NPIMap

Organization Active NPI

St. Marys Hospital and Medical Center Inc

  • Rehabilitation Hospital Unit
  • Grand Junction, CO
National Provider Identifier
1124274436
Registry record updated Dec 10, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation Hospital UnitTaxonomy code 273Y00000X
License
011160 Issued in CO
Legal business name
ST. MARYS HOSPITAL AND MEDICAL CENTER INC
Practice address
2635 N 7TH St
Grand Junction, CO 81501-8209
Phone
(970) 298-2273
NPI assigned
Aug 18, 2008
Organization subpart
Yes
Parent organization
SISTERS OF CHARITY OF LEAVENWORTH HEALTHAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 10, 2019

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

Authorized official

Name
Terri Chinn
Title
Vice President, Cfo
Phone
(970) 298-2020

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Hospital Unit 273Y00000X 011160 CO Primary

Addresses

Primary practice location

2635 N 7TH St
Grand Junction, CO 81501-8209

Mailing address

2635 N 7TH St
Grand Junction, CO 81501-8209
Phone (970) 298-2273

Other names 1

  • St. Mary's Medical Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20071205000409 CO Part A Provider - Hospital 1557267069 1 other NPI on this enrollment
Practice locations: Grand Junction, CO

Hospital certification: CCN 06T023

Legal name
ST MARYS HOSPITAL AND MEDICAL CENTER INC
Doing business as
INTERMOUNTAIN HEALTH ST. MARY'S REGIONAL HOSPITAL
Organization structure
CorporationNon-profit
Incorporated
Mar 24, 1975 in CO
Enrollment address
2635 N 7TH St
Grand Junction, CO 81501-8209
Hospital Rehabilitation Unit
Hospital subgroups
Rehabilitation unit

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

Other NPIs with the same Medicare PAC ID 2

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

Other NPIs on the same Medicare enrollment 1

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

Care Compare: Inpatient rehabilitation facility

Medicare Care Compare
Listed as
St. Marys Hospital and Medical Center IncCCN 06T023
Ownership
Non-profit
Certified
Jun 1, 1996

National Provider Directory

National Provider Directory
Tax ID family
Colorado West ER Physic8 organizations share this tax ID, including this one
Part of
Sisters of Charity of Leavenworth Health System Inc

Other organizations with this tax ID 7

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

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
Tom Benton Individual Corporate DirectorBoard Member Jan 1, 2021
Mark C Griffin Individual Corporate DirectorBoard Member Jan 2, 2020
John Merrick Taggart Individual Corporate DirectorBoard Member Jan 1, 2024
Amy Lynn Davis Individual Corporate DirectorBoard Member Jan 1, 2024
Angela Padalecki Individual Corporate DirectorBoard Member Jan 1, 2023
Jeffrey Taets Individual Corporate DirectorBoard Member Jan 1, 2021
Vincent Donohue Individual Corporate OfficerAvp Finance Jan 1, 2025
W-2 Managing EmployeeAvp Finance Jan 1, 2025
Vance Wagner Individual Corporate DirectorBoard Member Jan 1, 2018
Timothy Foster Individual Corporate DirectorBoard Member May 1, 2023
Sisters of Charity of Leavenworth Health System Inc Organization, Broomfield, CO Non-profit, Chain home office 5% Or Greater Direct Ownership Interest Dec 19, 1972
Bryan Johnson Individual Corporate OfficerPresident Aug 9, 2019
Corporate DirectorPresident Aug 9, 2019
W-2 Managing EmployeePresident Aug 9, 2019
Intermountain Health Care, Inc Organization, Salt Lake City, UT Non-profit, Chain home office Operational/Managerial Control Apr 1, 2022
Lenna Watson Individual Corporate Director Jan 1, 2020
Brian Hill Individual Corporate DirectorBoard Member Jul 1, 2022
Joseph Carlson Individual Corporate DirectorBoard Member Jan 1, 2022

Owners & managing parties with NPI records 5

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

Facilities with the same owner 15

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

View all 15

Practitioners & affiliated clinicians

Practitioners 2

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

Affiliated clinicians 7

Clinicians who list this facility as an affiliation in Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1219017600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1575936000000",
    "number": "1124274436",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2635 N 7TH ST",
            "city": "GRAND JUNCTION",
            "state": "CO",
            "postal_code": "815018209",
            "telephone_number": "970-298-2273"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2635 N 7TH ST",
            "city": "GRAND JUNCTION",
            "state": "CO",
            "postal_code": "815018209",
            "telephone_number": "970-298-2273"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. MARYS HOSPITAL AND MEDICAL CENTER INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SISTERS OF CHARITY OF LEAVENWORTH HEALTH",
        "enumeration_date": "2008-08-18",
        "last_updated": "2019-12-10",
        "certification_date": "2019-12-10",
        "status": "A",
        "authorized_official_last_name": "CHINN",
        "authorized_official_first_name": "TERRI",
        "authorized_official_title_or_position": "VICE PRESIDENT, CFO",
        "authorized_official_telephone_number": "970-298-2020"
    },
    "taxonomies": [
        {
            "code": "273Y00000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Unit",
            "state": "CO",
            "license": "011160",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "St. Mary's Medical Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Grand Junction, CO

Sources for this page

Verify at the official NPI Registry.