TETON COUNTY HOSPITAL DISTRICT (NPI# 1215064985) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1215064985 |
| Entity Type | Organization |
| Organization Name | TETON COUNTY HOSPITAL DISTRICT |
| Other Organization Name | ST JOHN'S NURSING HOME |
| Practice Address |
625 East Broadway Jackson WY 83001-8642 |
| Mailing Address |
Po Box 428 Jackson WY 83001-0428 |
| Practice Telephone | 3077397450 |
| Practice Fax Number | 3077397344 |
| Mailing Telephone | 3077397450 |
| Mailing Fax Number | 3077397344 |
| Enumeration Date | 2007-02-28 |
| Last Update Date | 2020-09-21 |
| Authorized Official Name | JOHN KREN (CFO) |
| Authorized Official Telephone | 3077397526 |
| Is Organization Subpart | Y |
| Parent Organization Name | TETON COUNTY HOSPITAL DISTRICT |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 314000000X | Skilled Nursing Facility | 15145 | WY | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WY | 106299901 | 05 |
| Other Name | Type Code |
|---|---|
| St John's Living Center | Doing Business As Name - Organization |
| St John's Nursing Home | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952823783 | Teton County Hospital District | Pharmacy | 555 E Broadway Ave Ste 212, Jackson, WY 83001-8640 | 2017-07-13 |
| 1457665333 | Teton County Hospital District | General Practice | Box 428 625 E Broadway Ave, Jackson, WY 83001-8642 | 2010-08-03 |
| 1679859797 | Teton County Hospital District | General Practice | 852 Valley Centre Dr, Driggs, ID 83422-5005 | 2011-11-03 |
| 1821317595 | Teton County Hospital District | Emergency Medicine | 625 E Broadway Ave, Jackson Hole, WY 83001-8642 | 2010-05-20 |
| 1487818605 | Teton County Hospital District | General Practice | 625 E Broadway Ave, Jackson, WY 83001-8642 | 2008-07-16 |
| 1881896694 | Teton County Hospital District | General Acute Care Hospital | 625 East Broadway, Jackson, WY 83001 | 2007-06-04 |
| 1801929997 | Teton County Hospital District | Medicare Defined Swing Bed Unit | 625 E Broadway, Jackson, WY 83001-0428 | 2007-03-14 |
| 1972657179 | Teton County Hospital District | Pharmacy | 625 E Broadway Ave, Jackson, WY 83001-8642 | 2007-01-23 |
| 1194744235 | Teton County Hospital District | Case Management | 555 E Broadway Ave, Ste 115, Jackson, WY 83001-8640 | 2006-07-19 |
| 1568493989 | Teton County Hospital District | Hospice Care, Community Based | 555 E Broadway Ave, Suite #115, Jackson, WY 83001-8640 | 2006-07-05 |
| Street Address |
625 EAST BROADWAY |
| City | JACKSON |
| State | WY |
| Zip Code | 83001-8642 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316979057 | William David Hamilton | Nurse Anesthetist, Certified Registered | 625 East Broadway, Jackson, WY 83001 | 2006-07-06 |
| 1881896694 | Teton County Hospital District | General Acute Care Hospital | 625 East Broadway, Jackson, WY 83001 | 2007-06-04 |
| 1700990777 | Robert C Berlin | Radiology | 625 East Broadway, St Johns Medical Center Dept of Radiology, Jackson, WY 83001 | 2006-08-18 |
| 1417061482 | Christopher Sean Haling | Radiology | 625 East Broadway, St Johns Medical Center Dept of Radiology, Jackson, WY 83001 | 2006-08-18 |
| 1689788655 | Thomas J Wilson | Radiology | 625 East Broadway, St Johns Medical Center Dept of Radiology, Jackson, WY 83001 | 2006-08-18 |
| 1952317323 | Gary W Heath | Radiology | 625 East Broadway, St Johns Medical Center Dept of Radiology, Jackson, WY 83001 | 2006-07-31 |
| 1184656191 | Jean Ann Hamilton | Nurse Anesthetist, Certified Registered | 625 East Broadway, Jackson, WY 83001 | 2006-07-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861006108 | Anne Kathleen Milburn | Physical Therapist | 3620 S Park Drive, Jackson, WY 83001 | 2020-09-03 |
| 1568009637 | Katherine Pringle Ford | Case Manager/Care Coordinator | 2065 E. Limber Pine Road, Jackson, WY 83001 | 2019-12-07 |
| 1043878408 | Cossette Burnham | Physical Therapist | Four Pines Physical Therapy, 1090 S Hwy 89, Jackson, WY 83001 | 2019-05-31 |
| 1982169371 | Cynthia Buck Huyffer | Social Worker | 755a Cache Creek Drive, Jackson, WY 83001 | 2019-02-10 |
| 1093281594 | Lara Cilo | Speech-Language Pathologist | 1300 W. Valley Springs Road, Jackson, WY 83001 | 2018-10-23 |
| 1740776202 | Teton Oral and Maxillofacial Surgery | Dentist | 1160 Alpine Ln Ste 1d, Jackson, WY 83001 | 2018-07-09 |
| 1437642055 | Anna Yanchek | Physical Therapist | 1090 Us- 89, Jackson Hole, WY 83001 | 2018-06-08 |
| 1891200762 | Tyler Ross Wright | Chiropractor | 1325 Us-89, Suite 108, Jackson, WY 83001 | 2017-12-13 |
| 1073027280 | Root To Rise Counseling and Consulting, Pllc | Social Worker | 2033 Dandelion Court, Jackson, WY 83001 | 2017-11-27 |
| 1962923912 | Piper Worthington | Social Worker | 1910 High School Rd, Jackson, WY 83001 | 2017-06-29 |
| Find all providers in zip 83001 | ||||
| Taxonomy Code | 314000000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Skilled Nursing Facility |
| (1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to reach a degree of body functioning to permit self care in essential daily living. It meets any licensing or certification standards et forth by the jurisdiction where it is located. A skilled nursing facility may be a freestanding facility or part of a hospital that has been certified by Medicare to admit patients requiring subacute care and rehabilitation; (2) Provides non-acute medical and skilled nursing care services, therapy and social services under the supervision of a licensed registered nurse on a 24-hour basis. |
| Notes: Source: (1) "Glossary of terms used in managed care" Developed by the Managed Care Assembly (MCA) of Medical Group Management Association (MGMA), MGM Journal, September/October 1995, p. 64; (2) AHA Guide, 1996 Annual Survey. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326348897 | Laurie L. Mcbride | Skilled Nursing Facility | 180 W University Pkwy Ste H, Jackson, TN 38305-1612 | 2010-10-29 |
| 1407179039 | Caring Hands Community Services Inc | Skilled Nursing Facility | 3318 Longwood Drive, Jackson, MS 39212 | 2010-03-10 |
| 1568791804 | North Street Healthcare LLC | Skilled Nursing Facility | 865 North St, Jackson, MS 39202-3020 | 2009-12-16 |
| 1679712665 | West Tennessee Transitional Care Inc | Skilled Nursing Facility | 597 West Forest Ave, Jackson, TN 38301 | 2009-02-13 |
| 1285802652 | Trilogy Healthcare of Jackson, LLC | Skilled Nursing Facility | 703 Robinson Road, Jackson, MI 49203-2538 | 2008-02-19 |
| 1174732333 | Louisiana War Veterans Home | Skilled Nursing Facility | 4739 Highway 10, Jackson, LA 70748 | 2007-05-22 |
| 1760521256 | Omni Visions, Inc | Skilled Nursing Facility | 50 Directors Row, Jackson, TN 38305 | 2007-02-05 |
| 1326197211 | Cottage Grove Nursing Home, Lp | Skilled Nursing Facility | 1116 Forest Ave, Jackson, MS 39206-3216 | 2007-01-09 |
| 1164597688 | Countryside Care Center, Inc. | Skilled Nursing Facility | 2121 Robinson Rd, Jackson, MI 49203-3658 | 2006-11-21 |
| 1073687083 | Chadwick Nursing and Rehabilitation Center, LLC | Skilled Nursing Facility | 1900 Chadwick Dr, Jackson, MS 39204-3406 | 2006-11-20 |
| Find all providers in JACKSON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.