TETON COUNTY HOSPITAL DISTRICT (NPI# 1487818605) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1487818605 |
| Entity Type | Organization |
| Organization Name | TETON COUNTY HOSPITAL DISTRICT |
| Other Organization Name | ST JOHN'S MEDICAL CENTER |
| Practice Address |
625 E Broadway Ave Jackson WY 83001-8642 |
| Mailing Address |
Po Box 428 Jackson WY 83001-0428 |
| Practice Telephone | 3077333636 |
| Practice Fax Number | 8772052024 |
| Mailing Telephone | 3077333636 |
| Mailing Fax Number | 8772052024 |
| Enumeration Date | 2008-07-16 |
| Last Update Date | 2020-07-16 |
| 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 | 208D00000X | General Practice | 15109 | WY | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WY | 1062999-09 | 05 | |
| ID | 806430200 | 05 |
| Other Name | Type Code |
|---|---|
| St John's Medical Center | 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 |
| 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 |
| 1215064985 | Teton County Hospital District | Skilled Nursing Facility | 625 East Broadway, Jackson, WY 83001-8642 | 2007-02-28 |
| 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 E BROADWAY AVE |
| City | JACKSON |
| State | WY |
| Zip Code | 83001-8642 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679534432 | Lars T Conway | Pathology | 625 E Broadway Ave, Jackson, WY 83001-8642 | 2006-03-31 |
| 1154969251 | Michelle Robertson | Dietitian, Registered | 625 E Broadway Ave, Jackson, WY 83001-8642 | 2019-12-19 |
| 1942848072 | Anna Sigrid Eide | Dietitian, Registered | 625 E Broadway Ave, Jackson, WY 83001-8642 | 2019-12-19 |
| 1104464734 | Lisa Lauritzen Smith | Dietitian, Registered | 625 E Broadway Ave, Jackson, WY 83001-8642 | 2019-12-13 |
| 1598325193 | Katrina Rush | Occupational Therapist | 625 E Broadway Ave, Jackson, WY 83001-8642 | 2019-06-17 |
| 1669949590 | Elizabeth Smith Dannewald | Nurse Practitioner | 625 E Broadway Ave, Jackson, WY 83001 | 2018-10-29 |
| 1528533973 | Hanna Kirsten | Occupational Therapy Assistant | 625 E Broadway Ave, Jackson, WY 83001-8642 | 2018-10-11 |
| 1891270500 | Jamie Loomis | Physical Therapy Assistant | 625 E Broadway Ave, Jackson, WY 83001-8642 | 2018-09-27 |
| 1942784806 | Jared Travis Martin | Physical Therapy Assistant | 625 E Broadway Ave, Jackson, WY 83001-8642 | 2018-09-17 |
| 1891274320 | Wendy Carbone | Physical Therapist | 625 E Broadway Ave, Jackson, WY 83001-8642 | 2018-08-07 |
| Find all providers in the same location | ||||
| 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 | 208D00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | General Practice |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366991523 | Jackson State University | General Practice | 1400 Jr Lynch St, Jackson, MS 39217-0002 | 2016-09-29 |
| 1124475371 | Donald Lafont | General Practice | 331 Edenwood Dr, Jackson, TN 38301-3432 | 2016-05-18 |
| 1669717302 | Lift Wellness Inc | General Practice | 101 Jackson Walk Plaza, Jackson, TN 38301 | 2012-12-06 |
| 1457665333 | Teton County Hospital District | General Practice | Box 428 625 E Broadway Ave, Jackson, WY 83001-8642 | 2010-08-03 |
| 1851524730 | Byrd Lamar Payne | General Practice | 1205 Lyncrest Ave, Jackson, MS 39202-2106 | 2009-08-26 |
| 1801031703 | Total Spine Surgical Center LLC | General Practice | 1455 College Ave, Jackson, AL 36545-2410 | 2008-12-05 |
| 1992974018 | Visiting Doctors PC | General Practice | 2108 4th St Ste A, Jackson, MI 49203-4518 | 2008-02-22 |
| 1821127093 | Peter Thomas Gardner | General Practice | 2075 Pleasant Plains Ext Rd, Jackson, TN 38305-6087 | 2007-03-05 |
| 1154491579 | Bruce Hayse | General Practice | 269 West Broadway, Jackson, WY 83001-1884 | 2006-11-09 |
| 1104880558 | Lorna Gaye Pinson | General Practice | 3235 East Michigan Ave, Jackson, MI 49202 | 2006-04-13 |
| 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.