St Mary'S Hospital and Medical Center, Inc
Organization Active NPI Ambulance · Grand Junction, CO
NPI 1164060877 · NPPES record last updated May 11, 2022
Key facts
- NPI
- 1164060877
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Ambulance 341600000X
- Legal business name
- ST MARY'S HOSPITAL AND MEDICAL CENTER, INC
- Practice address
- 2635 N 7TH St
Grand Junction, CO 81501-8209 - Phone
- (970) 298-2273
- NPI assigned
- Dec 12, 2019
- Organization subpart
- Yes
- Parent organization (as reported)
- SISTERS OF CHARITY OF LEAVENWORTH HEALTH SYSTEM INC
Authorized official
- Name
- Terri L Chinn
- Title
- VP Finance
- Phone
- (970) 298-2020
Owners & managing parties with NPI records 6
-
Amy Davis, M.D.
-
Mark C Griffin, MD
-
Teyen P Shiao, MD
Other NPIs on the same Medicare enrollment 3
Corporate family (same tax ID) 7
Related certifications (CCN) 2
Affiliated clinicians 717
-
Joseph Adragna IV, MD, MHA, MGH
-
Basheal M. Agrawal, M.D.
-
Bilal Aijaz, M.D
-
Ivan S Alkes, MD
-
Melinda Beth Allen, DNP
-
Arianna M Andersen, FNP
-
Christi Renee Anderson, RN, MSN, WHNP-BC, NP
-
Dustin Anderson, MD
-
Mojgan Arashvand, DO
-
Amy J Archer, DO
-
Elizabeth Arena Arena, DO, MPH
-
Tarek T. Arja, D.O.
-
Merrilynn Artman, CNM
-
Michael J Ash, MD
-
Michael F Atwell, MD
-
Monica Ayala, DO
-
Jack Ryan Bagley, M.D.
-
Andrew H Baker, M.D.
-
Jamie Jon Ball, PA-C
-
Leah Barjenbruch, PA-C
Medicare Care Compare: Hospital
- Listed as
- Intermountain Health St. Mary'S Regional Hospital
- Overall star rating
- ★★★★☆ 4 of 5
- Type
- Acute Care Hospitals
- Ownership
- Voluntary non-profit - Church
- Medicare certification status
- Active
- Emergency services
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CO
Hospital certification: CCN 060023
- Legal name
- ST MARYS HOSPITAL AND MEDICAL CENTER INC
- Doing business as
- INTERMOUNTAIN HEALTH ST. MARY'S REGIONAL HOSPITAL
- Certification status
- Active
- Provider type (POS)
- Hospital – Short-term
- Participating since
- Jul 1, 1966
- Last certification
- Mar 25, 2015
- Beds
- 346
- Ownership / control type
- Church
- Organization structure
- Corporation · Non-profit
- Incorporated
- Mar 24, 1975 in CO
- Enrollment address
- 2635 N 7TH St
Grand Junction, CO 81501-8209 - Hospital subgroups
- General, Acute care
All disclosed owners & managing parties 16
| Name | Role | Since | Share |
|---|---|---|---|
| Tom Benton |
Corporate Director |
Jan 1, 2022 | |
| Mark C Griffin |
Corporate Director |
Jan 1, 2020 | |
| John Merrick Taggart |
Corporate Director |
Jan 1, 2024 | |
| Amy Lynn Davis |
Corporate Director |
Jan 1, 2024 | |
| Teyen P. Shiao |
Corporate Director |
Mar 1, 2025 | |
| Angela Padalecki |
Corporate Director |
Jan 1, 2023 | |
| Jeffrey Taets |
Corporate Director |
Jan 1, 2021 | |
| Vincent Donohue |
Corporate Director | Jan 1, 2025 | |
| W-2 Managing Employee | Jan 1, 2025 | ||
| Vance Wagner |
Corporate Director |
Jan 1, 2018 | |
| Timothy Foster |
Corporate Director | May 1, 2023 | |
| Sisters of Charity of Leavenworth Health System Inc |
5% Or Greater Direct Ownership Interest | Dec 19, 1972 | 100% |
| Bryan Johnson |
Corporate Officer |
Aug 9, 2019 | |
| Corporate Director |
Aug 9, 2019 | ||
| W-2 Managing Employee |
Aug 9, 2019 | ||
| Intermountain Health Care, Inc |
Operational/Managerial Control | Apr 1, 2022 | |
| Lenna Watson |
Corporate Director |
Jan 1, 2020 | |
| Brian Hill |
Corporate Director |
Jul 1, 2022 | |
| Joseph Carlson |
Corporate Director |
Jan 1, 2022 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20071205000395 | CO | Part a Provider - Hospital | 1557267069 |
3 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Rifle, CO; Montrose, CO; Grand Junction, CO |
National Provider Directory
- Tax ID family
- Colorado West ER Physic
- Part of
- Sisters of Charity of Leavenworth Health System Inc
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ambulance | 341600000X | Yes | ||
| Air Ambulance | 3416A0800X | |||
| Land Ambulance | 3416L0300X |
Addresses
Primary practice location
2635 N 7TH St
Grand Junction, CO 81501-8209
Mailing address
2635 N 7TH St
Grand Junction, CO 81501-8209
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 9000144631 | Medicaid | CO |
Other names
- St Mary's CareFlight
Other providers in Grand Junction, CO
- Kurt D Spriggs
- Ann Spry
- Ashlynn Squires
- Danielle Dawn Squires
- St Mary'S Hospital and Medical Center, Inc
- St Mary'S Hospital and Medical Center, Inc
- St Mary'S Hospital and Medical Center, Inc
- St Mary'S Hospital and Medical Center, Inc
- St Mary'S Hospital and Medical Center, Inc
- St Mary'S Hospital and Medical Center, Inc
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 11, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.