NPIMap

Organization Active NPI

West Park Hospital District

  • Medicare Defined Swing Bed Hospital Unit
  • Cody, WY
National Provider Identifier
1740360288
Registry record updated Nov 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medicare Defined Swing Bed Hospital UnitTaxonomy code 275N00000X
Legal business name
WEST PARK HOSPITAL DISTRICT
Practice address
707 Sheridan Ave
Cody, WY 82414-3409
Phone
(307) 527-5201
Fax
(307) 578-2485
NPI assigned
Oct 17, 2006
Last updated
Nov 19, 2025By the provider in NPPES
Organization subpart
Yes
Parent organization
WEST PARK HOSPITAL DISTRICTAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 19, 2025

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

Authorized official

Name
Coby La Blue
Title
Cfo
Phone
(307) 578-2489

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medicare Defined Swing Bed Hospital Unit 275N00000X Primary

Addresses

Primary practice location

707 Sheridan Ave
Cody, WY 82414-3409

Mailing address

707 Sheridan Ave
Cody, WY 82414-3409
Phone (307) 527-5201

Other identifiers 4

IdentifierTypeStateIssuer
106133000MedicaidWY
106133005MedicaidWY
007062OtherWYBLUE CROSS
041795OtherWYBLUE CROSS

Other names 1

  • Swing Bed Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090427000596 WY Part A Provider - Critical Access Hospital 7315855624 Practice locations: Cody, WY

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1740360288. Details of each certification follow.

Hospital certification: CCN 53Z312

Legal name
WEST PARK HOSPITAL DISTRICT
Doing business as
CODY REGIONAL HEALTH
Organization structure
GovernmentNon-profit
Enrollment address
707 Sheridan Ave
Cody, WY 82414-3409
Hospital Swing-Bed Unit

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

Other NPIs with the same Medicare PAC ID 5

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

National Provider Directory

National Provider Directory
Tax ID family
Lake Hosp and Clinic13 organizations share this tax ID, including this one
Part of
Lake Hosp and Clinic

Other organizations with this tax ID 12

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

Ownership & related parties

All disclosed owners & managing parties 7

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

NameRoleSinceShare
Peter D Sidor Individual OtherSecretary Nov 1, 2024 16%
Angela Johnson Individual OtherVice-Chariman Oct 19, 2023 16%
Richard Tyler Nelson Individual OtherChairman Jan 1, 2013 16%
Jennifer M Talich Individual OtherTreasurer Nov 1, 2024 16%
Coby Lablue Individual Corporate OfficerCfo May 19, 2025 18%
Operational/Managerial ControlCfo May 19, 2025
West Park Hospital District Organization, Cody, WY Medical provider/supplier, Non-profit 5% Or Greater Direct Ownership Interest Jan 1, 1986 100%
Mary Hannah McRae Individual Corporate OfficerCeo Oct 1, 2021 18%

Owners & managing parties with NPI records 6

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

All facility ownership & control disclosures 6

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

FacilityTypeRoleSince
Cody Regional HealthCody, WY, CCN 531312 Hospital Operational/Managerial Control Jan 22, 2009
Cody Regional Health Long Term Care CenterCody, WY, CCN 535027 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control
Adp of the SNF		 Feb 23, 2009
Feb 23, 2009
Feb 3, 2009
Cody Regional Health Home HealthCody, WY, CCN 537031 Home health agency 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Aug 9, 2012
Aug 9, 2012
Cody Regional Health Home Health and Spirit Mountain HospiceCody, WY, CCN 531505 Hospice Other (100%) Jul 1, 1995
Cody Regional HealthCody, WY, CCN 533401 Rural health clinic 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control		 Nov 25, 2021
Nov 25, 2021
Cody Regional Basin Rural Health ClinicBasin, WY, CCN 538500 Rural health clinic Operational/Managerial Control Jan 1, 2023

Owned or controlled facilities with NPI records 7

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

Facilities with the same owner 5

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

Practitioners & affiliated clinicians

Affiliated clinicians 6

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": "1161043200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1763510400000",
    "number": "1740360288",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "707 SHERIDAN AVE",
            "city": "CODY",
            "state": "WY",
            "postal_code": "824143409",
            "telephone_number": "307-527-5201",
            "fax_number": "307-578-2485"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "707 SHERIDAN AVE",
            "city": "CODY",
            "state": "WY",
            "postal_code": "824143409",
            "telephone_number": "307-527-5201",
            "fax_number": "307-578-2485"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WEST PARK HOSPITAL DISTRICT",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "WEST PARK HOSPITAL DISTRICT",
        "enumeration_date": "2006-10-17",
        "last_updated": "2025-11-19",
        "certification_date": "2025-11-19",
        "status": "A",
        "authorized_official_last_name": "LA BLUE",
        "authorized_official_first_name": "COBY",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "307-578-2489"
    },
    "taxonomies": [
        {
            "code": "275N00000X",
            "taxonomy_group": "",
            "desc": "Medicare Defined Swing Bed Unit",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "106133000",
            "state": "WY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "106133005",
            "state": "WY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "007062",
            "state": "WY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "041795",
            "state": "WY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Swing Bed",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Swing Bed",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Cody, WY

Sources for this page

Verify at the official NPI Registry.