NPIMap

Organization Active NPI

Valley-Wide Health Systems, Inc

Doing business as Las Animas Clinic

  • Federally Qualified Health Center (FQHC)
  • Las Animas, CO
National Provider Identifier
1124015607
Registry record updated Apr 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
VALLEY-WIDE HEALTH SYSTEMS, INC
Doing business as
Las Animas Clinic
Practice address
245 Vine Ave
Las Animas, CO 81054-1039
Phone
(719) 456-2653
Fax
(719) 456-0105
NPI assigned
Sep 30, 2005
Last updated
Apr 30, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2024

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

Authorized official

Name
Jania Arnoldi
Title
President/Ceo
Phone
(719) 589-5161

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X
Federally Qualified Health Center (FQHC) 261QF0400X CO Primary

Addresses

Primary practice location

245 Vine Ave
Las Animas, CO 81054-1039

Mailing address

128 Market St
Alamosa, CO 81101-2290
Phone (719) 587-1001

Other names 1

  • Las Animas Clinic Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100625000520 CO Part A Provider - Federally Qualified Health Center (FQHC) 5991609067 Practice locations: Las Animas, CO

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1124015607. Details of each certification follow.

Federally qualified health center certification: CCN 061860

Legal name
VALLEY-WIDE HEALTH SYSTEMS, INC.
Doing business as
LAS ANIMAS 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
CorporationNon-profit
Incorporated
Apr 15, 1976 in CO
Enrollment address
245 Vine Ave
Las Animas, CO 81054-1039

National Provider Directory

National Provider Directory
Tax ID family
Valley-Wide Health Systems Inc33 organizations share this tax ID, including this one

Other organizations with this tax ID 32

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

View all 32

Ownership & related parties

All disclosed owners & managing parties 8

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

NameRoleSinceShare
Javier Martinez Individual W-2 Managing EmployeeCfo Mar 19, 2019
Jania Arnoldi Individual Corporate DirectorCeo/President Mar 15, 2019
W-2 Managing EmployeeCeo/President Mar 15, 2019
Linda Deherrera Individual Corporate Director Feb 28, 2018
Mattew Martinez Individual Corporate Director Mar 19, 2019
Jeremy Silva Individual Corporate Director Oct 23, 2019
Michelle Ferrera Individual Corporate Director Feb 27, 2019
Michelle Ballantyne Individual Corporate Director Mar 22, 2017
Patricia Freda Individual Corporate Director Apr 29, 2015

All facility ownership & control disclosures 1

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

FacilityTypeRoleSince
Valley-Wide Health Systems, Inc.Canon City, CO, CCN 061019 Federally qualified health center Other Aug 17, 2020

NPI Registry JSON

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

{
    "created_epoch": "1128038400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1714435200000",
    "number": "1124015607",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "128 MARKET ST",
            "city": "ALAMOSA",
            "state": "CO",
            "postal_code": "811012290",
            "telephone_number": "719-587-1001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "245 VINE AVE",
            "city": "LAS ANIMAS",
            "state": "CO",
            "postal_code": "810541039",
            "telephone_number": "719-456-2653",
            "fax_number": "719-456-0105"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VALLEY-WIDE HEALTH SYSTEMS, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-30",
        "last_updated": "2024-04-30",
        "certification_date": "2024-04-30",
        "status": "A",
        "authorized_official_last_name": "ARNOLDI",
        "authorized_official_first_name": "JANIA",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "719-589-5161"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "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": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Las Animas Clinic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Las Animas Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Las Animas, CO

Sources for this page

Verify at the official NPI Registry.