Mountain Family Health Centers

Primary specialty

Community Health Clinic/CenterTaxonomy code 261QC1500X

License

1020 Issued in CO

Legal business name

MOUNTAIN FAMILY HEALTH CENTERS

Practice address

1905 Blake Ave
Suite 101
Glenwood Springs, CO 81601-4288

Phone

(970) 945-2840

Fax

(970) 945-2893

NPI assigned

Dec 13, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Ross A Brooks

Title

Ceo

Phone

(970) 945-2840

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CO2 enrollments

Enrollment records 2

Federally qualified health center certification: CCN 061872

Legal name

MOUNTAIN FAMILY HEALTH CENTERS

Certification status

Active

Provider type (POS)

Federally qualified health center

Participating since

Jun 28, 2002

Last certification

Jun 28, 2002

Ownership / control type

For profit – partnership

Organization structure

CorporationNon-profit

Incorporated

Jul 7, 1978 in CO

Enrollment address

1905 Blake Ave
Ste 101
Glenwood Springs, CO 81601-4206

Related CCNs

061837

Other NPIs on the same Medicare enrollment 9

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

• Mountain Family Health Centers

  • Community Health Clinic/Center
  • Black Hawk, CO
  • NPI 1235292293

  O20040316000175

  Same enrollment
• Mountain Family Health Centers

  • Federally Qualified Health Center (FQHC)
  • Glenwood Springs, CO
  • NPI 1477552388

  O20040316000175, O20070827000778

  Same enrollment
• Mountain Family Health Centers

  • Federally Qualified Health Center (FQHC)
  • Basalt, CO
  • NPI 1548569924

  O20040316000175

  Same enrollment
• Mountain Family Health Centers

  • Federally Qualified Health Center (FQHC)
  • Avon, CO
  • NPI 1548613409

  O20040316000175

  Same enrollment
• Mountain Family Health Centers

  • Community Health Clinic/Center
  • Nederland, CO
  • NPI 1578625174

  O20040316000175

  Same enrollment
• Mountain Family Health Centers

  • Federally Qualified Health Center (FQHC)
  • Rifle, CO
  • NPI 1578862983

  O20040316000175

  Same enrollment
• Mountain Family Health Centers

  • Federally Qualified Health Center (FQHC)
  • Gypsum, CO
  • NPI 1710661194

  O20040316000175

  Same enrollment
• Mountain Family Health Centers

  • Federally Qualified Health Center (FQHC)
  • Edwards, CO
  • NPI 1972933992

  O20040316000175

  Same enrollment
• Mountain Family Health Centers

  • Federally Qualified Health Center (FQHC)
  • Avon, CO
  • NPI 1982328969

  O20040316000175

  Same enrollment

Locations

All disclosed owners & managing parties 15

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

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

{
    "created_epoch": "1165968000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1465430400000",
    "number": "1114088762",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1905 BLAKE AVE",
            "address_2": "SUITE 101",
            "city": "GLENWOOD SPRINGS",
            "state": "CO",
            "postal_code": "816014288",
            "telephone_number": "970-945-2840",
            "fax_number": "970-945-2893"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1905 BLAKE AVE",
            "address_2": "SUITE 101",
            "city": "GLENWOOD SPRINGS",
            "state": "CO",
            "postal_code": "816014288",
            "telephone_number": "970-945-2840",
            "fax_number": "970-945-2893"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOUNTAIN FAMILY HEALTH CENTERS",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-13",
        "last_updated": "2016-06-09",
        "status": "A",
        "authorized_official_last_name": "BROOKS",
        "authorized_official_first_name": "ROSS",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "970-945-2840",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QC1500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Community Health",
            "state": "CO",
            "license": "1020",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "05600812",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Amy Fritzsche Mosier
• Elena Motuzko, MD
• Susan Mount
• Mountain Cardiology, PC
• Mountain Family Health Centers
• Mountain Family Health Centers
• Mountain Family Health Centers
• Mountain Shadows Chiropractic & Rehabilitation, Inc
• Mountain Soul Resources, Inc
• Mountain Valley Developmental Services

• Community Health Clinic/Center in Glenwood Springs, CO
• Providers in Glenwood Springs, CO by specialty
• Community Health Clinic/Center in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2016; 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.

Verify at the official NPI Registry.