NPIMap

Organization Active NPI

Northwest Colorado Visting Nurse Association

Doing business as Northwest Colorado Health

  • Federally Qualified Health Center (FQHC)
  • Craig, CO
National Provider Identifier
1063663292
Registry record updated Jun 17, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
NORTHWEST COLORADO VISTING NURSE ASSOCIATION
Doing business as
Northwest Colorado Health
Practice address
745 Russell St
Craig, CO 81625-2019
Phone
(970) 824-8233
Fax
(970) 824-2548
NPI assigned
Oct 7, 2008
Last updated
Jun 17, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2022

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

Authorized official

Name
Matt Morrill
Title
Cfo
Phone
(970) 871-7635

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Clinic/Center 261QC1500X
Federally Qualified Health Center (FQHC) 261QF0400X Primary

Addresses

Primary practice location

745 Russell St
Craig, CO 81625-2019

Mailing address

745 Russell St
Craig, CO 81625-2019
Phone (970) 824-8233

Other identifiers 1

IdentifierTypeStateIssuer
69909253MedicaidCO

Other names 1

  • Northwest Colorado Health Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20070925000419 CO Part B Supplier - Clinic/Group Practice 3173617883 Receives reassigned benefits from 16 practitioners
2 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Craig, CO; Steamboat Springs, CO
O20081218000470 CO Part A Provider - Federally Qualified Health Center (FQHC) 3173617883 1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Craig, CO

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1063663292. Details of each certification follow.

Federally qualified health center certification: CCN 061905

Legal name
NORTHWEST COLORADO VISITING NURSE ASSOCIATION
Doing business as
NORTHWEST COLORADO HEALTH - COMMUNITY HEALTH CENTER
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Feb 3, 2009
Last certification
Feb 3, 2009
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Jun 3, 1964 in CO
Enrollment address
745 Russell St
Craig, CO 81625-2019

Other NPIs on the same Medicare enrollment 2

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

National Provider Directory

National Provider Directory
Tax ID family
Northwest Colorado Visiting25 organizations share this tax ID, including this one

Other organizations with this tax ID 24

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

View all 24

Ownership & related parties

All disclosed owners & managing parties 12

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

NameRoleSinceShare
Matt Morrill Individual Corporate OfficerCfo May 9, 2022
W-2 Managing EmployeeCfo May 9, 2022
Victoria Klohr Individual Corporate DirectorBoard Member Nov 30, 2022
Lynn Dubinsky Individual Corporate DirectorBoard Member Oct 1, 2025
James David Park Individual Corporate DirectorBoard Member Sep 28, 2022
Elizabeth Plummer Individual Corporate DirectorBoard Member Oct 26, 2022
Rosalind D Leaming Individual Corporate Director Oct 31, 2021
Arin Daigneau Individual Corporate OfficerCoo Oct 1, 2024
Erin Wilson Individual Corporate Director Nov 30, 2020
Rebecca Lewis Individual Corporate Director Nov 30, 2020
Erika Murphy Individual Corporate DirectorBoard Member Nov 30, 2022
Stephanie Einfeld Individual Corporate OfficerChief Executive Officer Feb 16, 2018
Jesse Arthurs Individual Corporate DirectorBoard Member Aug 28, 2024

Practitioners & affiliated clinicians

Practitioners 20

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.

View all 20

NPI Registry JSON

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

{
    "created_epoch": "1223337600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1655424000000",
    "number": "1063663292",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "745 RUSSELL ST",
            "city": "CRAIG",
            "state": "CO",
            "postal_code": "816252019",
            "telephone_number": "970-824-8233",
            "fax_number": "970-824-2548"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "745 RUSSELL ST",
            "city": "CRAIG",
            "state": "CO",
            "postal_code": "816252019",
            "telephone_number": "970-824-8233",
            "fax_number": "970-824-2548"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHWEST COLORADO VISTING NURSE ASSOCIATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-10-07",
        "last_updated": "2022-06-17",
        "certification_date": "2022-06-17",
        "status": "A",
        "authorized_official_last_name": "MORRILL",
        "authorized_official_first_name": "MATT",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "970-871-7635"
    },
    "taxonomies": [
        {
            "code": "261QC1500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Community Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "69909253",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Northwest Colorado Health",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Northwest Colorado Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Craig, CO

Sources for this page

Verify at the official NPI Registry.