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Grand River Hospital District

Organization Active NPI Rural Health Clinic/Center · Rifle, CO

NPI 1124074042 · NPPES record last updated Oct 30, 2020

Key facts

NPI
1124074042
Entity type
Organization (NPI type 2)
Primary specialty
Rural Health Clinic/Center 261QR1300X
Legal business name
GRAND RIVER HOSPITAL DISTRICT
Practice address
501 Airport Rd
Rifle, CO 81650-8510
Phone
(970) 625-1100
NPI assigned
May 25, 2006
Organization subpart
Yes
Parent organization (as reported)
GRAND RIVER HOSPITAL DISTRICT

Authorized official

Name
Mr. James Curtis Coombs
Title
Ceo
Phone
(970) 625-6405

Owners & managing parties with NPI records 4

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

Owned or controlled facilities with NPI records 4

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

Other NPIs on the same Medicare enrollment 2

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

Other NPIs with the same Medicare PAC ID 4

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

Facilities connected through Provider of Services related, parent or unit certification numbers.

Facilities with the same owner 4

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

Practitioners 121

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 121

Laboratory certificates & supplier records

Name & address match These CMS records do not include an NPI. They are shown here because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
06D1054213Grand River Health Primary Care - Rifle
501 Airport Rd, Rifle, CO 81650		Provider-performed microscopyMay 14, 2028

Medicare participation

Medicare fee-for-service enrollment
Enrolled (2 enrollments) in CO

Rural health clinic certification: CCN 063980

Legal name
GRAND RIVER HOSPITAL DISTRICT
Doing business as
GRAND RIVER PRIMARY CARE
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Jul 20, 1994
Last certification
Sep 24, 2025
Ownership / control type
Non-profit – church related
Organization structure
Other · Non-profit
Incorporated
Apr 24, 1961 in CO
Enrollment address
501 Airport Rd
2ND Floor
Rifle, CO 81650-8510
Related CCNs
061317

All disclosed owners & managing parties 9

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

NameRoleSinceShare
Kelly Hilgers
Individual 		W-2 Managing Employee
Administrative Director of Clinics		 Dec 20, 2019
James Coombs
Individual 		Corporate Officer
Ceo		 May 1, 2006
W-2 Managing Employee
Ceo		 May 1, 2006
Todd Ellis
Individual 		Corporate Director
Board Member		 Jan 19, 2023
Edward Weiss
Individual 		Corporate Director
Board President		 Jun 1, 2019
Sharon M Raggio
Individual 		Corporate Director
Board Member		 May 1, 2010
Raquel Mendizabal
Individual 		Corporate Director
Board Member		 Jun 1, 2019
Grand River Hospital District
Organization · Rifle, CO 		5% Or Greater Direct Ownership Interest Apr 24, 1966 100%
Jay Rickstrew
Individual 		Corporate Director
Board Member		 Jan 19, 2023
Perry Will
Individual 		Corporate Director
Board Member		 Jan 19, 2023

All facility ownership & control disclosures 4

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

FacilityTypeRoleSince
Grand River Health Medical Center
Rifle, CO · CCN 061317		 Hospital Operational/Managerial Control (100%) Apr 24, 1966
Grand River Medical Center
Rifle, CO · CCN 06Z317		 Hospital 5% Or Greater Direct Ownership Interest (100%) Apr 24, 1966
Grand River Health Care Center
Rifle, CO · CCN 065381		 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Jan 1, 1966
Grand River Health Clinic West
Parachute, CO · CCN 063996		 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Jan 1, 1990

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20030529000066 CO Part a Provider - Rural Health Clinic 7113837469 Practice locations: Rifle, CO
O20040310000898 CO Part B Supplier - Clinic/Group Practice 7113837469 Receives reassigned benefits from 116 practitioners
2 other NPIs on this enrollment
Practice locations: Parachute, CO; Rifle, CO

National Provider Directory

Part of
Grand River Hospital District

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X
Rural Health Clinic/Center 261QR1300X Yes

Addresses

Primary practice location

501 Airport Rd
Rifle, CO 81650-8510

Mailing address

501 Airport Rd
Rifle, CO 81650-8510
Phone (970) 625-1100

Other identifiers

IdentifierTypeStateIssuer
05638523MedicaidCO

Other names

  • Grand River Primary Care Doing business as

Other providers in Rifle, CO

All providers in Rifle, CO · Rural Health Clinic/Center in Colorado

Sources for this page

Verify at the official NPI Registry.