NPIMap

Organization Active NPI

St. Vincent General Hospital District

  • Critical Access Hospital
  • Leadville, CO
National Provider Identifier
1457315152
Registry record updated Aug 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Access HospitalTaxonomy code 282NC0060X
License
010908 Issued in CO
Legal business name
ST. VINCENT GENERAL HOSPITAL DISTRICT
Practice address
816 W 4TH St
Leadville, CO 80461-3861
Phone
(719) 486-0230
Fax
(719) 486-1077
NPI assigned
Apr 12, 2006
Last updated
Aug 27, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2024

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

Authorized official

Name
Andrew Dreesen
Title
Authorized Official
Phone
(719) 486-7161

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Access Hospital 282NC0060X 0185 CO
Critical Access Hospital 282NC0060X 010908 CO Primary
Ambulance 341600000X
Land Ambulance 3416L0300X CO

Addresses

Primary practice location

816 W 4TH St
Leadville, CO 80461-3861

Mailing address

822 W 4TH St
Leadville, CO 80461
Phone (719) 486-0230

Other practice location 1

822 W 4th St
Leadville, CO 80461
Phone (719) 486-0230

Other identifiers 5

IdentifierTypeStateIssuer
05029004MedicaidCO
05656160MedicaidCO
040039828MedicaidCO
04003828MedicaidCO
06060156MedicaidCO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
O20040316001421 CO Part B Supplier - Clinic/Group Practice 4587574884 Receives reassigned benefits from 54 practitioners
3 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Leadville, CO
O20061104000149 CO Part A Provider - Critical Access Hospital 4587574884 Receives reassigned benefits from 24 practitioners
1 other NPI on this enrollment
Practice locations: Leadville, CO
O20200922001566 CO Part A Provider - Rural Health Clinic 4587574884 1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Leadville, CO

NPI to CCN mapping 2

The Medicare certification numbers (CCNs) connected to NPI 1457315152. Details of each certification follow.

Hospital certification: CCN 061319

Legal name
ST. VINCENT GENERAL HOSPITAL DISTRICT
Certification status
Active
Provider type (POS)
Hospital – Critical access hospital
Participating since
May 2, 2003
Last certification
Oct 14, 2021
Beds
25
Ownership / control type
Hospital district or authority
Organization structure
OtherNon-profit
Incorporated
Nov 9, 1988 in CO
Enrollment address
816 W 4TH St
Leadville, CO 80461-3861
Other Hospital Practice Location

Rural health clinic certification: CCN 068529

Legal name
ST. VINCENT GENERAL HOSPITAL DISTRICT
Doing business as
ST.VINCENT FAMILY HEALTH CENTER AND URGENT CARE
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Sep 22, 2022
Last certification
Sep 22, 2022
Ownership / control type
Non-profit – church related
Organization structure
GovernmentNon-profit
Incorporated
in CO
Enrollment address
822 W 4TH St
Leadville, CO 80461-3861
Related CCNs
061319

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

Other NPIs with the same Medicare PAC ID 3

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

Other NPIs on the same Medicare enrollment 4

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

Care Compare: Hospital

Medicare Care Compare
Listed as
St Vincent General Hospital DistrictCCN 061319 · All quality measures
Type
Critical Access Hospitals
Ownership
Government - Hospital District or Authority
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory

Locations

1444 S Potomac St
Ste 300
Denver, CO 80012
Phone (303) 750-0822

1361 Francis St
Longmont, CO 80501
Phone (720) 432-0096

Ownership & related parties

All disclosed owners & managing parties 3

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

NameRoleSinceShare
Ruth Hart Individual Corporate DirectorDirector Jan 4, 2022
W-2 Managing EmployeeDirector Jan 4, 2022
W-2 Managing EmployeeManager Jan 4, 2022
St. Vincent General Hospital District Organization, Leadville, CO 5% Or Greater Direct Ownership Interest Jun 25, 2013
Operational/Managerial Control Nov 22, 2010
5% Or Greater Direct Ownership Interest Sep 10, 2020 100%
Operational/Managerial Control Sep 10, 2020 100%
Justin Bartlett Individual 5% Or Greater Direct Ownership InterestCeo Oct 6, 2025 100%
Corporate OfficerCeo Oct 6, 2025
Operational/Managerial ControlCeo Oct 6, 2025 100%
Corporate OfficerCeo Oct 6, 2025 100%

Owners & managing parties with NPI records 3

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

All facility ownership & control disclosures 2

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

FacilityTypeRoleSince
St. Vincent General Hospital DistrictLeadville, CO, CCN 06Z319 Hospital 5% Or Greater Direct Ownership Interest
Operational/Managerial Control		 Jun 25, 2013
Nov 22, 2010
St.Vincent Family Health Center and Urgent CareLeadville, CO, CCN 068529 Rural health clinic 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Sep 10, 2020
Sep 10, 2020

Owned or controlled facilities with NPI records 3

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

Facilities with the same owner 2

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

Practitioners & affiliated clinicians

Practitioners 26

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.

View all 26

Affiliated clinicians 34

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 34

NPI Registry JSON

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

{
    "created_epoch": "1144800000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1724716800000",
    "number": "1457315152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "822 W 4TH ST",
            "city": "LEADVILLE",
            "state": "CO",
            "postal_code": "80461",
            "telephone_number": "719-486-0230",
            "fax_number": "719-486-1077"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "816 W 4TH ST",
            "city": "LEADVILLE",
            "state": "CO",
            "postal_code": "804613861",
            "telephone_number": "719-486-0230",
            "fax_number": "719-486-1077"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "822 W 4th St",
            "address_purpose": "LOCATION",
            "city": "Leadville",
            "state": "CO",
            "postal_code": "80461",
            "country_code": "US",
            "telephone_number": "719-486-0230",
            "fax_number": "719-486-1077",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "ST. VINCENT GENERAL HOSPITAL DISTRICT",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-12",
        "last_updated": "2024-08-27",
        "certification_date": "2024-08-27",
        "status": "A",
        "authorized_official_last_name": "DREESEN",
        "authorized_official_first_name": "ANDREW",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "719-486-7161"
    },
    "taxonomies": [
        {
            "code": "282NC0060X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Critical Access",
            "state": "CO",
            "license": "0185",
            "primary": false
        },
        {
            "code": "282NC0060X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Critical Access",
            "state": "CO",
            "license": "010908",
            "primary": true
        },
        {
            "code": "341600000X",
            "taxonomy_group": "",
            "desc": "Ambulance",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "CO",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "05029004",
            "state": "CO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "05656160",
            "state": "CO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "040039828",
            "state": "CO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04003828",
            "state": "CO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "06060156",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Leadville, CO

Sources for this page

Verify at the official NPI Registry.