NPIMap

Organization Active NPI

Denver Health and Hospital Authority

  • Federally Qualified Health Center (FQHC)
  • Denver, CO
National Provider Identifier
1174158992
Registry record updated Jan 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
DENVER HEALTH AND HOSPITAL AUTHORITY
Practice address
4007 W Colfax Ave
Denver, CO 80204
Phone
(303) 436-6000
NPI assigned
Mar 12, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2025

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

Authorized official

Name
April Audain
Title
Chief Financial Officer
Phone
(303) 602-4965

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X Primary

Addresses

Primary practice location

4007 W Colfax Ave
Denver, CO 80204

Mailing address

777 Bannock St # Mc1923
Denver, CO 80204-4507
Phone (303) 436-6000

Other names 1

  • Sloan's Lake Primary Care Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20201117003254 CO Part A Provider - Federally Qualified Health Center (FQHC) 2769893056 Practice locations: Denver, CO

Federally qualified health center certification: CCN 061021

Legal name
DENVER HEALTH AND HOSPITAL AUTHORITY
Doing business as
SLOAN'S LAKE PRIMARY CARE CENTER
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Nov 18, 2020
Last certification
Nov 18, 2020
Ownership / control type
For profit – corporation
Organization structure
OtherNon-profit
Enrollment address
4007 W Colfax Ave
Denver, CO 80204-1404

Other NPIs with the same Medicare PAC ID 2

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

National Provider Directory

National Provider Directory
Tax ID family
Denver Health and Hospital Authority4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

Ownership & related parties

All disclosed owners & managing parties 13

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

NameRoleSinceShare
Patricia Dean Individual Corporate DirectorBoard Member Aug 19, 2020
Frank Verloin Degruy Individual Corporate DirectorBoard Member Nov 1, 2025
Denver Health and Hospital Authority Organization, Denver, CO 5% Or Greater Direct Ownership Interest Jan 1, 1997 100%
Thomas Kim Individual Corporate DirectorBoard Member Nov 1, 2025
April Audain Individual Corporate OfficerChief Financial Officer Nov 1, 2025
Elias Provencio-Vasquez Individual Corporate DirectorBoard Member Nov 1, 2025
Richard Jim Chavez Individual Corporate DirectorBoard Member Aug 19, 2020
Hollie Velasquez-Horvath Individual Corporate DirectorBoard Member Nov 1, 2025
Lilia Cervantes Individual Corporate DirectorBoard Member Nov 1, 2025
Kathryn Nesbitt Individual Corporate DirectorBoard Member Nov 1, 2025
Chris Watney Individual Corporate DirectorBoard Member Nov 1, 2025
Patti Klinge Individual Corporate DirectorBoard Member Aug 19, 2020
Jeremy Springston Individual W-2 Managing EmployeeDirector of Reimbursement Aug 19, 2020

Owners & managing parties with NPI records 3

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
Rose Andom Health CenterDenver, CO, CCN 061020 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Jun 11, 2019
Adult Urgent Care CenterDenver, CO, CCN 061023 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Jul 1, 2021

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 1

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

NPI Registry JSON

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

{
    "created_epoch": "1583971200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1736985600000",
    "number": "1174158992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "777 BANNOCK ST # MC1923",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802044507",
            "telephone_number": "303-436-6000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4007 W COLFAX AVE",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "80204",
            "telephone_number": "303-436-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DENVER HEALTH AND HOSPITAL AUTHORITY",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-03-12",
        "last_updated": "2025-01-16",
        "certification_date": "2025-01-16",
        "status": "A",
        "authorized_official_last_name": "AUDAIN",
        "authorized_official_first_name": "APRIL",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "303-602-4965"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sloan's Lake Primary Care",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Sloan's Lake Primary Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Denver, CO

Sources for this page

Verify at the official NPI Registry.