NPIMap

Organization Active NPI

Crook County Medical Services District

  • Family Medicine Physician
  • Hulett, WY
National Provider Identifier
1912075102
Registry record updated May 6, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
CROOK COUNTY MEDICAL SERVICES DISTRICT
Practice address
122 Main Street
Hulett, WY 82720
Phone
(307) 467-5281
Fax
(307) 283-2255
NPI assigned
Dec 4, 2006
Last updated
May 6, 2026By the provider in NPPES
Organization subpart
Yes
Parent organization
CROOK COUNTY MEDICAL SERVICES DISTRICTAs reported in NPPES

NPPES NPI Registry

Updated by the provider on May 6, 2026

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

Authorized official

Name
Micki Dahne Lyons, DNPNPI 1023445459
Title
Ceo
Phone
(307) 283-3501

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X Primary
Rural Health Clinic/Center 261QR1300X

Addresses

Primary practice location

122 Main Street
Hulett, WY 82720

Mailing address

PO Box 517
713 Oak Street
Sundance, WY 82729-0517
Phone (307) 283-3501

Other identifiers 2

IdentifierTypeStateIssuer
106178003MedicaidWY
106178007MedicaidWY

Other names 1

  • Hulett Clinic Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WY2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040127001018 WY Part B Supplier - Clinic/Group Practice 9234032483 Receives reassigned benefits from 13 practitioners
4 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Hulett, WY; Moorcroft, WY; Sundance, WY
O20101026001460 WY Part A Provider - Rural Health Clinic 9234032483 Practice locations: Hulett, WY

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1912075102. Details of each certification follow.

Rural health clinic certification: CCN 533978

Legal name
CROOK COUNTY MEDICAL SERVICES DISTRICT
Doing business as
HULETT CLINIC
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Aug 24, 1994
Last certification
Oct 2, 2018
Ownership / control type
2B
Organization structure
GovernmentNon-profit
Enrollment address
122 Main St
Hulett, WY 82720
Related CCNs
531311

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).

Other NPIs on the same Medicare enrollment 4

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Sundance Clinic6 organizations share this tax ID, including this one
Part of
Sundance Clinic

Other organizations with this tax ID 5

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
Micki D Lyons Individual Corporate DirectorCeo May 1, 2020
W-2 Managing EmployeeCeo May 1, 2020
Operational/Managerial ControlCeo May 1, 2020
Sandra Neiman Individual Corporate DirectorBoard Member Oct 1, 2010

Owners & managing parties with NPI records 1

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
Crook County Medical Services DistrictSundance, WY, CCN 531311 Hospital Operational/Managerial Control May 14, 1999
Crook County Medical Services DistrictSundance, WY, CCN 53Z311 Hospital Operational/Managerial Control Nov 23, 2015
Sundance ClinicSundance, WY, CCN 533976 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Jun 26, 1995

Owned or controlled facilities with NPI records 2

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

Practitioners & affiliated clinicians

Practitioners 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1165190400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1778025600000",
    "number": "1912075102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 517",
            "address_2": "713 OAK STREET",
            "city": "SUNDANCE",
            "state": "WY",
            "postal_code": "827290517",
            "telephone_number": "307-283-3501",
            "fax_number": "307-283-2255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "122 MAIN STREET",
            "city": "HULETT",
            "state": "WY",
            "postal_code": "82720",
            "telephone_number": "307-467-5281",
            "fax_number": "307-283-2255"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CROOK COUNTY MEDICAL SERVICES DISTRICT",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CROOK COUNTY MEDICAL SERVICES DISTRICT",
        "enumeration_date": "2006-12-04",
        "last_updated": "2026-05-06",
        "certification_date": "2026-05-06",
        "status": "A",
        "authorized_official_last_name": "LYONS",
        "authorized_official_first_name": "MICKI",
        "authorized_official_middle_name": "DAHNE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "307-283-3501",
        "authorized_official_credential": "DNP"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "106178003",
            "state": "WY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "106178007",
            "state": "WY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Hulett Clinic",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Hulett Clinic",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Hulett, WY

Sources for this page

Verify at the official NPI Registry.