 2017 | |
| Gerri Ackley |
Corporate Director | Jan 1, 2017 | |
| Nicole Ostemiller |
Corporate Director |
Jan 1, 2017 | |
| W-2 Managing Employee |
Jan 1, 2017 | ||
| Nathaniel Rieb |
Corporate Director |
Jan 1, 2017 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20090617000663 | WY | Part a Provider - Critical Access Hospital | 5092798561 |
Receives reassigned benefits from 73 practitioners Practice locations: Powell, WY |
| O20220216002459 | WY | MDPP Supplier - in-Person MDPP Supplier | 5092798561 | Practice locations: Powell, WY |
National Provider Directory
- Tax ID family
- Powell Hospital
Locations
428 Alan Rd
Powell, WY 82435
Phone (307) 754-7750
Interoperability endpoints
- jclarkson@powellvalleyhealthcare.cernerdirect.com
- kchristensen2@powellvalleyhealthcare.cernerdirect.com
- daniel.fong@powellvalleyhealthcare.cernerdirect.com
- charles.lambiotte@powellvalleyhealthcare.cernerdirect.com
- jkeeler2@powellvalleyhealthcare.cernerdirect.com
- gclark@powellvalleyhealthcare.cernerdirect.com
- lindsay.carlson@powellvalleyhealthcare.cernerdirect.com
- bchristensen1@powellvalleyhealthcare.cernerdirect.com
- vlengfelder@powellvalleyhealthcare.cernerdirect.com
- espomer@powellvalleyhealthcare.cernerdirect.com
- mbohlman@powellvalleyhealthcare.cernerdirect.com
- abelmont@powellvalleyhealthcare.cernerdirect.com
- btipton1@powellvalleyhealthcare.cernerdirect.com
- lhill3@powellvalleyhealthcare.cernerdirect.com
- apolson@powellvalleyhealthcare.cernerdirect.com
- sfenwick@powellvalleyhealthcare.cernerdirect.com
- shawna.martin@powellvalleyhealthcare.cernerdirect.com
- achilders1@powellvalleyhealthcare.cernerdirect.com
- abuck1@powellvalleyhealthcare.cernerdirect.com
- acrawford@powellvalleyhealthcare.cernerdirect.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Critical Access Hospital | 282NC0060X | 07084 | WY | Yes |
| Rural Acute Care Hospital | 282NR1301X | 10207 | WY | |
| Land Ambulance | 3416L0300X | 065 | WY |
Addresses
Primary practice location
777 Avenue H
Powell, WY 82435
Mailing address
777 Avenue H
Powell, WY 82435-2260
Phone (307) 754-2267
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 107185807 | Medicaid | WY | |
| 007203 | Other | WY | BCBS PROVIDER NUMBER |
| 107185805 | Medicaid | WY | |
| 107185800 | Medicaid | WY | |
| 107185809 | Medicaid | WY |
Other providers in Powell, WY
- Aida R Polson
- Positive Progressions
- Positive Progressions, LLC
- Powell Valley Health Care Inc
- Powell Valley Health Care Inc
- Powell Valley Health Care Inc
- Powell Valley Health Care Inc
- Powell Valley Health Care Inc
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- Powell Valley Health Care Inc
All providers in Powell, WY · Critical Access Hospital in Wyoming
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 7, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.