NPIMap

Organization Active NPI

Memorial Hospital of Converse County

Doing business as Register Cliff Rural Health Clinic

  • Rural Health Clinic/Center
  • Guernsey, WY
National Provider Identifier
1871503375
Registry record updated Mar 5, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
License
07163 Issued in WY
Legal business name
MEMORIAL HOSPITAL OF CONVERSE COUNTY
Doing business as
Register Cliff Rural Health Clinic
Practice address
650 W Whalen
Guernsey, WY 82214-9999
Phone
(307) 836-3009
Fax
(307) 836-3022
NPI assigned
Aug 8, 2006
Last updated
Mar 5, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 5, 2013

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

Authorized official

Name
Mr. Curt Dugger
Title
Cfo
Phone
(307) 358-2122

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X 07163 WY Primary

Addresses

Primary practice location

650 W Whalen
Guernsey, WY 82214-9999

Mailing address

PO Box 1450
Douglas, WY 82633-1450
Phone (307) 358-2122

Other identifiers 1

IdentifierTypeStateIssuer
107215318MedicaidWY

Other names 1

  • Register Cliff Rural Health Clinic Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040902000318 WY Part A Provider - Rural Health Clinic 2264340843 Practice locations: Guernsey, WY

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1871503375. Details of each certification follow.

Rural health clinic certification: CCN 533989

Legal name
MEMORIAL HOSPITAL OF CONVERSE COUNTY
Doing business as
REGISTER CLIFF RURAL HEALTH CLINIC
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Nov 24, 2004
Last certification
Sep 16, 2025
Ownership / control type
Non-profit – church related
Organization structure
GovernmentNon-profit
Incorporated
Jun 1, 2004 in WY
Enrollment address
650 W Whalen St
Guernsey, WY 82214
Related CCNs
531302

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

Other NPIs with the same Medicare PAC ID 4

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

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
53D1034218Register Cliff Rural Health Clinic650 West Whalen Street, Guernsey, WY 82214ComplianceMay 29, 2026

National Provider Directory

National Provider Directory
Tax ID family
Memorial Hospital of Co5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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

Ownership & related parties

All disclosed owners & managing parties 2

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

NameRoleSinceShare
Memorial Hospital of Converse County Organization, Douglas, WY Non-profit 5% Or Greater Direct Ownership Interest Jun 1, 2004 100%
James Cussins Individual W-2 Managing Employee Jan 2, 2019 100%

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 3

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

FacilityTypeRoleSince
Memorial Hospital of Converse CountyDouglas, WY, CCN 531302 Hospital 5% Or Greater Direct Ownership Interest (100%) Dec 31, 2009
Memorial Hospital of Converse CountyDouglas, WY, CCN 53Z302 Hospital 5% Or Greater Indirect Ownership Interest (100%) Jan 1, 2014
Oregon Trail Rural Health ClinicRolling Hills, WY, CCN 533987 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Jan 1, 1990

Owned or controlled facilities with NPI records 3

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

Facilities with the same owner 3

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

NPI Registry JSON

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

{
    "created_epoch": "1154995200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1362441600000",
    "number": "1871503375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1450",
            "city": "DOUGLAS",
            "state": "WY",
            "postal_code": "826331450",
            "telephone_number": "307-358-2122",
            "fax_number": "307-358-9216"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "650 W WHALEN",
            "city": "GUERNSEY",
            "state": "WY",
            "postal_code": "822149999",
            "telephone_number": "307-836-3009",
            "fax_number": "307-836-3022"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEMORIAL HOSPITAL OF CONVERSE COUNTY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-08",
        "last_updated": "2013-03-05",
        "status": "A",
        "authorized_official_last_name": "DUGGER",
        "authorized_official_first_name": "CURT",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "307-358-2122",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "WY",
            "license": "07163",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "107215318",
            "state": "WY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Register Cliff Rural Health Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Guernsey, WY

Sources for this page

Verify at the official NPI Registry.