NPIMap

Organization Active NPI

Huerfano County Hospital District

Doing business as Spanish Peaks Family Clinic

  • Rural Health Clinic/Center
  • Walsenburg, CO
National Provider Identifier
1154799526
Registry record updated Jul 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
HUERFANO COUNTY HOSPITAL DISTRICT
Doing business as
Spanish Peaks Family Clinic
Practice address
23400 US Highway 160
Walsenburg, CO 81089-8100
Phone
(719) 738-4590
NPI assigned
Sep 2, 2015
Last updated
Jul 25, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2022

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

Authorized official

Name
Colette C Martin
Title
Cfo
Phone
(719) 738-5137

Specialties & licenses 1

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

Addresses

Primary practice location

23400 US Highway 160
Walsenburg, CO 81089-8100

Mailing address

23500 US Highway 160
Walsenburg, CO 81089-9524
Phone (719) 738-5144

Other names 1

  • Spanish Peaks Family Clinic Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
O20040202001045 CO Part B Supplier - Clinic/Group Practice 4789591769 Receives reassigned benefits from 28 practitioners
5 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Walsenburg, CO
O20110426000426 CO Part A Provider - Rural Health Clinic 4789591769 1 other NPI on this enrollment
Practice locations: Walsenburg, CO
O20171006000019 CO Part B Supplier - Clinic/Group Practice 4789591769 Receives reassigned benefits from 18 practitioners
Practice locations: Walsenburg, CO

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1154799526. Details of each certification follow.

Rural health clinic certification: CCN 068517

Legal name
HUERFANO COUNTY HOSPITAL DISTRICT
Doing business as
SPANISH PEAKS FAMILY CLINIC
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Aug 25, 2011
Last certification
Oct 23, 2024
Ownership / control type
Non-profit – church related
Organization structure
OtherNon-profit
Incorporated
Dec 1, 1961 in CO
Enrollment address
23400 US Highway 160
Walsenburg, CO 81089-8100
Related CCNs
061316

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

Other NPIs with the same Medicare PAC ID 7

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

Other NPIs on the same Medicare enrollment 5

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

National Provider Directory

National Provider Directory

Locations

23400 US Highway 160
#X
Walsenburg, CO 81089

23400 US Highway 160
#Z
Walsenburg, CO 81089

23450 US Highway 160
#X
Walsenburg, CO 81089

23450 US Highway 160
Ste A
Walsenburg, CO 81089

355 W Pine St
Walsenburg, CO 81089

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
Brenda J Parnell Individual Corporate DirectorCfo May 1, 2025
John Davis Individual Corporate DirectorBoard Vice-Chairman May 1, 2020
Maurice E Heikes Individual Corporate DirectorSecretary May 1, 2025
Huerfano County Hospital District Organization, Walsenburg, CO Non-profit Operational/Managerial Control Mar 16, 2011
Nancy M Nielsen Individual Corporate DirectorDirector at Large May 1, 2022
Kay Whitley Individual Corporate DirectorCeo Aug 1, 2016
W-2 Managing EmployeeCeo Aug 1, 2016
Joann Ugolini Individual Corporate DirectorDirector at Large May 1, 2025
Jill Davis Homerding Individual Corporate DirectorChairman May 1, 2022

Owners & managing parties with NPI records 7

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

All facility ownership & control disclosures 2

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

FacilityTypeRoleSince
Spanish Peaks Regional Health CenterWalsenburg, CO, CCN 061316 Hospital Operational/Managerial Control Mar 16, 2011
Spanish Peaks Regional Health CenterWalsenburg, CO, CCN 06Z316 Hospital 5% Or Greater Direct Ownership Interest (100%) Jan 1, 1966

Owned or controlled facilities with NPI records 2

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

Facilities with the same owner 2

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

Practitioners & affiliated clinicians

Practitioners 20

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 20

NPI Registry JSON

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

{
    "created_epoch": "1441152000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658707200000",
    "number": "1154799526",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23500 US HIGHWAY 160",
            "city": "WALSENBURG",
            "state": "CO",
            "postal_code": "810899524",
            "telephone_number": "719-738-5144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23400 US HIGHWAY 160",
            "city": "WALSENBURG",
            "state": "CO",
            "postal_code": "810898100",
            "telephone_number": "719-738-4590"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HUERFANO COUNTY HOSPITAL DISTRICT",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-09-02",
        "last_updated": "2022-07-25",
        "certification_date": "2022-07-25",
        "status": "A",
        "authorized_official_last_name": "MARTIN",
        "authorized_official_first_name": "COLETTE",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "719-738-5137"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Spanish Peaks Family Clinic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Spanish Peaks Family Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Walsenburg, CO

Sources for this page

Verify at the official NPI Registry.