Organization Active NPI

Platte County Hospital District Board

  • Skilled Nursing Facility
  • Wheatland, WY
National Provider Identifier
1821324567
Registry record updated Apr 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
10302 Issued in WY
Legal business name
PLATTE COUNTY HOSPITAL DISTRICT BOARD
Practice address
100 19TH St
Wheatland, WY 82201-3162
Phone
(307) 322-7351
Fax
(307) 322-7351
NPI assigned
Oct 31, 2009
Organization subpart
Yes
Parent organization
PLATTE COUNTY HOSPITAL DISTRICT BOARDAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 30, 2024

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

Authorized official

Name
Josie Lauck, NHA
Title
Administrator
Phone
(307) 322-7351

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 10302 WY Primary

Addresses

Primary practice location

100 19TH St
Wheatland, WY 82201-3162

Mailing address

204 15TH St
PO Box 1148
Wheatland, WY 82201
Phone (307) 322-6406

Other identifiers 1

IdentifierTypeStateIssuer
128523800MedicaidWY

Other names 1

  • Platte County Legacy Home Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20101027000747 WY Part A Provider - Skilled Nursing Facility 1951595628 Practice locations: Wheatland, WY

Skilled nursing facility certification: CCN 535053

Legal name
PLATTE COUNTY HOSPITAL DISTRICT BOARD
Doing business as
PLATTE COUNTY LEGACY HOME
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Nov 1, 2010
Last certification
Jul 25, 2024
Beds
50
Ownership / control type
Other Nonprofit
Organization structure
OtherNon-profit
Enrollment address
100 19TH St
Wheatland, WY 82201-3162
Nursing home name
PLATTE COUNTY LEGACY HOME

Care Compare: Nursing home

Medicare Care Compare
Listed as
Platte County Legacy HomeCCN 535053
Overall star rating
3 of 5
Health inspections
3 of 5
Staffing
4 of 5
Quality measures
4 of 5
Type
Medicare and Medicaid
Ownership
Non profit - Other
Certified
Nov 1, 2010
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
5044.3 residents per day on average

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
53D1106553Platte County Legacy Home100 19TH Street, Wheatland, WY 82201Certificate of waiverOct 15, 2027

National Provider Directory

National Provider Directory
Part of
Platte County Hospital District Board

Locations

100 19th St
Wheatland, WY 82201
Phone (307) 322-6406

Ownership & related parties

All disclosed owners & managing parties 5

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

NameRoleSinceShare
Lauri a Palmer Individual Operational/Managerial Control Dec 9, 2024
Adp of the SNF Dec 9, 2024
Charles Frederick Individual Corporate DirectorVice-Chairman Feb 4, 2013
Jalea Jo Brockman Individual Operational/Managerial Control Dec 9, 2024
Adp of the SNF Dec 9, 2024
Platte County Hospital District Board Organization, Wheatland, WY Non-profit 5% Or Greater Direct Ownership Interest Nov 1, 2009 100%
Operational/Managerial Control Jan 1, 2023
Adp of the SNF Nov 1, 2009
Lori Modesitt Individual Corporate DirectorBoard Member Aug 24, 2010

Owners & managing parties with NPI records 1

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

Practitioners & affiliated clinicians

Practitioners 1

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

Affiliated clinicians 1

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": "1256947200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1714435200000",
    "number": "1821324567",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "204 15TH ST",
            "address_2": "PO BOX 1148",
            "city": "WHEATLAND",
            "state": "WY",
            "postal_code": "82201",
            "telephone_number": "307-322-6406",
            "fax_number": "307-322-4065"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 19TH ST",
            "city": "WHEATLAND",
            "state": "WY",
            "postal_code": "822013162",
            "telephone_number": "307-322-7351",
            "fax_number": "307-322-7351"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PLATTE COUNTY HOSPITAL DISTRICT BOARD",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PLATTE COUNTY HOSPITAL  DISTRICT BOARD",
        "enumeration_date": "2009-10-31",
        "last_updated": "2024-04-30",
        "certification_date": "2024-04-30",
        "status": "A",
        "authorized_official_last_name": "LAUCK",
        "authorized_official_first_name": "JOSIE",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "307-322-7351",
        "authorized_official_credential": "NHA"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "WY",
            "license": "10302",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "128523800",
            "state": "WY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Platte County Legacy Home",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Wheatland, WY

Sources for this page

Verify at the official NPI Registry.