Active NPI
Tristate Ambulatory Surgery Center
Doing business as Colorado River Medical Center
- Critical Access Hospital
- Needles, CA
National Provider Identifier
1033587308
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Critical Access Hospital
- License
- 240000227
- Legal business name
- TRISTATE AMBULATORY SURGERY CENTER
- Doing business as
- Colorado River Medical Center
- Practice address
- 1401 Bailey Ave
Building a
Needles, CA 92363-3103 - Phone
- (760) 326-7160
- Fax
- (760) 326-7292
- NPI assigned
- Sep 3, 2015
- Last updated
- Sep 3, 2015
- Organization subpart
- Yes
- Parent organization
- COMMUNITY HEALTHCARE PARTNER, INC
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Steve Kelley Lopez
- Title
- Ceo
- Phone
- (760) 326-7160
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ambulatory Surgical Clinic/Center | 261QA1903X | NU | ||
| Critical Access Hospital | 282NC0060X | 240000227 | CA | Primary |
Addresses
Primary practice location
1401 Bailey Ave
Building a
Needles, CA 92363-3103
Mailing address
1401 Bailey Ave
Needles, CA 92363-3103
Phone (760) 326-7160
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 330130 | Medicaid | AZ | |
| 240000227 | Medicaid | CA |
Other names 1
- Colorado River Medical Center
National Provider Directory
National Provider Directory- Part of
- Community Healthcare Partner Inc
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1441238400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1441238400000",
"number": "1033587308",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1401 BAILEY AVE",
"city": "NEEDLES",
"state": "CA",
"postal_code": "923633103",
"telephone_number": "760-326-7160",
"fax_number": "760-326-7292"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1401 BAILEY AVE",
"address_2": "BUILDING A",
"city": "NEEDLES",
"state": "CA",
"postal_code": "923633103",
"telephone_number": "760-326-7160",
"fax_number": "760-326-7292"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "TRISTATE AMBULATORY SURGERY CENTER",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "COMMUNITY HEALTHCARE PARTNER, INC",
"enumeration_date": "2015-09-03",
"last_updated": "2015-09-03",
"status": "A",
"authorized_official_last_name": "LOPEZ",
"authorized_official_first_name": "STEVE",
"authorized_official_middle_name": "KELLEY",
"authorized_official_title_or_position": "CEO",
"authorized_official_telephone_number": "760-326-7160",
"authorized_official_name_prefix": "Mr."
},
"taxonomies": [
{
"code": "261QA1903X",
"taxonomy_group": "",
"desc": "Clinic/Center, Ambulatory Surgical",
"state": "NU",
"license": null,
"primary": false
},
{
"code": "282NC0060X",
"taxonomy_group": "",
"desc": "General Acute Care Hospital, Critical Access",
"state": "CA",
"license": "240000227",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "330130",
"state": "AZ"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "240000227",
"state": "CA"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Colorado River Medical Center",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Needles, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.