NPIMap

Organization Active NPI

Metro Community Provider Network Inc

Doing business as STRIDE Community Health Center

  • Federally Qualified Health Center (FQHC)
  • Lakewood, CO
National Provider Identifier
1114213972
Registry record updated Mar 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
METRO COMMUNITY PROVIDER NETWORK INC
Doing business as
STRIDE Community Health Center
Practice address
12055 W 2ND PL
Lakewood, CO 80228-1506
Phone
(303) 360-6276
Fax
(303) 789-7222
NPI assigned
Jun 21, 2011
Last updated
Mar 4, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
METRO COMMUNITY PROVIDER NETWORK INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 4, 2024

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

Authorized official

Name
April Peer
Title
Chief Financial Officer
Phone
(303) 761-1977

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X CO Primary

Addresses

Primary practice location

12055 W 2ND PL
Lakewood, CO 80228-1506

Mailing address

7495 W 29TH Ave
Wheat Ridge, CO 80033-8002
Phone (303) 360-6276

Other identifiers 1

IdentifierTypeStateIssuer
86602373MedicaidCO

Other names 2

  • STRIDE Community Health Center Doing business as
  • STRIDE CHC - Union Square Health Plaza at Jefferson Center Other name

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20051025000562 CO Part B Supplier - Clinic/Group Practice 0648181214 Receives reassigned benefits from 151 practitioners
9 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Aurora, CO; Englewood, CO; Lakewood, CO; Parker, CO; Wheat Ridge, CO; Arvada, CO
O20120831000686 CO Part A Provider - Federally Qualified Health Center (FQHC) 0648181214 Practice locations: Lakewood, CO

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1114213972. Details of each certification follow.

Federally qualified health center certification: CCN 061928

Legal name
METRO COMMUNITY PROVIDER NETWORK INC
Doing business as
UNION SQUARE PLAZA AT JEFFERSON CENTER FOR MENTAL HEALTH
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Oct 12, 2012
Last certification
Oct 12, 2012
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
May 29, 1987 in CO
Enrollment address
12055 W 2ND PL
Lakewood, CO 80228-1506

Other NPIs with the same Medicare PAC ID 17

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

View all 17

Other NPIs on the same Medicare enrollment 9

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

National Provider Directory

National Provider Directory
Tax ID family
Metro Community Provider Networkinc36 organizations share this tax ID, including this one
Part of
Metro Community Provider Networkinc

Other organizations with this tax ID 35

Organizations that report the same tax identification number in the National Provider Directory.

View all 35

Locations

7495 W 29th Ave
Wheat Ridge, CO 80033
Phone (303) 239-9964

Ownership & related parties

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.

NameRoleSinceShare
Metro Community Provider Network Inc Organization, Wheat Ridge, CO Corporation, Non-profit Operational/Managerial Control Oct 12, 2012
Rene Chavez Individual Corporate DirectorBoard Member Jul 1, 2022
Kristine Bolin Individual Corporate DirectorBoard Member Aug 1, 2022
Susan Saukas Individual W-2 Managing EmployeeDirector of Revenue Cycle Operation Oct 15, 2021
Shyanne Ching Individual Corporate DirectorCfo Apr 11, 2022
W-2 Managing EmployeeCfo Apr 11, 2022
Operational/Managerial ControlCfo Apr 11, 2022
Benjamin Honigman Individual Corporate DirectorBoard Member Aug 1, 2019
Ashley Garcia Torres Individual Corporate DirectorBoard Member Sep 1, 2021
Christi Garriott Individual Corporate DirectorSenior Director Or Organization Mar 28, 2022
W-2 Managing EmployeeSenior Director of Organization Mar 28, 2022
Operational/Managerial ControlSenior Director of Organization Mar 28, 2022
Annamarie Martinez Individual Corporate DirectorBoard Member Dec 1, 2020
Stacey Adimou Individual Corporate DirectorBoard Member Nov 1, 2021
Vincent Atchity Individual Corporate DirectorBoard Member Aug 22, 2016
Jean a Sisneros Individual Corporate DirectorBoard Member Aug 20, 2011
Emily Glancy-West Individual Corporate DirectorBoard Member Jul 1, 2022
Marta Arbildo Individual Corporate DirectorBoard Member Aug 1, 2022
Mark Schumacher Individual Corporate DirectorBoard Member Sep 1, 2017

Owners & managing parties with NPI records 17

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

View all 17

All facility ownership & control disclosures 11

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

FacilityTypeRoleSince
Stride CHC - Wheat RidgeWheat Ridge, CO, CCN 061933 Federally qualified health center Operational/Managerial Control Jan 27, 2021
Stride Community Health Center - del MarAurora, CO, CCN 061969 Federally qualified health center 5% Or Greater Direct Ownership Interest
Operational/Managerial Control		 Jun 1, 2016
Jun 1, 2016
Metro Community Provider Network IncAurora, CO, CCN 061038 Federally qualified health center Operational/Managerial Control (100%) Dec 28, 2022
Stride Community Health CenterAurora, CO, CCN 061039 Federally qualified health center Operational/Managerial Control (100%) Feb 28, 2022
Stride Community Health CenterConifer, CO, CCN 061041 Federally qualified health center Operational/Managerial Control (100%) May 14, 2021
Stride Community Health CenterAurora, CO, CCN 061040 Federally qualified health center Operational/Managerial Control Dec 1, 2017
Stride Community Health CenterAurora, CO, CCN 061042 Federally qualified health center Operational/Managerial Control Oct 1, 1991
Stride Community Health Center - Golden High SchoolGolden, CO, CCN 061043 Federally qualified health center Operational/Managerial Control Sep 6, 2019
Stride Community Health CenterLakewood, CO, CCN 061048 Federally qualified health center Operational/Managerial Control Oct 20, 2022
Stride Community Health CenterAurora, CO, CCN 061052 Federally qualified health center Operational/Managerial Control (100%) Feb 28, 2022
Stride Community Health CenterAurora, CO, CCN 061066 Federally qualified health center Operational/Managerial Control (100%) Dec 1, 2023

Owned or controlled facilities with NPI records 11

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

Facilities with the same owner 11

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

Practitioners & affiliated clinicians

Practitioners 15

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 15

NPI Registry JSON

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

{
    "created_epoch": "1308614400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1709510400000",
    "number": "1114213972",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7495 W 29TH AVE",
            "city": "WHEAT RIDGE",
            "state": "CO",
            "postal_code": "800338002",
            "telephone_number": "303-360-6276",
            "fax_number": "303-343-0247"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12055 W 2ND PL",
            "city": "LAKEWOOD",
            "state": "CO",
            "postal_code": "802281506",
            "telephone_number": "303-360-6276",
            "fax_number": "303-789-7222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "METRO COMMUNITY PROVIDER NETWORK INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "METRO COMMUNITY PROVIDER NETWORK INC",
        "enumeration_date": "2011-06-21",
        "last_updated": "2024-03-04",
        "certification_date": "2024-03-04",
        "status": "A",
        "authorized_official_last_name": "PEER",
        "authorized_official_first_name": "APRIL",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "303-761-1977"
    },
    "taxonomies": [
        {
            "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": "86602373",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "STRIDE Community Health Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "STRIDE CHC - Union Square Health Plaza at Jefferson Center",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Lakewood, CO

Sources for this page

Verify at the official NPI Registry.