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University of Wyoming

Organization Active NPI Federally Qualified Health Center (FQHC) · Laramie, WY

NPI 1639617061 · NPPES record last updated Apr 22, 2026

Key facts

NPI
1639617061
Entity type
Organization (NPI type 2)
Primary specialty
Federally Qualified Health Center (FQHC) 261QF0400X
Legal business name
UNIVERSITY OF WYOMING
Practice address
2710 Harney St Ste 202
Laramie, WY 82072-2899
Phone
(307) 766-3313
Fax
(307) 766-3316
NPI assigned
Feb 6, 2017
Organization subpart
Yes
Parent organization (as reported)
UNIVERSITY OF WYOMING

Authorized official

Name
Sara Dalton
Title
Clinic Director
Phone
(307) 766-3313

Owners & managing parties with NPI records 2

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

Owned or controlled facilities with NPI records 2

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

Other NPIs on the same Medicare enrollment 4

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

Other NPIs with the same Medicare PAC ID 2

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

Corporate family (same tax ID) 10

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

Facilities with the same owner 2

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

Practitioners 167

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

View all 167

Laboratory certificates & supplier records

Name & address match These CMS records do not include an NPI. They are shown here because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
53D2132597University of Wyoming, Albany Community
2710 E Harney Street, Suite 202 and Suite 204, Laramie, WY 82072		Provider-performed microscopyJan 13, 2028

Medicare participation

Medicare fee-for-service enrollment
Enrolled (2 enrollments) in WY

Federally qualified health center certification: CCN 531824

Legal name
UNIVERSITY OF WYOMING
Doing business as
ALBANY COMMUNITY HEALTH CLINIC
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Apr 3, 2017
Last certification
Apr 3, 2017
Ownership / control type
For profit – corporation
Organization structure
Other · Non-profit
Enrollment address
2710 Harney St
Ste 202
Laramie, WY 82072-2899

All disclosed owners & managing parties 4

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

NameRoleSinceShare
Jonnie M Jenkins
Individual 		Corporate Officer
Chief Financial Officer		 Jan 1, 2023
Thomas Smoll
Individual 		Corporate Director
Executive Director		 Jan 1, 2023
University of Wyoming
Organization · Laramie, WY 		Operational/Managerial Control Jan 1, 2017
Jessyca Rodriguez
Individual 		W-2 Managing Employee
Revenue Cycle Manager		 Oct 2, 2024

All facility ownership & control disclosures 2

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

FacilityTypeRoleSince
University of Wyoming
Casper, WY · CCN 531818		 Federally qualified health center Operational/Managerial Control Jul 1, 1976
University of Wyoming
Cheyenne, WY · CCN 531819		 Federally qualified health center Operational/Managerial Control Jul 1, 1976

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20040610001637 WY Part B Supplier - Clinic/Group Practice 4183607054 Receives reassigned benefits from 82 practitioners
4 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Cheyenne, WY; Laramie, WY; Casper, WY
O20170502002191 WY Part a Provider - Federally Qualified Health Center (FQHC) 4183607054 Practice locations: Laramie, WY

National Provider Directory

Tax ID family
Uw Family Practice-Casp (11 organizations share this tax ID)
Part of
Uw Family Practice-Casp

Locations

1174 N 22nd St
Laramie, WY 82072
Phone (307) 745-3704

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician
Group: 193200000X MULTI-SPECIALTY GROUP		 207Q00000X
Federally Qualified Health Center (FQHC) 261QF0400X Yes

Addresses

Primary practice location

2710 Harney St Ste 202
Laramie, WY 82072-2899

Mailing address

2710 Harney St Ste 202
Laramie, WY 82072-2899
Phone (307) 766-3313

Other names

  • Albany Community Health Clinic Doing business as

Other providers in Laramie, WY

All providers in Laramie, WY · Federally Qualified Health Center (FQHC) in Wyoming

Sources for this page

Verify at the official NPI Registry.