NPIMap

Organization Active NPI

Gunnison Valley Health Senior Care Center

  • Home Health Agency
  • Gunnison, CO
National Provider Identifier
1083831010
Registry record updated Mar 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
040904 Issued in CO
Legal business name
GUNNISON VALLEY HEALTH SENIOR CARE CENTER
Practice address
1498 W Tomichi Ave
Gunnison, CO 81230-3703
Phone
(970) 641-4254
Fax
(970) 641-7239
NPI assigned
Apr 19, 2007
Organization subpart
Yes
Parent organization
GUNNISON LIVING COMMUNITYAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 14, 2024

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

Authorized official

Name
Wade Baker
Title
Adminstrator
Phone
(970) 642-4807

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X 040904 CO Primary

Addresses

Primary practice location

1498 W Tomichi Ave
Gunnison, CO 81230-3703

Mailing address

1498 W Tomichi Ave
Gunnison, CO 81230-3703
Phone (970) 641-4254

Other names 1

  • Gunnison Valley Health Home Medical Services Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20101230000659 CO Part A Provider - Home Health Agency 5991831877 Practice locations: Gunnison, CO

Home health agency certification: CCN 067191

Legal name
GUNNISON VALLEY HEALTH SENIOR CARE CENTER
Doing business as
HOME HEALTH AND HOSPICE
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Jun 5, 1991
Last certification
Oct 30, 2019
Ownership / control type
Proprietary
Organization structure
GovernmentNon-profit
Enrollment address
120 N Boulevard St
Gunnison, CO 81230-3013
HHA Branch

Other NPIs with the same Medicare PAC ID 2

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

Care Compare: Home health agency

Medicare Care Compare
Listed as
Gunnison Valley Health Home Medical ServicesCCN 067191
Overall star rating
2.5 of 5
Ownership
Proprietary
Certified
Jun 5, 1991
Medicare certification status
ActiveFrom the Provider of Services file
Services
Nursing, Medical social, Physical therapy, Speech pathology, Occupational therapy

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
06D2030195Gunnison Valley Health Home Medical Services1498 W Tomichi Ave, Suite B, Gunnison, CO 81230Certificate of waiverSep 21, 2027

National Provider Directory

National Provider Directory
Tax ID family
Gunnison Valley Health Senior Care Center4 organizations share this tax ID, including this one
Part of
Gunnison Valley Health Senior Care Center

Other organizations with this tax ID 3

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

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Ownership & related parties

All disclosed owners & managing parties 6

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

NameRoleSinceShare
Thad G Harlow Individual Corporate DirectorDirector of Home Medical Services Oct 1, 2010
W-2 Managing Employee Oct 1, 2010
Gunnison Valley Health Senior Care Center Organization, Gunnison, CO Non-profit 5% Or Greater Direct Ownership Interest Dec 29, 2010
Marla Hutchison Crockett Individual W-2 Managing EmployeeTrustee Jan 1, 2023
Angela Kobel Individual Corporate OfficerCfo Dec 1, 2023
County of Gunnison Organization, Gunnison, CO 5% Or Greater Indirect Ownership Interest Jan 1, 1966 100%
Joseph Baker Individual W-2 Managing EmployeeVP Operations Oct 27, 2010

Owners & managing parties with NPI records 3

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Facilities with the same owner 5

Facilities that share an organizational owner with 5% or greater ownership or operational control.

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Affiliated clinicians 7

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

NPI Registry JSON

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

{
    "created_epoch": "1176940800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1710374400000",
    "number": "1083831010",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1498 W TOMICHI AVE",
            "city": "GUNNISON",
            "state": "CO",
            "postal_code": "812303703",
            "telephone_number": "970-641-4254",
            "fax_number": "970-641-7239"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1498 W TOMICHI AVE",
            "city": "GUNNISON",
            "state": "CO",
            "postal_code": "812303703",
            "telephone_number": "970-641-4254",
            "fax_number": "970-641-7239"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GUNNISON VALLEY HEALTH SENIOR CARE CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "GUNNISON LIVING COMMUNITY",
        "enumeration_date": "2007-04-19",
        "last_updated": "2024-03-14",
        "certification_date": "2024-03-14",
        "status": "A",
        "authorized_official_last_name": "BAKER",
        "authorized_official_first_name": "WADE",
        "authorized_official_title_or_position": "ADMINSTRATOR",
        "authorized_official_telephone_number": "970-642-4807"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "CO",
            "license": "040904",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Gunnison Valley Health Home Medical Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Gunnison, CO

Sources for this page

Verify at the official NPI Registry.