NPIMap

Organization Active NPI

Sublette County Hospital District

  • Skilled Nursing Facility
  • Pinedale, WY
National Provider Identifier
1689448748
Registry record updated Jul 14, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
SUBLETTE COUNTY HOSPITAL DISTRICT
Practice address
550 Fremont Lake Rd
Pinedale, WY 82941-5427
Phone
(307) 367-4161
Fax
(307) 367-4135
NPI assigned
Nov 9, 2023
Organization subpart
Yes
Parent organization
SUBLETTE COUNTY HOSPITAL DISTRICTAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 14, 2026

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

Authorized official

Name
Rex Walk
Title
Chief Executive Officer
Phone
(307) 367-0150

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X Primary

Addresses

Primary practice location

550 Fremont Lake Rd
Pinedale, WY 82941-5427

Mailing address

PO Box 788
Pinedale, WY 82941-0788
Phone (307) 367-4133

Other names 2

  • Heritage Home Doing business as
  • Sublette County Health Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240214002826 WY Part A Provider - Skilled Nursing Facility 5496163461 Practice locations: Pinedale, WY

Skilled nursing facility certification: CCN 535017

Legal name
SUBLETTE COUNTY HOSPITAL DISTRICT
Doing business as
HERITAGE HOME
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
May 20, 1982
Last certification
Feb 23, 2024
Beds
50
Ownership / control type
Hospital District
Organization structure
GovernmentNon-profit
Enrollment address
550 Fremont Lake Rd
Pinedale, WY 82941-5427
Nursing home name
HERITAGE HOME

Other NPIs with the same Medicare PAC ID 3

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

Care Compare: Nursing home

Medicare Care Compare
Listed as
Heritage HomeCCN 535017
Overall star rating
4 of 5
Health inspections
3 of 5
Staffing
4 of 5
Quality measures
5 of 5
Type
Medicare and Medicaid
Ownership
Government - Hospital district
Certified
May 20, 1982
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
5048.2 residents per day on average
Penalties (3 years)
1Fines totaling $9,718

Processed by Care Compare on Aug 1, 2026.

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
53D0678856Sublette County Hospital District550 Fremont Lake Rd, Pinedale, WY 82941Certificate of waiverMar 3, 2027

National Provider Directory

National Provider Directory
Tax ID family
Sublette County Hospital6 organizations share this tax ID, including this one
Part of
Sublette County Hospital

Other organizations with this tax ID 5

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

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

Ownership & related parties

All disclosed owners & managing parties 15

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

NameRoleSinceShare
Dawn Walker Individual Operational/Managerial Control Jan 1, 2024
Adp of the SNF Jan 1, 2024
Organization, Elkhorn, NE Corporation, LLC, Medical staffing company Adp of the SNF Nov 4, 2025
Marissa Mendes Individual Operational/Managerial Control Aug 31, 2025
Organization, Kalispell, MT Corporation, Holding company, Financial institution Adp of the SNF Nov 12, 2025
Organization, Pinedale, WY Corporation, For-profit Adp of the SNF Nov 4, 2025
Individual Adp of the SNF Apr 1, 2024
Organization, Elkhorn, NE LLC, Medical staffing company Adp of the SNF Nov 11, 2025
Sublette County Hospital District Organization, Pinedale, WY 5% Or Greater Direct Ownership Interest Jul 1, 2021 100%
Operational/Managerial Control Jan 1, 2024
Adp of the SNF Jan 1, 2024
Organization, Fargo, ND Consulting firm, For-profit Adp of the SNF Nov 12, 2025
William David Burnett Individual Operational/Managerial Control Nov 29, 2023
Adp of the SNF Nov 29, 2023
Organization, Spring Hill, TN Corporation, Management services company Adp of the SNF Jan 14, 2026
Organization, Omaha, NE Medical staffing company Adp of the SNF Nov 3, 2025
Organization, Pinedale, WY Corporation, Holding company, Financial institution Adp of the SNF Nov 12, 2025
Eide Bailly LLP Organization, Fargo, ND Consulting firm, For-profit Adp of the SNF Sep 10, 2024
William D Patten Individual Corporate OfficerInterim Chief Executive Officer Sep 12, 2025
Operational/Managerial Control Sep 12, 2025
Adp of the SNF Sep 12, 2025

Owners & managing parties with NPI records 4

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

All facility ownership & control disclosures 1

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

FacilityTypeRoleSince
Sublette County HealthPinedale, WY, CCN 531320 Hospital 5% Or Greater Direct Ownership Interest (100%) Jul 1, 2021

Owned or controlled facilities with NPI records 1

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

Facilities with the same owner 1

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

Practitioners & affiliated clinicians

Practitioners 3

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

Affiliated clinicians 4

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

NPI Registry JSON

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

{
    "created_epoch": "1699488000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1783987200000",
    "number": "1689448748",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 788",
            "city": "PINEDALE",
            "state": "WY",
            "postal_code": "829410788",
            "telephone_number": "307-367-4133",
            "fax_number": "307-367-6636"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 FREMONT LAKE RD",
            "city": "PINEDALE",
            "state": "WY",
            "postal_code": "829415427",
            "telephone_number": "307-367-4161",
            "fax_number": "307-367-4135"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUBLETTE COUNTY HOSPITAL DISTRICT",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SUBLETTE COUNTY HOSPITAL DISTRICT",
        "enumeration_date": "2023-11-09",
        "last_updated": "2026-07-14",
        "certification_date": "2026-07-14",
        "status": "A",
        "authorized_official_last_name": "WALK",
        "authorized_official_first_name": "REX",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "307-367-0150"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Heritage Home",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Sublette County Health",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Sublette County Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Pinedale, WY

Sources for this page

Verify at the official NPI Registry.