NPIMap

Organization Active NPI

University of Wyoming

Doing business as Albany Community Health Clinic

  • Federally Qualified Health Center (FQHC)
  • Laramie, WY
National Provider Identifier
1639617061
Registry record updated Apr 22, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
UNIVERSITY OF WYOMING
Doing business as
Albany Community Health Clinic
Practice address
2710 Harney St Ste 202
Laramie, WY 82072-2899
Phone
(307) 766-3313
Fax
(307) 766-3316
NPI assigned
Feb 6, 2017
Last updated
Apr 22, 2026By the provider in NPPES
Organization subpart
Yes
Parent organization
UNIVERSITY OF WYOMINGAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 22, 2026

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

Authorized official

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X Primary
Family Medicine Physician 207Q00000X

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 1

  • Albany Community Health Clinic Doing business as

Medicare participation

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

Enrollment records 2

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

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1639617061. Details of each certification follow.

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
OtherNon-profit
Enrollment address
2710 Harney St
Ste 202
Laramie, WY 82072-2899

Other NPIs with the same Medicare PAC ID 2

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.

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
53D2132597University of Wyoming, Albany Community2710 E Harney Street, Suite 202 and Suite 204, Laramie, WY 82072Provider-performed microscopyJan 13, 2028

National Provider Directory

National Provider Directory
Tax ID family
U W Family Prac at Casp11 organizations share this tax ID, including this one
Part of
U W Family Prac at Casp

Other organizations with this tax ID 10

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

Locations

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

Ownership & related parties

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 OfficerChief Financial Officer Jan 1, 2023
Thomas Smoll Individual Corporate DirectorExecutive Director Jan 1, 2023
University of Wyoming Organization, Laramie, WY Operational/Managerial Control Jan 1, 2017
Jessyca Rodriguez Individual W-2 Managing EmployeeRevenue Cycle Manager Oct 2, 2024

Owners & managing parties with NPI records 2

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

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 WyomingCasper, WY, CCN 531818 Federally qualified health center Operational/Managerial Control Jul 1, 1976
University of WyomingCheyenne, WY, CCN 531819 Federally qualified health center Operational/Managerial Control Jul 1, 1976

Owned or controlled facilities with NPI records 2

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

Facilities with the same owner 2

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

Practitioners & affiliated clinicians

Practitioners 164

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 164

NPI Registry JSON

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

{
    "created_epoch": "1486339200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1776816000000",
    "number": "1639617061",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2710 HARNEY ST STE 202",
            "city": "LARAMIE",
            "state": "WY",
            "postal_code": "820722899",
            "telephone_number": "307-766-3313",
            "fax_number": "307-766-3316"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2710 HARNEY ST STE 202",
            "city": "LARAMIE",
            "state": "WY",
            "postal_code": "820722899",
            "telephone_number": "307-766-3313",
            "fax_number": "307-766-3316"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNIVERSITY OF WYOMING",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "UNIVERSITY OF WYOMING",
        "enumeration_date": "2017-02-06",
        "last_updated": "2026-04-22",
        "certification_date": "2026-04-22",
        "status": "A",
        "authorized_official_last_name": "DALTON",
        "authorized_official_first_name": "SARA",
        "authorized_official_title_or_position": "CLINIC DIRECTOR",
        "authorized_official_telephone_number": "307-766-3313"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Albany Community Health Clinic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Albany Community Health Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Laramie, WY

Sources for this page

Verify at the official NPI Registry.