Active NPI
Southwest Health System, Inc.
- Multi-Specialty Clinic/Center
- Cortez, CO
National Provider Identifier
1285614941
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Multi-Specialty Clinic/Center
- 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
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) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 04021333 | Medicaid | CO |
Other names 1
- Southwest Memorial Medical Clinic
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CO
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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.
-
- Multi-Specialty Clinic/Center
- Cortez, CO
- NPI 1235655838
O20031125000607
-
- Multi-Specialty Clinic/Center
- Cortez, CO
- NPI 1932475894
O20031125000607
-
- Emergency Medicine Physician
- Cortez, CO
- NPI 1972078814
O20031125000607
National Provider Directory
National Provider DirectoryLocations
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 NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 06D2020879 | Southwest Memorial Clinics | Provider-performed microscopy | Feb 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.