NPIMap

Organization Active NPI

Southwest Health System, Inc.

Doing business as Cortez Primary Care

  • Clinic/Center
  • Cortez, CO
National Provider Identifier
1104823939
Registry record updated Jun 8, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
License
19961032821 Issued in CO
Legal business name
SOUTHWEST HEALTH SYSTEM, INC.
Doing business as
Cortez Primary Care
Practice address
118 N Chestnut
Cortez, CO 81321
Phone
(970) 564-9777
Fax
(970) 564-8833
NPI assigned
Jul 7, 2005
Last updated
Jun 8, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 8, 2018

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

Authorized official

Name
Mr. Anthony Sudduth
Title
Ceo
Phone
(970) 564-2150

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X 19961032821 CO Primary
Critical Access Hospital 282NC0060X 11206 CO

Addresses

Primary practice location

118 N Chestnut
Cortez, CO 81321

Mailing address

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

Other names 1

  • Cortez Primary Care Doing business as

Medicare participation

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

Enrollment records 1

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

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

Member of 1

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

Locations

1311 N Mildred Rd
#A
Cortez, CO 81321
Phone (970) 565-8556

1311 N Mildred Rd
#D
Cortez, CO 81321

1311 N Mildred Rd
Ste B
Cortez, CO 81321

1311 N Mildred Rd
Ste C
Cortez, CO 81321

1311 N Mildred Rd
Ste D
Cortez, CO 81321

20 S Market St
Ste 1
Cortez, CO 81321
Phone (970) 565-4291

20 S Market St
Ste 3
Cortez, CO 81321

2095 N Dolores Rd
Cortez, CO 81321
Phone (970) 564-8086

Practitioners & affiliated clinicians

Practitioners 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1120694400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1528416000000",
    "number": "1104823939",
    "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": "118 N CHESTNUT",
            "city": "CORTEZ",
            "state": "CO",
            "postal_code": "81321",
            "telephone_number": "970-564-9777",
            "fax_number": "970-564-8833"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHWEST HEALTH SYSTEM, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-07",
        "last_updated": "2018-06-08",
        "status": "A",
        "authorized_official_last_name": "SUDDUTH",
        "authorized_official_first_name": "ANTHONY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "970-564-2150",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "CO",
            "license": "19961032821",
            "primary": true
        },
        {
            "code": "282NC0060X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Critical Access",
            "state": "CO",
            "license": "11206",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Cortez Primary Care",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Cortez Primary Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Cortez, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.