NPIMap

Organization Active NPI

Rangely Hospital District

Doing business as Rangely District Hospital

  • Critical Access Hospital
  • Rangely, CO
National Provider Identifier
1063430346
Registry record updated Dec 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Access HospitalTaxonomy code 282NC0060X
License
0682 Issued in CO
Legal business name
RANGELY HOSPITAL DISTRICT
Doing business as
Rangely District Hospital
Practice address
225 Eagle Crest Dr.
Rangely, CO 81648-2100
Phone
(970) 675-5011
Fax
(970) 675-5224
NPI assigned
Jul 17, 2006
Last updated
Dec 10, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 10, 2021

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

Authorized official

Name
Kyle Wren
Title
Ceo
Phone
(970) 675-5011

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Access Hospital 282NC0060X 0682 CO Primary

Addresses

Primary practice location

225 Eagle Crest Dr.
Rangely, CO 81648-2100

Mailing address

225 Eagle Crest Dr.
Rangely, CO 81648-2100
Phone (970) 675-5011

Other identifiers 2

IdentifierTypeStateIssuer
00073 RAOtherCOBLUE CROSS
05073002MedicaidCO

Other names 1

  • Rangely District Hospital Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050727000573 CO Part A Provider - Critical Access Hospital 6103714175 Receives reassigned benefits from 9 practitioners
Practice locations: Rangely, CO

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1063430346. Details of each certification follow.

Hospital certification: CCN 061307

Legal name
RANGELY HOSPITAL DISTRICT
Doing business as
RANGELY DISTRICT HOSPITAL
Certification status
Active
Provider type (POS)
Hospital – Critical access hospital
Participating since
Sep 28, 2000
Last certification
Feb 22, 2023
Beds
25
Ownership / control type
Hospital district or authority
Organization structure
GovernmentNon-profit
Enrollment address
225 Eagle Crest Dr
Rangely, CO 81648-3105
Other Hospital Practice Location

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs with the same Medicare PAC ID 3

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

Care Compare: Hospital

Medicare Care Compare
Listed as
Rangely District HospitalCCN 061307 · All quality measures
Type
Critical Access Hospitals
Ownership
Government - Hospital District or Authority
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory
Tax ID family
Rangely Family Medicine9 organizations share this tax ID, including this one

Other organizations with this tax ID 8

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

Networks

  • devoted network organization-a4751131-f16f-4e82-8f2b-b08e66379a7a

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/15452/brand/2/csg/1/fhir/r4

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
Kyle Wren Individual Corporate OfficerCeo Dec 1, 2019 10%
W-2 Managing EmployeeCeo Dec 1, 2019 90%
Operational/Managerial Control Dec 1, 2019 90%
James Lloyd Dillon Individual Corporate OfficerChief Financial Officer Aug 1, 2021 10%
W-2 Managing EmployeeChief Financial Officer Aug 1, 2021 90%
Operational/Managerial ControlChief Financial Officer Aug 1, 2021 90%

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Rangely Family MedicineRangely, CO, CCN 068524 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Jan 1, 1975

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 9

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.

Affiliated clinicians 23

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 23

NPI Registry JSON

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

{
    "created_epoch": "1153094400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1639094400000",
    "number": "1063430346",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "225 EAGLE CREST DR.",
            "city": "RANGELY",
            "state": "CO",
            "postal_code": "816482100",
            "telephone_number": "970-675-5011",
            "fax_number": "970-675-5224"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "225 EAGLE CREST DR.",
            "city": "RANGELY",
            "state": "CO",
            "postal_code": "816482100",
            "telephone_number": "970-675-5011",
            "fax_number": "970-675-5224"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RANGELY HOSPITAL DISTRICT",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-17",
        "last_updated": "2021-12-10",
        "certification_date": "2021-12-10",
        "status": "A",
        "authorized_official_last_name": "WREN",
        "authorized_official_first_name": "KYLE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "970-675-5011"
    },
    "taxonomies": [
        {
            "code": "282NC0060X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Critical Access",
            "state": "CO",
            "license": "0682",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "00073 RA",
            "state": "CO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "05073002",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Rangely District Hospital",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Rangely District Hospital",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Rangely, CO

Sources for this page

Verify at the official NPI Registry.