NPIMap

Organization Active NPI

Salud Family Health

  • Federally Qualified Health Center (FQHC)
  • Trinidad, CO
National Provider Identifier
1497393003
Registry record updated Jan 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
SALUD FAMILY HEALTH
Practice address
928 Smith Ave
Trinidad, CO 81082-2841
Phone
(303) 697-2583
NPI assigned
Dec 13, 2019
Last updated
Jan 25, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2023

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

Authorized official

Name
David Madsen
Title
Cfo
Phone
(720) 322-9405

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X Primary

Addresses

Primary practice location

928 Smith Ave
Trinidad, CO 81082-2841

Mailing address

203 S Rollie Ave
Fort Lupton, CO 80621-1508
Phone (303) 892-6401

Other names 1

  • Plan De Salud Del Valle, Inc Former legal business name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20031126000756 CO Part B Supplier - Clinic/Group Practice 3173433398 Receives reassigned benefits from 93 practitioners
5 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Fort Morgan, CO; Frederick, CO; Longmont, CO; Sterling, CO; Trinidad, CO; Aurora, CO; Brighton, CO; Commerce City, CO…
O20200127000591 CO Part A Provider - Federally Qualified Health Center (FQHC) 3173433398 Practice locations: Trinidad, CO

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1497393003. Details of each certification follow.

Federally qualified health center certification: CCN 061009

Legal name
SALUD FAMILY HEALTH
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Jan 27, 2020
Last certification
Jan 27, 2020
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Jun 21, 1971 in CO
Enrollment address
928 Smith Ave
Trinidad, CO 81082-2841

Other NPIs with the same Medicare PAC ID 14

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

View all 14

Other NPIs on the same Medicare enrollment 5

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

National Provider Directory

National Provider Directory
Tax ID family
Salud Family Health18 organizations share this tax ID, including this one

Other organizations with this tax ID 17

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

View all 17

Locations

1115 2nd St
Fort Lupton, CO 80621
Phone (303) 857-2771

5995 Iris Pkwy
Frederick, CO 80504
Phone (303) 833-2050

220 E Rogers Rd
Longmont, CO 80501
Phone (303) 776-3250

911 Robinson Ave
Trinidad, CO 81082
Phone (303) 386-2727

Ownership & related parties

All disclosed owners & managing parties 5

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

NameRoleSinceShare
Colleen L Laeger Individual Corporate OfficerBoard Member Jan 1, 1978
Jesus a Tijerina Individual Corporate OfficerBoard Member Jan 7, 1970
David Madsen Individual Corporate OfficerCfo Aug 24, 2016
Operational/Managerial Control Aug 24, 2016
John Santistevan Individual Corporate DirectorPresident/Ceo Sep 27, 1996
Joseph Daniel O'Connor Individual Corporate Officer Apr 1, 2018

Practitioners & affiliated clinicians

Practitioners 19

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 19

NPI Registry JSON

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

{
    "created_epoch": "1576195200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1674604800000",
    "number": "1497393003",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "203 S ROLLIE AVE",
            "city": "FORT LUPTON",
            "state": "CO",
            "postal_code": "806211508",
            "telephone_number": "303-892-6401",
            "fax_number": "303-892-1511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "928 SMITH AVE",
            "city": "TRINIDAD",
            "state": "CO",
            "postal_code": "810822841",
            "telephone_number": "303-697-2583"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SALUD FAMILY HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-12-13",
        "last_updated": "2023-01-25",
        "certification_date": "2023-01-25",
        "status": "A",
        "authorized_official_last_name": "MADSEN",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "720-322-9405"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Plan De Salud Del Valle, Inc",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Trinidad, CO

Sources for this page

Verify at the official NPI Registry.