Valley-Wide Health Systems, Inc
Organization Active NPI Federally Qualified Health Center (FQHC) · Rocky Ford, CO
NPI 1104813682 · NPPES record last updated May 10, 2024
Key facts
- NPI
- 1104813682
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Federally Qualified Health Center (FQHC) 261QF0400X
- Legal business name
- VALLEY-WIDE HEALTH SYSTEMS, INC
- Practice address
- 903 S 12TH St
Rocky Ford, CO 81067-2127 - Phone
- (719) 254-7623
- Fax
- (719) 254-5112
- NPI assigned
- Sep 30, 2005
- Organization subpart
- No
Authorized official
- Name
- Jania Arnoldi
- Title
- President/Ceo
- Phone
- (719) 589-5161
Corporate family (same tax ID) 33
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CO
Federally qualified health center certification: CCN 061858
- Legal name
- VALLEY-WIDE HEALTH SYSTEMS, INC.
- Doing business as
- ROCKY FORD CLINIC
- Certification status
- Active
- Provider type (POS)
- Federally qualified health center
- Participating since
- Apr 21, 1997
- Last certification
- Apr 21, 1997
- Ownership / control type
- For profit – partnership
- Organization structure
- Corporation · Non-profit
- Incorporated
- Apr 15, 1976 in CO
- Enrollment address
- 903 S 12TH St
Rocky Ford, CO 81067-2127
All disclosed owners & managing parties 10
| Name | Role | Since | Share |
|---|---|---|---|
| Javier Martinez |
W-2 Managing Employee |
Mar 19, 2019 | |
| Sally Espinoza |
Corporate Director | Mar 30, 2016 | |
| Jennifer Pollmiller |
Corporate Director | Jan 26, 2022 | |
| Jania Arnoldi |
Corporate Director |
Mar 15, 2019 | |
| W-2 Managing Employee |
Mar 15, 2019 | ||
| Linda Deherrera |
Corporate Director | Feb 28, 2018 | |
| Mattew Martinez |
Corporate Director | Mar 19, 2019 | |
| Jeremy Silva |
Corporate Director | Oct 23, 2019 | |
| Michelle Ferrera |
Corporate Director | Feb 27, 2019 | |
| Michelle Ballantyne |
Corporate Director | Mar 22, 2017 | |
| Patricia Freda |
Corporate Director | Apr 29, 2015 |
All facility ownership & control disclosures 1
| Facility | Type | Role | Since |
|---|---|---|---|
| Valley-Wide Health Systems, Inc. |
Federally qualified health center | Other | Aug 17, 2020 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040105000527 | CO | Part a Provider - Federally Qualified Health Center (FQHC) | 5991609067 | Practice locations: Rocky Ford, CO |
National Provider Directory
- Tax ID family
- Valley-Wide Health Systems Inc
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dental Clinic/Center | 261QD0000X | |||
| Federally Qualified Health Center (FQHC) | 261QF0400X | CO | Yes |
Addresses
Primary practice location
903 S 12TH St
Rocky Ford, CO 81067-2127
Mailing address
128 Market St
Alamosa, CO 81101-2290
Phone (719) 589-5161
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| CE 9669 | Other | CO | TRAVELERS MEDICARE NUMBER |
| 04280270 | Medicaid | CO | |
| VAC 4808 | Other | CO | ANTHEM BCBS |
Other names
- Rocky Ford Clinic
Other providers in Rocky Ford, CO
- Southeast Mental Health Services
- Southeast Mental Health Services
- Joni Anne Stevens
- Mollie R Stuchlik
- Jayvin David Sunga
- Valley-Wide Health Systems, Inc.
- Walter Chiropractic
- Thomas T Walter
- Jenna White
- Willow Tree Counseling
All providers in Rocky Ford, CO · Federally Qualified Health Center (FQHC) in Colorado
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 10, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.