Organization Active NPI

Five Star Quality Care-Wy LLC

Doing business as Worland Healthcare & Rehabilitation Center

  • Skilled Nursing Facility
  • Worland, WY
National Provider Identifier
1639124712
Registry record updated Mar 28, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
06-137 Issued in WY
Legal business name
FIVE STAR QUALITY CARE-WY LLC
Doing business as
Worland Healthcare & Rehabilitation Center
Practice address
1901 Howell Ave
Worland, WY 82401-3733
Phone
(307) 347-4285
Fax
(307) 347-2154
NPI assigned
May 24, 2006
Last updated
Mar 28, 2019By the provider in NPPES
Organization subpart
Yes
Parent organization
FIVE STAR QUALITY CARE-WY LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 28, 2019

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

Authorized official

Name
Katherine E Potter
Title
President & Chief Executive Officer
Phone
(617) 796-8387

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 06-137 WY Primary

Addresses

Primary practice location

1901 Howell Ave
Worland, WY 82401-3733

Mailing address

1901 Howell Ave
Worland, WY 82401-3733
Phone (307) 347-4285

Other identifiers 1

IdentifierTypeStateIssuer
115809100MedicaidWY

Other names 1

  • Worland Healthcare & Rehabilitation Center Doing business as

National Provider Directory

National Provider Directory
Part of
Five Star Quality Care-Wy LLC

NPI Registry JSON

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

{
    "created_epoch": "1148428800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1553731200000",
    "number": "1639124712",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1901 HOWELL AVE",
            "city": "WORLAND",
            "state": "WY",
            "postal_code": "824013733",
            "telephone_number": "307-347-4285",
            "fax_number": "307-347-2154"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1901 HOWELL AVE",
            "city": "WORLAND",
            "state": "WY",
            "postal_code": "824013733",
            "telephone_number": "307-347-4285",
            "fax_number": "307-347-2154"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FIVE STAR QUALITY CARE-WY LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "FIVE STAR QUALITY CARE-WY LLC",
        "enumeration_date": "2006-05-24",
        "last_updated": "2019-03-28",
        "status": "A",
        "authorized_official_last_name": "POTTER",
        "authorized_official_first_name": "KATHERINE",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "PRESIDENT & CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "617-796-8387"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "WY",
            "license": "06-137",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "115809100",
            "state": "WY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Worland Healthcare & Rehabilitation Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Worland Healthcare & Rehabilitation Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Worland, WY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.