Active NPI
Hospice del Valle, Inc.
- Community Based Hospice Care Agency
- Alamosa, CO
National Provider Identifier
1427090968
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community Based Hospice Care Agency
- License
- 0981
- Legal business name
- HOSPICE DEL VALLE, INC.
- Practice address
- 514 Main St
Alamosa, CO 81101-2644 - Phone
- (719) 589-9019
- Fax
- (719) 589-5094
- NPI assigned
- Jun 11, 2006
- Last updated
- Aug 22, 2020
- 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
- Ms. Lois Booth, RN
- Title
- Ceo
- Phone
- (719) 589-9019
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community Based Hospice Care Agency | 251G00000X | 0981 | CO | Primary |
Addresses
Primary practice location
514 Main St
Alamosa, CO 81101-2644
Mailing address
514 Main St
Alamosa, CO 81101-2644
Phone (719) 589-9019
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 05800024 | Medicaid | CO |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CO
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040326000641 | CO | Part A Provider - Hospice | 6204728009 | Practice locations: Alamosa, CO |
NPI to CCN mapping 1
The Medicare certification numbers (CCNs) connected to NPI 1427090968. Details of each certification follow.
Hospice certification: CCN 061511
- Legal name
- HOSPICE DEL VALLE, INC.
- Doing business as
- HOSPICE DEL VALLE
- Certification status
- Active
- Provider type (POS)
- Hospice
- Participating since
- Jan 6, 1986
- Last certification
- Jun 8, 2022
- Ownership / control type
- Non-Profit - Private
- Organization structure
- Corporation
- Incorporated
- Jan 18, 1982 in CO
- Enrollment address
- 514 Main St
Alamosa, CO 81101-2644
Care Compare: Hospice
Medicare Care Compare- Listed as
- Hospice del Valle, Inc.
- Ownership
- Non-Profit
- Certified
- Jan 6, 1986
- Medicare certification status
- Active
National Provider Directory
National Provider DirectoryLocations
514 Main St
Alamosa, CO 81101
Phone (719) 589-9019
Ownership & related parties
All disclosed owners & managing parties 6
As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.
| Name | Role | Since | Share |
|---|---|---|---|
| Mary Jo Merkley | Corporate Director | Nov 27, 2017 | |
| Karla S Willschau | Corporate Director | May 1, 2007 | |
| Anthony R Bagwell | 5% Or Greater Indirect Ownership Interest | Aug 1, 2013 | 5% |
| Corporate Director | Aug 1, 2013 | ||
| Marguerite F Hoagland | Corporate Director | Feb 1, 2006 | |
| Kimberley Temple | Corporate Director | Jun 25, 2015 | |
| Amber R Cortez | Corporate Officer | Apr 1, 2023 | |
| Operational/Managerial Control | Apr 1, 2023 |
Practitioners & affiliated clinicians
Affiliated clinicians 5
Clinicians who list this facility as an affiliation in Medicare Care Compare.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149984000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1598054400000",
"number": "1427090968",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "514 MAIN ST",
"city": "ALAMOSA",
"state": "CO",
"postal_code": "811012644",
"telephone_number": "719-589-9019",
"fax_number": "719-589-5094"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "514 MAIN ST",
"city": "ALAMOSA",
"state": "CO",
"postal_code": "811012644",
"telephone_number": "719-589-9019",
"fax_number": "719-589-5094"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "HOSPICE DEL VALLE, INC.",
"organizational_subpart": "NO",
"enumeration_date": "2006-06-11",
"last_updated": "2020-08-22",
"status": "A",
"authorized_official_last_name": "BOOTH",
"authorized_official_first_name": "LOIS",
"authorized_official_title_or_position": "CEO",
"authorized_official_telephone_number": "719-589-9019",
"authorized_official_name_prefix": "Ms.",
"authorized_official_credential": "RN"
},
"taxonomies": [
{
"code": "251G00000X",
"taxonomy_group": "",
"desc": "Hospice Care, Community Based",
"state": "CO",
"license": "0981",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "05800024",
"state": "CO"
}
],
"endpoints": [],
"other_names": []
}Other providers in Alamosa, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
- 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.