Organization Active NPI

Southwest Health System, Inc.

  • Multi-Specialty Clinic/Center
  • Cortez, CO
National Provider Identifier
1285614941
Registry record updated Jun 6, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
Legal business name
SOUTHWEST HEALTH SYSTEM, INC.
Practice address
1413 N Mildred Rd
Cortez, CO 81321
Phone
(970) 565-4436
Fax
(970) 565-2007
NPI assigned
Jan 19, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 6, 2018

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

Authorized official

Name
Mr. Anthony Sudduth
Title
Ceo
Phone
(970) 564-2150

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Multi-Specialty Clinic/Center 261QM1300X Primary

Addresses

Primary practice location

1413 N Mildred Rd
Cortez, CO 81321

Mailing address

1311 N Mildred Road
Cortez, CO 81321-2231
Phone (970) 564-2152

Other identifiers 1

IdentifierTypeStateIssuer
04021333MedicaidCO

Other names 1

  • Southwest Memorial Medical Clinic Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031125000607 CO Part B Supplier - Clinic/Group Practice 5890699326 Receives reassigned benefits from 107 practitioners
11 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Cortez, CO; Mancos, CO

Other NPIs on the same Medicare enrollment 11

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

National Provider Directory

National Provider Directory

Locations

1311 N Mildred Rd
Cortez, CO 81321
Phone (970) 565-6666

208 W North St
Cortez, CO 81321
Phone (970) 565-2600

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
06D2020879Southwest Memorial Clinics1413 N Mildred Rd, Cortez, CO 81321Provider-performed microscopyFeb 28, 2027

NPI Registry JSON

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

{
    "created_epoch": "1137628800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1528243200000",
    "number": "1285614941",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1311 N MILDRED ROAD",
            "city": "CORTEZ",
            "state": "CO",
            "postal_code": "813212231",
            "telephone_number": "970-564-2152",
            "fax_number": "970-564-2155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1413 N MILDRED RD",
            "city": "CORTEZ",
            "state": "CO",
            "postal_code": "81321",
            "telephone_number": "970-565-4436",
            "fax_number": "970-565-2007"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHWEST HEALTH SYSTEM, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-19",
        "last_updated": "2018-06-06",
        "status": "A",
        "authorized_official_last_name": "SUDDUTH",
        "authorized_official_first_name": "ANTHONY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "970-564-2150",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04021333",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Southwest Memorial Medical Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Cortez, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.