Lutheran Hospital Association of the San Luis Valley
Organization Active NPI Orthopaedic Surgery Physician · Monte Vista, CO
NPI 1184866410 · NPPES record last updated Apr 1, 2009
Key facts
- NPI
- 1184866410
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Orthopaedic Surgery Physician 207X00000X
- Legal business name
- LUTHERAN HOSPITAL ASSOCIATION OF THE SAN LUIS VALLEY
- Practice address
- 103 Chico CT
Suite B
Monte Vista, CO 81144-1065 - Phone
- (719) 852-7240
- Fax
- (719) 852-0332
- NPI assigned
- Apr 1, 2009
- Organization subpart
- Yes
- Parent organization (as reported)
- SLV REGIONAL MEDICAL CENTER
Authorized official
- Name
- Mr. Russell W Johnson, CEO
- Title
- Chief Executive Officer
- Phone
- (719) 587-1200
Corporate family (same tax ID) 10
Practitioners 8
-
Jackie Dawn Bennett, FNP-BC
-
William H Cooper, MD
-
Orlando R Deherrera, D.O.
-
Jeffrey A Oster, DPM
-
Aaron L Polzin, D.C.
-
Amy B. Cheatwood-Johnston, D.C., APRN-CNP, FNP
National Provider Directory
- Tax ID family
- San Luis Valley Reg Med Ctr
- Part of
- San Luis Valley Reg Med Ctr
Locations
106 Blanca Ave
Alamosa, CO 81101
Phone (719) 589-2511
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor |
111N00000X | |||
| Internal Medicine Physician |
207R00000X | |||
| Obstetrics & Gynecology Physician |
207V00000X | |||
| Orthopaedic Surgery Physician |
207X00000X | Yes | ||
| Pediatrics Physician |
208000000X | |||
| Psychiatry Physician |
2084P0800X | |||
| Surgery Physician |
208600000X | |||
| Physician Assistant |
363A00000X | |||
| Nurse Practitioner |
363L00000X |
Addresses
Primary practice location
103 Chico CT
Suite B
Monte Vista, CO 81144-1065
Mailing address
106 Blanca Ave
Alamosa, CO 81101-2340
Phone (719) 589-2511
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 68085770 | Medicaid | CO |
Other names
- SLV Regional Medical Center Physician Services
Other providers in Monte Vista, CO
- Theresa A. Kaiser-Griffin
- Tim L Kynion
- Ryan James Lopez
- Luis Alvarez LLC
- Lutheran Hospital Association of the San Luis Valley
- Lutheran Hospital Association of the San Luis Valley
- Daniel Lee Malouff Jr.
- Dana Manriquez
- Jose Antonio Manriquez
- Laura Lee Martin
All providers in Monte Vista, CO · Orthopaedic Surgery Physician in Colorado
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 1, 2009. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.