NPIMap

Organization Active NPI

Bighorn Valley Health Center Incorporated

Doing business as One Health

  • Federally Qualified Health Center (FQHC)
  • Powell, WY
National Provider Identifier
1922761600
Registry record updated Oct 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
BIGHORN VALLEY HEALTH CENTER INCORPORATED
Doing business as
One Health
Practice address
130 N Bent St Ste B
Powell, WY 82435-2742
Phone
(307) 764-4107
Fax
(307) 764-1879
NPI assigned
Oct 19, 2021
Last updated
Oct 20, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 20, 2022

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

Authorized official

Name
David Andrew Mark, MD
Title
Ceo
Phone
(406) 665-4103

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X Primary

Addresses

Primary practice location

130 N Bent St Ste B
Powell, WY 82435-2742

Mailing address

130 N Bent St Ste B
Powell, WY 82435-2742
Phone (307) 764-1602

Other names 1

  • ONE HEALTH Doing business as

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20220714004049 WY Part A Provider - Federally Qualified Health Center (FQHC) 8820246077 Practice locations: Powell, WY
O20220727003352 WY Part B Supplier - Clinic/Group Practice 8820246077 Receives reassigned benefits from 28 practitioners
7 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Sheridan, WY; Powell, WY; Lovell, WY; Cody, WY; Greybull, WY

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1922761600. Details of each certification follow.

Federally qualified health center certification: CCN 531831

Legal name
BIGHORN VALLEY HEALTH CENTER INCORPORATED
Doing business as
ONE HEALTH
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Apr 5, 2021
Last certification
Apr 5, 2021
Ownership / control type
For profit – corporation
Most recent change of ownership
Jun 1, 2022 (1 total)
Organization structure
CorporationNon-profit
Incorporated
Sep 2, 2010 in MT
Enrollment address
130 N Bent St
Ste B
Powell, WY 82435-2742

Other NPIs with the same Medicare PAC ID 23

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

View all 23

Other NPIs on the same Medicare enrollment 7

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

National Provider Directory

National Provider Directory
Tax ID family
Bighorn Valley HLTH Ctr Inc32 organizations share this tax ID, including this one

Other organizations with this tax ID 31

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

View all 31

Locations

130 N Bent St
Ste B
Powell, WY 82435
Phone (307) 764-1602

Ownership & related parties

All disclosed owners & managing parties 25

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

NameRoleSinceShare
Martin V Thone Individual Corporate DirectorBoard Member Sep 24, 2015
Sara Pretty Weasel Individual Corporate DirectorBoard Member Jan 8, 2015
Beth Hronek Individual Corporate DirectorBoard Member Jun 1, 2022
Corporate DirectorDirector Board Member Jan 4, 2020 9.1%
Barbara Skoyen Individual Corporate DirectorBoard Member Nov 1, 2018
Curtis B Whicker Individual Corporate DirectorBoard Member Jun 1, 2022
Julie Mann Individual Corporate OfficerAssistant Revenue Cycle Manager Jun 1, 2022
Timothy Hardy Individual Corporate DirectorBoard Member Mar 11, 2013
David a Mark Individual Corporate OfficerCeo Jun 28, 2012
W-2 Managing EmployeeCeo Jun 28, 2012
Eric Tiner Individual Corporate DirectorBoard Member Jun 8, 2017
Carrie McCleary Individual Corporate DirectorBoard Member Feb 12, 2015
Andrea Martin Individual Corporate OfficerRevenue Cycle Manager Sep 21, 2021
William Briggs Individual Corporate DirectorBoard Member Sep 24, 2015
Eli Hofer Individual Corporate DirectorBoard Member Nov 1, 2018
Juanita M Sapp Individual Corporate DirectorBoard Member Jun 1, 2022
Thomas Bibbey Individual Corporate OfficerPresident Feb 24, 2016 9.1%
Chad Miner Individual Corporate DirectorDirector Board Member Jan 4, 2020 9.1%
Patricia Moulton Individual Corporate OfficerTreasurer Feb 24, 2016 9.1%
Cindy Ibarra Individual Corporate DirectorSecretary Feb 24, 2019 9.1%
Brooke Fink Individual Corporate DirectorDirector Board Member Jan 4, 2020 9.1%
Sharon Earhart Individual Corporate DirectorDirector Board Member Jan 4, 2020 9.1%
Wes Metzler Individual Corporate DirectorDirector Board Member Feb 24, 2018 9.1%
Scott E Kolpitcke Individual Corporate OfficerVice President Jan 1, 2018 9.1%
Blake Thompson Individual Corporate DirectorDirector Board Member Jan 4, 2020 9.1%
Casey Bowe Individual Corporate DirectorDirector Board Member Jan 4, 2020 9.1%
Colette Mild Individual Corporate OfficerCeo Jun 8, 2015 100%
W-2 Managing EmployeeCeo Jun 8, 2015 100%

Owners & managing parties with NPI records 2

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

Change-of-ownership history 2

DateEventCounterparty
Jun 1, 2022 Change of OwnershipThis provider was the buyer Heritage Health CenterCCN 531831, WY, NPI 1922761600
Jun 1, 2022 Change of OwnershipThis provider was the seller One HealthCCN 531831, WY, NPI 1922761600

Practitioners & affiliated clinicians

Practitioners 4

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": "1634601600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1666224000000",
    "number": "1922761600",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 N BENT ST STE B",
            "city": "POWELL",
            "state": "WY",
            "postal_code": "824352742",
            "telephone_number": "307-764-1602",
            "fax_number": "307-764-1879"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 N BENT ST STE B",
            "city": "POWELL",
            "state": "WY",
            "postal_code": "824352742",
            "telephone_number": "307-764-4107",
            "fax_number": "307-764-1879"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BIGHORN VALLEY HEALTH CENTER INCORPORATED",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-10-19",
        "last_updated": "2022-10-20",
        "certification_date": "2022-10-20",
        "status": "A",
        "authorized_official_last_name": "MARK",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "ANDREW",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "406-665-4103",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ONE HEALTH",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Powell, WY

Sources for this page

Verify at the official NPI Registry.