Rocky Ford Family Health Center LLC

Primary specialty

Rural Health Clinic/CenterTaxonomy code 261QR1300X

Legal business name

ROCKY FORD FAMILY HEALTH CENTER LLC

Practice address

1014 Elm Ave
Rocky Ford, CO 81067-1328

Phone

(719) 254-7421

Fax

(719) 254-6966

NPI assigned

Nov 28, 2006

Organization subpart

No

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

Authorized official

Name

Mrs. Terry L Miller, MBA, CPA

Title

Business Manager

Phone

(719) 254-7421

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/26604/brand/1/csg/1/fhir/r4

Change-of-ownership history 1

Change of ownership 1

Medicare changes of ownership in which this facility was the buyer or the seller.

• Radiant Healthcare LLC

  • Rural Health Clinic/Center
  • Rocky Ford, CO
  • NPI 1659003200

  Sold to, 2023-01-01

  CMS change of ownership

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Matthew David Lewis, M.D.

  • Family Medicine Physician
  • Rocky Ford, CO
  • NPI 1174626402
  NPD (past)

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

{
    "created_epoch": "1164672000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1458172800000",
    "number": "1508932757",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1014 ELM AVE",
            "city": "ROCKY FORD",
            "state": "CO",
            "postal_code": "810671328",
            "telephone_number": "719-254-7421",
            "fax_number": "719-254-6966"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1014 ELM AVE",
            "city": "ROCKY FORD",
            "state": "CO",
            "postal_code": "810671328",
            "telephone_number": "719-254-7421",
            "fax_number": "719-254-6966"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROCKY FORD FAMILY HEALTH CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-28",
        "last_updated": "2016-03-17",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "TERRY",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "BUSINESS MANAGER",
        "authorized_official_telephone_number": "719-254-7421",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "MBA, CPA"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "70077371",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Pharmacy Services Inc
• Pioneer Health Care Group, Inc.
• Pioneer Healthcare Group, Inc.
• Radiant Healthcare LLC
• John Manuel Rocha Jr., RN
• Rocky Ford Healthcare LLC
• Rural Health Revenue Associates LLC
• James Satt, MD
• Southeast Mental Health Services
• Southeast Mental Health Services

• All providers in Rocky Ford, CO
• Rural Health Clinic/Center in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2016; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.