Active NPI
Peak Vista Community Health Centers
Doing business as Ronald McDonald Care Mobile
- Federally Qualified Health Center (FQHC)
- Colorado Springs, CO
National Provider Identifier
1083919674
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Federally Qualified Health Center (FQHC)
- Legal business name
- PEAK VISTA COMMUNITY HEALTH CENTERS
- Doing business as
- Ronald McDonald Care Mobile
- Practice address
- 340 Printers Pkwy
Colorado Springs, CO 80910 - Phone
- (719) 632-5700
- Fax
- (719) 344-7801
- NPI assigned
- Jan 13, 2011
- Last updated
- Sep 12, 2018
- Organization subpart
- Yes
- Parent organization
- PEAK VISTA COMMUNITY HEALTH CENTERS
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Tracy Narvet
- Title
- Cfo
- Phone
- (719) 344-6188
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Federally Qualified Health Center (FQHC) | 261QF0400X | |||
| Federally Qualified Health Center (FQHC) | 261QF0400X | CO | Primary |
Addresses
Primary practice location
340 Printers Pkwy
Colorado Springs, CO 80910
Mailing address
3205 Academy Blvd
Suite 130
Colorado Springs, CO 80917
Phone (719) 632-5700
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 66451761 | Medicaid | CO | |
| 05638267 | Medicaid | CO |
Other names 1
- Ronald McDonald Care Mobile
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
NPI to CCN mapping 1
The Medicare certification numbers (CCNs) connected to NPI 1083919674. Details of each certification follow.
Federally qualified health center certification: CCN 061906
Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.
- Legal name
- PEAK VISTA C H C - RONALD MCDONALD CARE MOBILE
- Certification status
- Active
- Provider type (POS)
- Federally qualified health center
- Participating since
- Oct 22, 2009
- Last certification
- Oct 22, 2009
- Ownership / control type
- For profit – partnership
- Facility address
- 340 Printers Parkway
Colorado Springs, CO 80910
National Provider Directory
National Provider Directory- Part of
- Community Health Ctr Co
Member of 1
Organizations this organization is a member of, according to the National Provider Directory.
-
dba Behavioral Health at Inside Out Youth Services
- Federally Qualified Health Center (FQHC)
- Colorado Springs, CO
- NPI 1871347443
Member Of
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1294876800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1536710400000",
"number": "1083919674",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3205 ACADEMY BLVD",
"address_2": "SUITE 130",
"city": "COLORADO SPRINGS",
"state": "CO",
"postal_code": "80917",
"telephone_number": "719-632-5700",
"fax_number": "719-344-7865"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "340 PRINTERS PKWY",
"city": "COLORADO SPRINGS",
"state": "CO",
"postal_code": "80910",
"telephone_number": "719-632-5700",
"fax_number": "719-344-7801"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "PEAK VISTA COMMUNITY HEALTH CENTERS",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "PEAK VISTA COMMUNITY HEALTH CENTERS",
"enumeration_date": "2011-01-13",
"last_updated": "2018-09-12",
"status": "A",
"authorized_official_last_name": "NARVET",
"authorized_official_first_name": "TRACY",
"authorized_official_title_or_position": "CFO",
"authorized_official_telephone_number": "719-344-6188"
},
"taxonomies": [
{
"code": "261QF0400X",
"taxonomy_group": "",
"desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
"state": null,
"license": null,
"primary": false
},
{
"code": "261QF0400X",
"taxonomy_group": "",
"desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
"state": "CO",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "66451761",
"state": "CO"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "05638267",
"state": "CO"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Ronald McDonald Care Mobile",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "Ronald McDonald Care Mobile",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Colorado Springs, CO
- Peak View Psychology, LLC
- Peak Vision Optical Center, Inc.
- Peak Vista Community Health Center (Peak Vista Pharmacy at Myron)
- Peak Vista Community Health Centers (Health Center at Wahsatch)
- Peak Vista Community Health Centers (Health Center at Rio Grande)
- Peak Vista Community Health Centers (Pediatric Health Center)
- Peak Vista Community Health Centers (Entrada School Based Health Center)
- Peak Vista Community Health Centers (Health Center at Academy Suite 3100)
- Peak Vista Community Health Centers (Health Center at 340 Printers Parkway)
- Peak Vista Community Health Centers (Health Center at 155 Printers Pkwy St230)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.