NPIMap

Organization Active NPI

Colorado Coalition for the Homeless

Doing business as 2100 Broadway Services Building

  • Federally Qualified Health Center (FQHC)
  • Denver, CO
National Provider Identifier
1346621208
Registry record updated Jan 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
License
CO DOES NOT REQUIRE Issued in CO
Legal business name
COLORADO COALITION FOR THE HOMELESS
Doing business as
2100 Broadway Services Building
Practice address
2100 Broadway
Denver, CO 80205-2827
Phone
(303) 297-4091
Fax
(303) 293-2309
NPI assigned
Jun 16, 2015
Last updated
Jan 2, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 2, 2025

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

Authorized official

Name
Pete J Stoller
Title
Cfo
Phone
(303) 312-9606

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X CO DOES NOT REQUIRE CO Primary

Addresses

Primary practice location

2100 Broadway
Denver, CO 80205-2827

Mailing address

2130 Stout Street
Denver, CO 80205-2526
Phone (303) 312-9983

Other identifiers 2

IdentifierTypeStateIssuer
90188870MedicaidCO
061955OtherCOMEDICARE

Other names 1

  • 2100 Broadway Services Building Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150902001890 CO Part A Provider - Federally Qualified Health Center (FQHC) 7618958687 Practice locations: Denver, CO

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1346621208. Details of each certification follow.

Federally qualified health center certification: CCN 061955

Legal name
COLORADO COALITION FOR THE HOMELESS
Doing business as
2100 BROADWAY SERVICES BUILDING
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Sep 8, 2015
Last certification
Sep 8, 2015
Ownership / control type
For profit – corporation
Organization structure
OtherNon-profit
Incorporated
May 1, 1984 in CO
Enrollment address
2100 Broadway
Denver, CO 80205-2529

Other NPIs with the same Medicare PAC ID 7

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

National Provider Directory

National Provider Directory
Tax ID family
Colorado Coalition for the38 organizations share this tax ID, including this one

Other organizations with this tax ID 37

Organizations that report the same tax identification number in the National Provider Directory.

View all 37

Locations

2100 N Broadway
Denver, CO 80205
Phone (303) 293-2217

Ownership & related parties

All disclosed owners & managing parties 25

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Charles F Savage Individual Corporate Director Mar 1, 2020
Leanne D Wheeler Individual Corporate DirectorBoard of Directors Jan 10, 2013
Cuicatl G Montoya Individual Corporate Director Mar 1, 2020
James R Davis Individual Corporate DirectorBoard Member Jan 4, 2011
Jynx N Messacar Individual Corporate DirectorBoard Member Jul 1, 2014
James R Brown Individual Corporate DirectorBoard Member Mar 2, 2004
Randle Loeb Individual Corporate DirectorBoard Member Jul 10, 2007
Jane Tidball Individual Corporate Director Mar 1, 2020
Christopher Aaron Bates Individual Corporate DirectorBoard Member Sep 3, 2013
Jennifer a Bettridge Individual Corporate Director Mar 1, 2020
Sam Mamet Individual Corporate Director Mar 1, 2020
Norman Haglund Individual Corporate Director Mar 1, 2020
Donna R Hilton Individual Corporate Director Mar 1, 2020
Andrew Romero Individual Corporate Director Mar 1, 2020
Britta Elise Monson Fisher Individual Operational/Managerial ControlCeo Apr 5, 2023 100%
James Winston Individual Corporate DirectorBoard Member May 7, 1997
Thomas R Reid Individual Corporate DirectorBoard Member Mar 6, 2007
Katherine H Kaley Individual Corporate Director Mar 1, 2020
Theresa Helweg Individual W-2 Managing EmployeeDirector of Revenue Cycle Jan 1, 2013
Colorado Coalition for the Homeless Organization, Denver, CO Non-profit 5% Or Greater Direct Ownership Interest Feb 20, 2014 100%
Pete Stoller Individual Corporate OfficerCfo Jan 1, 2014
W-2 Managing EmployeeCfo Jan 1, 2014 100%
Lori a Malone Individual Corporate Director Mar 1, 2020
Darrell a Brown Individual Corporate DirectorBoard Member Sep 10, 2013
Joel S Neckers Individual Corporate Director Mar 1, 2020
Melissa Jones Individual Corporate Director Mar 1, 2020

Owners & managing parties with NPI records 8

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

All facility ownership & control disclosures 4

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

FacilityTypeRoleSince
West End Health CenterDenver, CO, CCN 061922 Federally qualified health center 5% Or Greater Direct Ownership Interest Apr 10, 2012
Ft Lyon Health Care for the HomelessFort Lyon, CO, CCN 061952 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Feb 2, 2014
Colorado Coalition for the HomelessDenver, CO, CCN 061035 Federally qualified health center 5% Or Greater Direct Ownership Interest (0.05%) Mar 7, 2022
Stout Street Recuperative Care CenterDenver, CO, CCN 061045 Federally qualified health center 5% Or Greater Direct Ownership Interest Jan 1, 2022

Owned or controlled facilities with NPI records 4

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

Facilities with the same owner 4

Facilities that share an organizational owner with 5% or greater ownership or operational control.

NPI Registry JSON

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

{
    "created_epoch": "1434412800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1735776000000",
    "number": "1346621208",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2130 STOUT STREET",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802052526",
            "telephone_number": "303-312-9983",
            "fax_number": "303-293-2309"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 BROADWAY",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802052827",
            "telephone_number": "303-297-4091",
            "fax_number": "303-293-2309"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLORADO COALITION FOR THE HOMELESS",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-06-16",
        "last_updated": "2025-01-02",
        "certification_date": "2025-01-02",
        "status": "A",
        "authorized_official_last_name": "STOLLER",
        "authorized_official_first_name": "PETE",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "303-312-9606"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "CO",
            "license": "CO DOES NOT REQUIRE",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "90188870",
            "state": "CO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "061955",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "2100 Broadway Services Building",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "2100 Broadway Services Building",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Denver, CO

Sources for this page

Verify at the official NPI Registry.