NPIMap

Organization Active NPI

Southwest Health System, Inc.

Doing business as Southwest Walk-in Care

  • Rural Health Clinic/Center
  • Cortez, CO
National Provider Identifier
1083917868
Registry record updated May 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
SOUTHWEST HEALTH SYSTEM, INC.
Doing business as
Southwest Walk-in Care
Practice address
1413 N Mildred Rd
Cortez, CO 81321
Phone
(970) 564-1037
Fax
(970) 564-1041
NPI assigned
Dec 16, 2010
Last updated
May 28, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 28, 2025

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

Authorized official

Name
Joseph Theine
Title
Chief Executive Officer
Phone
(970) 564-2146

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X Primary

Addresses

Primary practice location

1413 N Mildred Rd
Cortez, CO 81321

Mailing address

1311 N Mildred Rd
Cortez, CO 81321-2231
Phone (970) 564-2152

Other identifiers 1

IdentifierTypeStateIssuer
26424371MedicaidCO

Other names 1

  • Southwest Walk-in Care Doing business as

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20031125000607 CO Part B Supplier - Clinic/Group Practice 5890699326 Receives reassigned benefits from 107 practitioners
11 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Cortez, CO; Mancos, CO
O20120328000426 CO Part A Provider - Rural Health Clinic 5890699326 Practice locations: Cortez, CO

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1083917868. Details of each certification follow.

Rural health clinic certification: CCN 068520

Legal name
SOUTHWEST HEALTH SYSTEM INC
Doing business as
SOUTHWEST WALK-IN CARE
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Aug 22, 2012
Last certification
Mar 22, 2024
Ownership / control type
For profit – corporation
Organization structure
OtherNon-profit
Incorporated
Aug 29, 1996 in CO
Enrollment address
1413 N Mildred Rd
Cortez, CO 81321-2258
Related CCNs
061327

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

Other NPIs with the same Medicare PAC ID 7

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

Other NPIs on the same Medicare enrollment 11

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

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 9

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

NameRoleSinceShare
Jay Wood Individual Corporate Director Jan 1, 2024
David L Dull Individual Corporate Director Jan 1, 2025
Joseph Theine Individual Corporate Officer Jul 1, 2023
W-2 Managing Employee Jul 1, 2023 100%
Shirley Jones Individual Corporate Director Dec 5, 2018
Southwest Health System Inc Organization, Cortez, CO Non-profit Operational/Managerial Control Mar 1, 2011 100%
Eric Croke Individual Corporate Director Jan 1, 2024
Mary Dodd Individual Corporate Director Jan 1, 2025
Marjorie Strangl Individual Corporate Director Jan 1, 2025
James S Rogers Individual Corporate Director Jan 1, 2024

Owners & managing parties with NPI records 7

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

All facility ownership & control disclosures 4

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

FacilityTypeRoleSince
Southwest Memorial HospitalCortez, CO, CCN 061327 Hospital 5% Or Greater Direct Ownership Interest
Operational/Managerial Control		 Dec 1, 2007
Dec 1, 2007
Southwest Memorial Hospital Swingbed UnitCortez, CO, CCN 06Z327 Hospital 5% Or Greater Direct Ownership Interest
Operational/Managerial Control		 May 1, 2009
May 1, 2009
Mancos Valley Health CenterMancos, CO, CCN 068521 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Aug 22, 2012
Southwest School-Based Health CenterCortez, CO, CCN 063406 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) May 28, 2015

Owned or controlled facilities with NPI records 6

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Facilities with the same owner 4

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

Practitioners & affiliated clinicians

Practitioners 27

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 27

NPI Registry JSON

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

{
    "created_epoch": "1292457600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1748390400000",
    "number": "1083917868",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1311 N MILDRED RD",
            "city": "CORTEZ",
            "state": "CO",
            "postal_code": "813212231",
            "telephone_number": "970-564-2152",
            "fax_number": "970-564-2155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1413 N MILDRED RD",
            "city": "CORTEZ",
            "state": "CO",
            "postal_code": "81321",
            "telephone_number": "970-564-1037",
            "fax_number": "970-564-1041"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHWEST HEALTH SYSTEM, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-12-16",
        "last_updated": "2025-05-28",
        "certification_date": "2025-05-28",
        "status": "A",
        "authorized_official_last_name": "THEINE",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "970-564-2146"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "26424371",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Southwest Walk-in Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Cortez, CO

Sources for this page

Verify at the official NPI Registry.