NPIMap

Organization Active NPI

Denver Health and Hospital Authority

Doing business as Eastside Family Health Center

  • Federally Qualified Health Center (FQHC)
  • Denver, CO
National Provider Identifier
1285675371
Registry record updated Jan 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
License
0900 Issued in CO
Legal business name
DENVER HEALTH AND HOSPITAL AUTHORITY
Doing business as
Eastside Family Health Center
Practice address
501 28TH St
Denver, CO 80205-3003
Phone
(303) 436-6000
NPI assigned
Jun 9, 2006
Last updated
Jan 16, 2025By the provider in NPPES
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 0900 CO Primary

Addresses

Primary practice location

501 28TH St
Denver, CO 80205-3003

Mailing address

777 Bannock St # Mc1925
Denver, CO 80204-4507
Phone (303) 436-6000

Other identifiers 1

IdentifierTypeStateIssuer
05050083MedicaidCO

Other names 1

  • Eastside Family Health Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20071010000833 CO Part A Provider - Federally Qualified Health Center (FQHC) 4688583578 Practice locations: Denver, CO

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1285675371. Details of each certification follow.

Federally qualified health center certification: CCN 061822

Legal name
DENVER HEALTH AND HOSPITAL AUTHORITY
Doing business as
EASTSIDE FAMILY HEALTH CENTER
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Oct 1, 1991
Last certification
Oct 1, 1991
Ownership / control type
Non-profit – corporation
Most recent change of ownership
Jan 1, 1997 (1 total)
Organization structure
OtherNon-profit
Enrollment address
501 E. 28TH Avenue
Eastside Family Health Center
Denver, CO 80205-3003
Related CCNs
060011

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs with the same Medicare PAC ID 19

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

View all 19

National Provider Directory

National Provider Directory
Tax ID family
Denver Health Hospital Aut86 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

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 Jan 1, 2017
Frank Verloin Degruy Individual Corporate DirectorBoard Member Jan 1, 2024
Peggy Burnette Individual Corporate DirectorChief Revenue Officer Jun 1, 2013
Thomas Kim Individual Corporate DirectorBoard Member Jan 1, 2024
Denver Health and Hospital Authority Organization, Denver, CO 5% Or Greater Direct Ownership Interest Jan 1, 1997
Elias Provencio-Vasquez Individual Corporate DirectorBoard Member Jan 1, 2024
Richard Jim Chavez Individual Corporate DirectorBoard Member Jan 1, 2024
Hollie Velasquez-Horvath Individual Corporate DirectorBoard Member Jan 1, 2024
Lilia Cervantes Individual Corporate DirectorBoard Member Jan 1, 2024
Kathryn Nesbitt Individual Corporate DirectorBoard Member Jan 1, 2024
Danielle Shoots Individual Corporate DirectorBoard Member Jan 1, 2024
Patti Klinge Individual Corporate DirectorBoard Member Jan 1, 2024
Jeremy Springston Individual W-2 Managing EmployeeDirector of Reimbursement Jun 1, 2013

Owners & managing parties with NPI records 20

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

View all 20

All facility ownership & control disclosures 12

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Denver Health Medical CenterDenver, CO, CCN 060011 Hospital 5% Or Greater Direct Ownership Interest Jan 1, 1997
Denver Health Medical Center - Psych UnitDenver, CO, CCN 06S011 Hospital 5% Or Greater Direct Ownership Interest Jan 1, 1997
Mobile Health ServicesDenver, CO, CCN 061876 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Jan 1, 1997
Wellington E Webb Center for Primary CareDenver, CO, CCN 061821 Federally qualified health center 5% Or Greater Direct Ownership Interest Jan 1, 1997
Montbello Family Health CenterDenver, CO, CCN 061848 Federally qualified health center 5% Or Greater Direct Ownership Interest Jan 1, 1997
Park Hill Family Health CenterDenver, CO, CCN 061826 Federally qualified health center 5% Or Greater Direct Ownership Interest Jan 1, 1997
Westside Family Health CenterDenver, CO, CCN 061829 Federally qualified health center 5% Or Greater Direct Ownership Interest Jan 1, 1997
Lowry Family Health CenterDenver, CO, CCN 061847 Federally qualified health center 5% Or Greater Direct Ownership Interest Jan 1, 1997
La Casa/ Quigg Newton Family Health CenterDenver, CO, CCN 061828 Federally qualified health center 5% Or Greater Direct Ownership Interest Jan 1, 1997
Westwood Family Health CenterDenver, CO, CCN 061824 Federally qualified health center 5% Or Greater Direct Ownership Interest Jan 1, 1997
Denver Health and Hospital AuthorityDenver, CO, CCN 061972 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Jan 1, 1997
Primary Care Clinic at WellpowerDenver, CO, CCN 061013 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Jan 1, 1997

Owned or controlled facilities with NPI records 14

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

View all 14

Facilities with the same owner 12

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, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1149811200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1736985600000",
    "number": "1285675371",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "777 BANNOCK ST # MC1925",
            "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": "501 28TH ST",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802053003",
            "telephone_number": "303-436-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DENVER HEALTH AND HOSPITAL AUTHORITY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-09",
        "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": "CO",
            "license": "0900",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "05050083",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Eastside Family Health Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Eastside Family Health Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Denver, CO

Sources for this page

Verify at the official NPI Registry.