NPIMap

Organization Active NPI

Community Healthcare Partner, Inc

Doing business as Colorado River Medical Center

  • Critical Access Hospital
  • Needles, CA
National Provider Identifier
1457520942
Registry record updated Mar 30, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Access HospitalTaxonomy code 282NC0060X
License
240000227 Issued in CA
Legal business name
COMMUNITY HEALTHCARE PARTNER, INC
Doing business as
Colorado River Medical Center
Practice address
1401 Bailey Avenue
Needles, CA 92363
Phone
(760) 326-7160
Fax
(760) 326-7292
NPI assigned
Feb 28, 2008
Last updated
Mar 30, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 30, 2016

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

Authorized official

Name
Mr. Steve Kelley Lopez
Title
Ceo
Phone
(760) 326-7160

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Access Hospital 282NC0060X 240000227 CA Primary
Emergency Medical Services (Emergency Medicine) Physician 207PE0004X NU

Addresses

Primary practice location

1401 Bailey Avenue
Needles, CA 92363

Mailing address

1401 Bailey Avenue
Needles, CA 92363
Phone (760) 326-7160

Other identifiers 3

IdentifierTypeStateIssuer
240000227MedicaidCA
CA204896OtherCAMEDICARE OSCAR/CERTIFICATION
330130MedicaidAZ

Other names 1

  • Colorado River Medical Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20130502000053 CA Part A Provider - Critical Access Hospital 5698912095 Receives reassigned benefits from 2 practitioners
Practice locations: Needles, CA
O20140113000061 CA Part B Supplier - Clinic/Group Practice 5698912095 Receives reassigned benefits from 9 practitioners
1 other NPI on this enrollment
Practice locations: Needles, CA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1457520942. Details of each certification follow.

Hospital certification: CCN 051323

Legal name
COMMUNITY HEALTHCARE PARTNER, INC
Doing business as
COLORADO RIVER MEDICAL CENTER
Certification status
Active
Provider type (POS)
Hospital – Critical access hospital
Participating since
Dec 15, 2005
Last certification
Jun 6, 2024
Beds
25
Ownership / control type
Private (not for profit)
Most recent change of ownership
May 31, 2013 (2 total)
Organization structure
CorporationNon-profit
Incorporated
Mar 5, 2012 in CA
Enrollment address
1401 Bailey Ave
Needles, CA 92363-3103
Other Hospital Practice Location

Other NPIs on the same Medicare enrollment 1

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

Care Compare: Hospital

Medicare Care Compare
Listed as
Colorado River Medical CenterCCN 051323 · All quality measures
Type
Critical Access Hospitals
Ownership
Voluntary non-profit - Private
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory
Tax ID family
Community Healthcare Inc5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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

Locations

705 E Virginia Way
Ste N
Barstow, CA 92311
Phone (760) 256-9243

Ownership & related parties

All disclosed owners & managing parties 7

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

NameRoleSinceShare
Joseph J Payson Individual Corporate DirectorBoard Member Mar 1, 2013
Darla J Walters Individual Corporate DirectorBoard Member Mar 1, 2013
Knaya Tabora Individual Corporate OfficerSecretary and Chief Nursing Offi Mar 1, 2013
Jocelyn Papa Individual Corporate OfficerChief Financial Officer Mar 1, 2013
Community Healthcare Partner, Inc Organization, Needles, CA Created for acquisition, Non-profit 5% Or Greater Direct Ownership Interest Mar 1, 2013 100%
Operational/Managerial Control Mar 1, 2013 100%
Lawrence P Bryan Individual Corporate DirectorBoard Member Mar 1, 2013
Bing K Lum Individual Corporate OfficerChief Executive Officer Mar 1, 2013 50%
Corporate DirectorBoard Member May 31, 2013
W-2 Managing EmployeeVP of Hospital Operations May 31, 2013

Practitioners & affiliated clinicians

Practitioners 10

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.

Affiliated clinicians 27

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

View all 27

NPI Registry JSON

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

{
    "created_epoch": "1204156800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1459296000000",
    "number": "1457520942",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1401 BAILEY AVENUE",
            "city": "NEEDLES",
            "state": "CA",
            "postal_code": "92363",
            "telephone_number": "760-326-7160",
            "fax_number": "760-326-7292"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 BAILEY AVENUE",
            "city": "NEEDLES",
            "state": "CA",
            "postal_code": "92363",
            "telephone_number": "760-326-7160",
            "fax_number": "760-326-7292"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY HEALTHCARE PARTNER, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-28",
        "last_updated": "2016-03-30",
        "status": "A",
        "authorized_official_last_name": "LOPEZ",
        "authorized_official_first_name": "STEVE",
        "authorized_official_middle_name": "KELLEY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "760-326-7160",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "282NC0060X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Critical Access",
            "state": "CA",
            "license": "240000227",
            "primary": true
        },
        {
            "code": "207PE0004X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Emergency Medical Services",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "240000227",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE OSCAR/CERTIFICATION",
            "identifier": "CA204896",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "330130",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Colorado River Medical Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Needles, CA

Sources for this page

Verify at the official NPI Registry.