NPIMap

Organization Active NPI

Powell Valley Health Care Inc

  • Critical Access Hospital
  • Powell, WY
National Provider Identifier
1497753115
Registry record updated Feb 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Access HospitalTaxonomy code 282NC0060X
License
07084 Issued in 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
Last updated
Feb 7, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 7, 2022

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

Authorized official

Name
Mrs. Terry Odom
Title
Ceo
Phone
(307) 754-1107

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Access Hospital 282NC0060X 07084 WY Primary
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

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
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

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1497753115. Details of each certification follow.

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
CorporationNon-profit
Incorporated
Jun 4, 1992 in WY
Enrollment address
777 Avenue H
Powell, WY 82435-2260
Other Hospital Practice Location

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

Other NPIs with the same Medicare PAC ID 4

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

Care Compare: Hospital

Medicare Care Compare
Listed as
Powell Valley HospitalCCN 531310 · All quality measures
Overall star rating
4 of 5
Type
Critical Access Hospitals
Ownership
Government - Hospital District or Authority
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory
Tax ID family
Powell Hospital6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

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

Locations

428 Alan Rd
Powell, WY 82435
Phone (307) 754-7750

Interoperability endpoints

  • Direct secure messaging: abaker@powellvalleyhealthcare.cernerdirect.com
  • Direct secure messaging: abelmont@powellvalleyhealthcare.cernerdirect.com
  • Direct secure messaging: abillin1@powellvalleyhealthcare.cernerdirect.com
  • Direct secure messaging: abuck1@powellvalleyhealthcare.cernerdirect.com
  • Direct secure messaging: achilders1@powellvalleyhealthcare.cernerdirect.com
  • Direct secure messaging: acrawford@powellvalleyhealthcare.cernerdirect.com
  • Direct secure messaging: apolson@powellvalleyhealthcare.cernerdirect.com
  • Direct secure messaging: bchristensen1@powellvalleyhealthcare.cernerdirect.com
  • Direct secure messaging: bnorth8@powellvalleyhealthcare.cernerdirect.com
  • Direct secure messaging: btipton1@powellvalleyhealthcare.cernerdirect.com
  • Direct secure messaging: ccollins1@powellvalleyhealthcare.cernerdirect.com
  • Direct secure messaging: charles.lambiotte@powellvalleyhealthcare.cernerdirect.com
  • Direct secure messaging: daniel.fong@powellvalleyhealthcare.cernerdirect.com
  • Direct secure messaging: espomer@powellvalleyhealthcare.cernerdirect.com
  • Direct secure messaging: gclark@powellvalleyhealthcare.cernerdirect.com
  • Direct secure messaging: jclarkson@powellvalleyhealthcare.cernerdirect.com
  • Direct secure messaging: jkeeler2@powellvalleyhealthcare.cernerdirect.com
  • Direct secure messaging: kchristensen2@powellvalleyhealthcare.cernerdirect.com
  • Direct secure messaging: lhill3@powellvalleyhealthcare.cernerdirect.com
  • Direct secure messaging: lindsay.carlson@powellvalleyhealthcare.cernerdirect.com

Ownership & related parties

All disclosed owners & managing parties 11

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

NameRoleSinceShare
Reynolds Kost Individual Corporate Director Jan 3, 2011
Larry Parker Individual Corporate Director Jan 3, 2011
Arleen Campeau Individual Corporate DirectorCno Jan 1, 2017
Bonita Katz Individual Corporate DirectorBoard Member Jan 1, 2017
Elizabeth M Gilb Individual OtherBoard Member Jan 1, 2017
James Carlson Individual Corporate Director Jan 3, 2011
Deborah Kleinfeldt Individual Corporate Director Apr 26, 2009
Stephen Miller Individual Corporate OfficerInterim Cfo May 1, 2017
Gerri Ackley Individual Corporate Director Jan 1, 2017
Nicole Ostemiller Individual Corporate DirectorLTC Admin Jan 1, 2017
W-2 Managing EmployeeAuthorized Official Jan 1, 2017
Nathaniel Rieb Individual Corporate DirectorBoard Member/Cos Jan 1, 2017

Owners & managing parties with NPI records 1

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

Practitioners & affiliated clinicians

Practitioners 107

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.

View all 107

Affiliated clinicians 191

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

View all 191

NPI Registry JSON

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

{
    "created_epoch": "1120780800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1644192000000",
    "number": "1497753115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "777 AVENUE H",
            "city": "POWELL",
            "state": "WY",
            "postal_code": "824352260",
            "telephone_number": "307-754-2267",
            "fax_number": "307-754-3176"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "777 AVENUE H",
            "city": "POWELL",
            "state": "WY",
            "postal_code": "82435",
            "telephone_number": "307-754-1101",
            "fax_number": "307-754-3176"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "POWELL VALLEY HEALTH CARE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-08",
        "last_updated": "2022-02-07",
        "certification_date": "2022-02-07",
        "status": "A",
        "authorized_official_last_name": "ODOM",
        "authorized_official_first_name": "TERRY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "307-754-1107",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "282NC0060X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Critical Access",
            "state": "WY",
            "license": "07084",
            "primary": true
        },
        {
            "code": "282NR1301X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Rural",
            "state": "WY",
            "license": "10207",
            "primary": false
        },
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "WY",
            "license": "065",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Powell, WY

Sources for this page

Verify at the official NPI Registry.