NPIMap

Organization Active NPI

Stillwater Hospice of Northern Wyoming LLC

  • Community Based Hospice Care Agency
  • Lovell, WY
National Provider Identifier
1740744473
Registry record updated Mar 5, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
Legal business name
STILLWATER HOSPICE OF NORTHERN WYOMING LLC
Practice address
444 Montana Ave
Lovell, WY 82431-1958
Phone
(406) 671-5686
NPI assigned
Jan 28, 2019
Last updated
Mar 5, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 5, 2019

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

Authorized official

Name
Christopher Graham
Title
Executive Director
Phone
(406) 671-5686

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Based Hospice Care Agency 251G00000X Primary

Addresses

Primary practice location

444 Montana Ave
Lovell, WY 82431-1958

Mailing address

444 Montana Ave
Lovell, WY 82431-1958
Phone (406) 671-5686

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190304001864 WY Part A Provider - Hospice 8628317997 Practice locations: Powell, WY

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1740744473. Details of each certification follow.

Hospice certification: CCN 531527

Legal name
STILLWATER HOSPICE OF NORTHERN WYOMING LLC
Certification status
Active
Provider type (POS)
Hospice
Participating since
Nov 13, 2019
Last certification
Aug 17, 2022
Ownership / control type
Proprietary - Partnership
Organization structure
LLCProprietary
Enrollment address
210 N Bent St
Powell, WY 82435-2336

Care Compare: Hospice

Medicare Care Compare
Listed as
Stillwater Hospice of Northern Wyoming LLCCCN 531527 · All quality measures
Ownership
For-Profit
Certified
Nov 13, 2019
Medicare certification status
ActiveFrom the Provider of Services file

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
53D2167812Stillwater Hospice of Northern Wyoming210 N Bent Street, Powell, WY 82435Certificate of waiverJun 16, 2027

National Provider Directory

National Provider Directory

Locations

444 Montana Ave
Lovell, WY 82431
Phone (307) 548-1750

Ownership & related parties

All disclosed owners & managing parties 13

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

NameRoleSinceShare
Linda Rae Walker Individual W-2 Managing EmployeeAd; Nov 19, 2025 100%
WP Stillwater, LLC Organization, Littleton, CO Holding company, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Feb 27, 2026 55.94%
Stillwater Hospice, LLC Organization, Billings, MT Holding company, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Feb 27, 2026 100%
Stillwater Hospice Holdings LLC Organization, Billings, MT Created for acquisition, Holding company, Owned by another organization or individual 5% Or Greater Direct Ownership Interest Dec 27, 2023 100%
Eagle Fund VI-a, LP Organization, Saint Louis, MO Investment firm, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Feb 27, 2026 16.08%
Judd Lane Larowe Individual Contracted Managing EmployeeMD; Apr 11, 2024 50%
Christopher a Graham Individual 5% Or Greater Indirect Ownership InterestOwner Dec 27, 2023 19.07%
Corporate OfficerCfo Jan 25, 2019
W-2 Managing EmployeeExecutive Director Jan 25, 2019 100%
Northcreek Mezzanine Fund IV, L.P. Organization, Cincinnati, OH Investment firm, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Feb 27, 2026 14.82%
Jason C Weyer Individual Contracted Managing EmployeeMD; Apr 11, 2024 50%
Stillwater Healthcare Holdings, LLC Organization, Billings, MT Holding company, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Feb 27, 2026 100%
Stillwater Topco, LLC Organization, Billings, MT Holding company, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Feb 27, 2026 100%
Matthew R Warnick Individual 5% Or Greater Indirect Ownership InterestOwner Dec 27, 2023 19.07%
Corporate OfficerCoo Dec 27, 2023
Rise & Shout Holdings, LLC Organization, Billings, MT Holding company, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Feb 27, 2026 40.16%

Owners & managing parties with NPI records 2

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

Facilities with the same owner 4

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

  • Grace of the Pines Hospice LLC
    • Community Based Hospice Care Agency
    • Hot Springs, SD
    • NPI 1518338227

    Eagle Fund VI-a, LP, Northcreek Mezzanine Fund IV, L.P., Rise & Shout Holdings, LLC, Stillwater Healthcare Holdings, LLC, Stillwater Hospice Holdings LLC, Stillwater Hospice, LLC, Stillwater Topco, LLC, WP Stillwater, LLC

    CMS ownership
  • Hestia in-Home Support LLC

    dba Hestia Home Advantage

    • Family Nurse Practitioner
    • Missoula, MT
    • NPI 1619325016

    Eagle Fund VI-a, LP, Northcreek Mezzanine Fund IV, L.P., Rise & Shout Holdings, LLC, Stillwater Healthcare Holdings, LLC, Stillwater Hospice Holdings LLC, Stillwater Hospice, LLC, Stillwater Topco, LLC, WP Stillwater, LLC

    CMS ownership
  • Hospice of Montana III LLC

    dba Stillwater Hospice

    • Community Based Hospice Care Agency
    • Butte, MT
    • NPI 1336149517

    Eagle Fund VI-a, LP, Northcreek Mezzanine Fund IV, L.P., Rise & Shout Holdings, LLC, Stillwater Healthcare Holdings, LLC, Stillwater Hospice Holdings LLC, Stillwater Hospice, LLC, Stillwater Topco, LLC, WP Stillwater, LLC

    CMS ownership
  • Hospice of Montana, LLC

    dba Stillwater Hospice of Montana

    • Community Based Hospice Care Agency
    • Billings, MT
    • NPI 1659891505

    Eagle Fund VI-a, LP, Northcreek Mezzanine Fund IV, L.P., Rise & Shout Holdings, LLC, Stillwater Healthcare Holdings, LLC, Stillwater Hospice Holdings LLC, Stillwater Hospice, LLC, Stillwater Topco, LLC, WP Stillwater, LLC

    CMS ownership

Practitioners & affiliated clinicians

Practitioners 2

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.

Affiliated clinicians 20

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

View all 20

NPI Registry JSON

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

{
    "created_epoch": "1548633600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1551744000000",
    "number": "1740744473",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "444 MONTANA AVE",
            "city": "LOVELL",
            "state": "WY",
            "postal_code": "824311958",
            "telephone_number": "406-671-5686"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "444 MONTANA AVE",
            "city": "LOVELL",
            "state": "WY",
            "postal_code": "824311958",
            "telephone_number": "406-671-5686"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STILLWATER HOSPICE OF NORTHERN WYOMING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-01-28",
        "last_updated": "2019-03-05",
        "status": "A",
        "authorized_official_last_name": "GRAHAM",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "406-671-5686"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lovell, WY

Sources for this page

Verify at the official NPI Registry.