Southern Colorado Ute Service Unit
Organization Active NPI Federal Public Health Clinic/Center · Towaoc, CO
NPI 1255422788 · NPPES record last updated Apr 3, 2025
Key facts
- NPI
- 1255422788
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Federal Public Health Clinic/Center 261QP0904X
- Legal business name
- SOUTHERN COLORADO UTE SERVICE UNIT
- Practice address
- 232 Rustling Willow St
Towaoc, CO 81334-0049 - Phone
- (970) 565-4441
- Fax
- (970) 565-9110
- NPI assigned
- Sep 28, 2006
- Organization subpart
- No
Authorized official
- Name
- Lucy Lansing
- Title
- Business Office Manager
- Phone
- (970) 565-4441
Corporate family (same tax ID) 4
Practitioners 12
-
Gwendolyn Grant, M.D.
-
Kimberly Vega, MD
-
Christie S. Williams, LCSW
-
Matthew Alexander Clark, M.D.
-
Dennis Michael Beaufait, ED D
-
Terry R Cook, DPM
-
Kristen Suzanne Anderson, PHARMD
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TX
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20050831000974 | TX | Part B Supplier - Clinic/Group Practice | 2163454968 |
Receives reassigned benefits from 11 practitioners Practice locations: Towaoc, CO |
National Provider Directory
- Tax ID family
- Ute Mountatin Ute Health Center
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Federal Public Health Clinic/Center | 261QP0904X | Yes |
Addresses
Primary practice location
232 Rustling Willow St
Towaoc, CO 81334-0049
Mailing address
PO Box 49
Towaoc, CO 81334-0049
Phone (970) 565-4441
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 700000000009 | Medicaid | UT | |
| 708000 | Medicaid | AZ | |
| 05600002 | Medicaid | CO | |
| G7123 | Medicaid | NM |
Other names
- SOUTHERN COLORADO HEALTH CENTER
Other providers in Towaoc, CO
- Laura Jeanene Martinez
- Laura Annabeth McCluney
- Helen C Newman
- Thomasita Roanhorse
- Ashley Day Scheier
- Southern Colorado Ute Service Unit
- Southern Colorado Ute Service Unit
- Stephanie G Stone
- Ute Mountain Counseling Treatment
- Ute Mountain Ute Tribe
All providers in Towaoc, CO · Federal Public Health Clinic/Center 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 3, 2025. 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.